Guidelines adherence for patients with community acquired pneumonia in a Greek hospital.

Background And Objectives: Community acquired pneumonia (CAP) remains an important cause of morbidity and mortality, with significant economical and social cost. Adherence to the international guidelines for the empiric treatment of CAP can improve patients' prognosis, reduces the need and shortens the length for hospitalization. However, adherence to guidelines varies among physicians.

Thiazolidinediones and type 2 diabetes: from cellular targets to cardiovascular benefit.

The prevalence of type 2 diabetes is evolving globally at an alarming rate. This fact is mainly the result of our global lifestyle "modernization" that has resulted in overweight and obesity. Dysfunction of peroxisome proliferator activated receptor-gamma (PPAR-gamma) has been implicated in the development of insulin resistance, while a reduce expression of many PPAR-gamma regulated genes has been observed in an obese diabetic state.

Polymorphisms of the NRAMP1 gene: distribution and susceptibility to the development of pulmonary tuberculosis in the Greek population.

Background: Ample evidence suggests that host genetic factors affect human susceptibility to tuberculosis. The natural resistance-associated macrophage protein 1 (NRAMP1) gene seems to play a role in the pathophysiology of a number of intracellular infections, including mycobacteria. A case-control study was conducted in the Greek population to determine whether NRAMP1 polymorphisms affect the susceptibility to development of overt pulmonary tuberculosis.

Serological evidence of Mycoplasma pneumoniae infection in patients with acute exacerbation of COPD: analysis of 100 hospitalizations.

Purpose: A prospective study was conducted in order to investigate the serologic evidence of Mycoplasma pneumoniae infection in Greek hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Furthermore, we have assessed the frequency of a number of variables in the group of patients with a serological diagnosis of an acute M. pneumoniae infection compared to patients in whom M.

Ambient air pollution and respiratory health effects in mail carriers.

Mail carriers represent an occupational group suffering from respiratory symptoms and lung function impairment. Although environmental conditions may play role, information on the effects of air pollution exposure in this population is lacking. The present study was conducted in Athens, Greece, in order to investigate the adverse effects of long-term air pollution exposure on respiratory outcomes in mail carriers.

Chlamydophila pneumoniae infection and COPD: more evidence for lack of evidence?

Chlamydophila pneumoniae has been recognized as a common cause of respiratory tract infections affecting all age groups. The organism has been implicated as an infectious trigger for acute exacerbations of COPD. Moreover, the intracellular existence of this pathogen and the ability to cause chronic respiratory infections have led to a number of studies that investigated its possible association with disease development.

Serological diagnosis of Chlamydophila pneumoniae infection in Greek COPD patients by microimmunofluorescence and ELISA.

Background: The possible role of Chlamydophila pneumoniae infection in episodes of acute exacerbation of COPD (AECOPD) was described in 4-34% of COPD patients, but never in Greece. The possible association of chronic C. pneumoniae infection with disease severity is under study, with a diversity of results reported.

Asymptomatic stage I sarcoidosis complicated by pulmonary tuberculosis: a case report.

Introduction: Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis and Nocardia species. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications for the patient.

Tumor necrosis factor-alpha promotes malignant pleural effusion.

Tumor necrosis factor (TNF)-alpha is present in the microenvironment of human tumors, including malignant pleural effusion (MPE). Although the cytokine is produced in the pleural cavity by both tumor and host cells, its effects on MPE formation are unknown. In these studies, we sought to determine the role of TNF-alpha in the pathogenesis of MPE and to assess the therapeutic effects of its neutralization in a preclinical model.

Microscopic polyangiitis complicated by the development of prostate cancer and flutamide-induced hepatitis.

We report a case of a 65-year-old man with microscopic polyangiitis who developed prostate cancer and gastric adenocarcinoma after prolonged oral use of cyclophosphamide. Acute hepatitis with jaundice and marked increase in aminotranferases occurred after 6 months of flutamide treatment for metastatic prostate carcinoma. It is suggested that patients with vasculitis or other autoimmune disorders should avoid prolonged use of cyclophosphamide and other cytotoxic drugs in order to minimize long-term adverse effects, of which the risk of cancer is by far the most important.

Leukotriene B4 in exhaled breath condensate and sputum supernatant in patients with COPD and asthma.

Study Objectives: Some patients with COPD present with significant reversibility of airflow limitation after receiving bronchodilation therapy. Leukotriene B(4) (LTB(4)) has been implicated in the pathophysiology of both COPD and asthma. We tested the hypothesis that COPD patients with airflow reversibility and asthmatic patients who smoke might have similar levels of LTB(4) in exhaled breath condensate (EBC) and sputum supernatant.

Tuberculous effusion: ADA activity correlates with CD4+ cell numbers in the fluid and the pleura.

Background: Adenosine deaminase (ADA) is a commonly used marker in the diagnosis of tuberculous effusion and there is evidence that its production is linked to T cells and monocytes. Data on the correlation between ADA and T cells or macrophages in tuberculous effusions are conflicting. Furthermore, no studies have examined a possible correlation between pleural tissue infiltration and ADA.

Sleep apnea-related cognitive deficits and intelligence: an implication of cognitive reserve theory.

Cognitive deficits in patients with obstructive sleep apnea syndrome (OSAS) are well demonstrated, but the pathophysiology of these deficits is still controversial, as the relationship between OSA severity and cognitive deficits is usually weak. Our study considers the possible relationship between OSA-related cognitive deficits and the overall intellectual function of OSA patients. Forty-seven OSA patients and 36 normal individuals underwent a neuropsychological battery test assessing attention and alertness.

Disseminated tuberculosis complicating anti-TNF-alpha treatment.

An unusually large number of cases of tuberculosis, often of miliary or disseminated form, have been reported in patients receiving infliximab therapy for rheumatoid arthritis or Crohn's disease. We describe a patient with rheumatoid arthritis who was treated with infliximab and became systemically ill with Mycobacterium tuberculosis-disseminated infection. Patients who are candidates for treatment with tumour necrosis factor-alfa inhibitors should be evaluated for the presence of latent or active

Sputum carcinoembryonic antigen, neuron-specific enolase and cytokeratin fragment 19 levels in lung cancer diagnosis.

Objective: The aim of the present study was to examine the impact of sputum carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin fragment 19 (CYFRA 21-1) levels in lung cancer diagnosis and to compare the diagnostic usefulness of sputum assays with that of serum assays.

Methodology: Forty-seven patients with lung cancer and 62 with benign lung disease were studied. Tumour marker levels in sputum (sp.

Sarcoidosis associated with interferon-alpha therapy for chronic hepatitis C.

Background: Recombinant interferon-alpha (IFN-alpha ) is widely used for the treatment of chronic hepatitis C. Pulmonary side effects of IFN-alpha therapy seem to be rare. So far, only a few cases of sarcoidosis in association with IFN-alpha treatment of chronic hepatitis C have been

Case Report: A 52-year-old woman with chronic hepatitis C developed sarcoidosis during treatment with IFN-alpha.

Combined expression of p53, Bcl-2, and p21WAF-1 proteins in lung cancer and premalignant lesions: association with clinical characteristics.

We examined p53, p21WAF-1, and Bcl-2 protein expression in malignant and nonmalignant bronchial specimens obtained during bronchoscopy from 60 lung cancer patients. Twenty-six (43.3%), 36 (60%), and 20 (33.

Expression of mdm-2 protein in neoplastic, preneoplastic, and normal bronchial mucosa specimens: comparative study with p53 expression.

Loss of function of the p53 tumor supressor gene is involved in nearly all human cancer. Recently a cellular oncogene product, mdm2, has been shown to bind to p53 and eliminate its ability to function as a transcription factor. mdm2 and p53 immunohistochemical protein expression was studied in tumor tissues, preneoplastic lesions, and normal bronchial mucosa.

Adenosine deaminase activity and lysozyme levels in bronchoalveolar lavage fluid in patients with pulmonary tuberculosis.

Setting: The estimations of adenosine deaminase (ADA) activity and lysozyme (LYS) levels in pleural fluid have been proved useful tools in the diagnosis of tuberculous pleural effusions. Little is known about their usefulness when estimated in bronchoalveolar lavage fluid (BALF).

Objective: To evaluate whether both ADA activity and LYS levels in BALF could be employed in the diagnosis of pulmonary tuberculosis, and especially in active but acid fast bacilli (AFB) smear negative cases.

Evaluation of CYFRA 21-1 in malignant and benign pleural effusions.

CYFRA 21-1 was evaluated in 115 untreated patients with malignant pleural effusions (96 with primary lung cancer and 19 with non lung cancer) and 99 patients with benign pleural effusions. The levels of pleural fluid CYFRA 21-1 were from 1 to 385 times higher than those in serum, in all the examined patients. The mean level of pleural fluid CYFRA 21-1 was significantly higher in cancer patients than in patients with benign pleural effusion (96.

An immunocytochemical study of ras and myc oncoproteins and EGFr expression in pleural effusion smears.

Pleural effusion smears from 112 patients with either benign or malignant lung disease were investigated for the expression of EGFr and the oncogene proteins myc p64 and ras p21. The streptavidin-biotin peroxidase technique was used. In the studied malignant group of effusions both EGFr and ras have greater sensitivity in the detection of a malignant process than does routine cytological examination though EGFr was less specific.

Tumour necrosis factor, interleukin-1 and adenosine deaminase in tuberculous pleural effusion.

Tumour necrosis factor (TNF) and interleukin-1 (IL-1) are powerful mediators with a key role in inflammation. This study was undertaken to study the presence of TNF and IL-1 in tuberculous effusion where there is marked inflammation and where examination of the pleural fluid may give information about the local inflammatory reaction. Adenosine deaminase activity (ADA, a marker of TB pleurisy) was also tested.

Expression of IGF-I, TGF-alpha and p53 protein in imprint smears of bronchial biopsy specimens of lung cancer.

The expression of insulin-like growth factor-I (IGF-I), transforming growth factor-alpha (TGF-alpha) and p53 protein was examined in bronchial biopsy imprint smears of patients with primary lung cancer and benign lung disorders, by immunohistochemistry. Of the 44 malignant imprint smears, 26 (59%) were positively stained for IGF-I, 18 (41%) for TGF-alpha and 29 (66%) for p53 protein. In contrast, of the 36 benign imprint smears none was positively stained for IGF-I (p<0.