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Biomedical subjects

D Bouros

Publications and source records attributed to D Bouros.

89 records · Page 5Linked to original sources
PubMed1992

Respiratory muscle strength in hyperthyroidism before and after treatment.

We undertook this study to investigate respiratory muscle strength in relation to thyroid function in 20 thyrotoxic patients and in a group of 20 normal subjects matched for age and sex. Global respiratory muscle strength was assessed by measuring mouth pressure during maximal static inspiratory (PImax) and expiratory (PEmax) efforts. We also measured VC, FVC, and FEV1 as well as thyroid-related hormones (T3, T4, TSH). Measurements were made once in normal subjects and twice in thyrotoxic patients, before and 3 months after medical treatment. Our results showed that both maximal pressures were significantly reduced (p less than 0.0001) before treatment in thyrotoxic patients in relation to the mean values of the normal subjects (p less than 0.0001), and they increased significantly (p less than 0.0003) after treatment. Lung volumes were significantly reduced (p less than 0.0001) before and increased significantly (p less than 0.008) after treatment. The ratio FEV1/FVC did not change. A statistically significant linear relationship was found when PImax of patients with thyrotoxicosis before treatment and of normal subjects were plotted against thyroid hormones (T3, T4) (r = -0.746 and r = -0.745, respectively, p less than 0.001). Similarly, a statistically significant linear relationship was found between PEmax and T3 and T4 (r = -0.837 and r = -0.838, respectively, p less than 0.001). No relationship was found between maximal pressures and TSH. Finally, a significant linear relationship was found between PImax and PEmax (r = 0.872, p less than 0.001). Our results confirm that in thyrotoxicosis respiratory muscle weakness occurs that affects both inspiratory and expiratory muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Respiratory muscle strength in hypothyroidism.

To investigate respiratory muscle strength in patients with hypothyroidism, global respiratory muscle strength was assessed by measuring mouth pressure during PImax and PEmax efforts. Maximum pressures, VC, FEV1, FVC, T3, T4, and TSH were measured in 43 hypothyroid patients. Measurements were made before and three months after replacement therapy with thyroxine. The results showed that the mean value of PImax and PEmax increased after treatment. Significant change was found in the mean value of VC, FEV1, and FVC after treatment but not in the FEV1/FVC ratio. A highly statistically significant linear relationship was found between PImax and TSH and between PEmax and TSH as well as between PImax and T3 and PEmax and T3. We conclude that hypothyroidism affects respiratory muscle strength and that this weakness is linearly related to thyroid hormone levels. Respiratory muscle weakness is present in both inspiratory and expiratory muscles and is reversible with treatment.

Adult↗
PubMed1992

Consequences of poor compliance in chronic respiratory diseases.

In this short report, we reviewed the literature on the consequences of poor compliance in chronic respiratory diseases. Unquestionably, poor compliance is a very significant medical issue in the management of tuberculosis. Poor compliance could cause serious personal and public health problems and is probably the major obstacle to the elimination of tuberculosis. Similarly, important consequences have been attributed to poor compliance with prescribed treatment in bronchial asthma. Those consequences could vary from impairment of daily life to life threatening attacks and death. However, it is difficult to apply methods to produce solid evidence that such consequences are the result of poor compliance. In conclusion a greater number of well designed studies are needed to investigate the various consequences of poor compliance in chronic respiratory diseases; a major issue that undoubtedly affects the outcome of treatment.

Chronic Disease↗
PubMed1991

Severe anaerobic necrotizing pneumonia complicated by pyopneumothorax and anaerobic monoarthritis due to Peptostreptococcus magnus.

A rare case of a severe anaerobic necrotizing pneumonia complicated by pyopneumothorax and monoarthritis due to anaerobic Peptostreptococcus magnus is described in a 20-year-old soldier. The patient's immunological status was normal. There were no predisposing underlying factors, and he was treated successfully without any residual damage. To our knowledge, a similar case has never been reported in the literature.

Adult↗
PubMed1991

Palpation vs pen method for the measurement of skin tuberculin reaction (Mantoux test).

In order to test the degree of concordance between ballpoint pen and palpation methods of measuring the skin induration after a Mantoux tuberculin test, we conducted a prospective, double-blind study. We performed a Mantoux skin test in 1,340 healthy subjects, aged 18 to 25 years, using the tuberculin PPD-RT 23, dose 2 IU, (1/5,000), of the Pasteur Institute, equivalent to 5 TU PPD-S. The same experienced reader, who was able to see only the site of the test (forearm), measured the induration after 48 hours by the palpation method, initially, and by the pen method later the same day, without knowing the identity of the examined person. Results of the study did not show any significant difference in any range of the measurements (p greater than 0.1) by the two methods. We conclude that the pen method is as reliable as the traditional palpation method. The sensitivity and the specificity of the two methods are comparable. Even though our study was not designed to investigate the effects with an inexperienced examiner, given the simplicity of the pen method, it could be the method of choice, especially for less experienced examiners.

Adolescent↗
PubMed1991

Lymphangitis after tuberculin test.

After Mantoux testing with purified protein derivative (PPD) equivalent to 5 tuberculin units (TU), a 28 yr old man developed extensive erythema, induration and proximal lymphangitis. This is the only such case observed after Mantoux testing in approximately 500,000 subjects during 10 yrs in the Greek Army.

Adult↗
PubMedDate not supplied

Bronchial carcinoids. A review of 22 cases.

This study investigated 22 patients with histologically proven primary bronchial carcinoids and in particular the relationship between assessment parameters and survival. In each patient, age, sex, smoking habits, mode of presentation, results of diagnostic investigations, methods of treatment and pathological examination of resected specimens were recorded. Follow-up was possible in all patients for at least 5 years. Patients with atypical carcinoids were 10 years older than patients with typical ones. Eleven patients were smokers, all the patients with atypical and 4 patients with typical carcinoid. The most common presenting mode was pneumonia. Fiberoptic bronchoscopy was diagnostic in 11 cases. The survival rate for patients with typical carcinoid was 100%, while it was 57% in patients with atypical carcinoids. Patients with limited disease had a survival of 100%, while in stage III/IV patients showed a lower survival rate (50%). In conclusion, carcinoid tumors of the lung are tumors showing a good prognosis. Five-year survival indicated a significant difference between typical and atypical carcinoids and between limited and extensive disease. A precise staging is recommended for a better treatment and follow-up.

Adolescent↗
PubMedDate not supplied

Patterns of pulmonary metastasis from uterine cancer.

BACKGROUND: Endometrial cancer is the most common female genital cancer and approximately 90% of the cases are diagnosed while they are still confined to the uterus. However, the frequency and the pattern of pulmonary metastasis (PM) have not been studied systematically. PATIENTS AND METHODS: From 1962 to 1989, 90 patients wit PM were identified by computerized search of the medical records of the 1,550 (5.8%) patients admitted to the Massachusetts General Hospital with the diagnosis of uterine cancer. The median age of the patients was 67 years (range from 42 to 88 years). The histology of the uterine neoplasms included 53 adenocarcinomas (59%), 19 sarcomas (21%), 12 adenosqamous carcinomas (13.5%), 4 adenoacanthomas (4.5%), and 2 clear cell adenocarcinomas (2%). Chest radiographs were retrospectively reviewed by two experienced readers. RESULTS: Lung metastases were found at the time of diagnosis of the primary tumor in 20 patients (22%). The usual pattern of PM involved multiple pulmonary nodules in 65 patients (72%); solitary pulmonary nodules were found in 16 (18%), mass lesion in 10 (11%), lymphangitic spread in 3, and pleural effusion in 6 (6.7%). Cavitation and tracheal metastasis were observed in one case each. CONCLUSION: Pulmonary metastases represent a common site of extrapelvic spread of disease for the small number of patients with advanced or recurrent endometrial carcinoma. The usual type of PM is multiple bilateral nodules.

Adult↗
PubMedDate not supplied

Expression of bcl-2 protein in bronchoalveolar lavage cell populations from patients with idiopathic pulmonary fibrosis.

OBJECTIVE: To investigate changes in the expression of the antiapoptotic protein bcl-2 in bronchoalveolar lavage fluid (BALF) cell populations in patients with idiopathic pulmonary fibrosis (IPF). STUDY DESIGN: Ten patients with IPF underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) in the area of maximal radiographic shadowing (based on high-resolution computed tomography findings). Results were compared with those of 10 normal people in the control group. Cellular bcl-2 expression was identified using an immunoperoxidase staining method. RESULTS: A statistically significant (P < .001) increase in the expression of bcl-2 in BALF neutrophils and eosinophils was observed in patients with IPF as compared with controls. BAL macrophages exhibited only a slight (statistically insignificant) increase in bcl-2 expression in IPF patients. No bcl-2 expression was observed in BAL lymphocytes from IPF patients in contrast to the control group. CONCLUSION: The overexpression of bcl-2 on BALF neutrophils and eosinophils, cells that characterize the special cellular profile of alveolitis in IPF, could be one of the pathophysiologic mechanisms of this disease.

Aged↗
PubMedDate not supplied

Evaluation of inflammatory cytokines in malignant and benign pleural effusions.

We measured the levels of inflammatory cytokines interleukin-1alpha (IL-1alpha), interleukin-1beta (IL-1beta), interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha) in pleural effusions and serum in 65 consecutive patients: 32 with malignant pleural effusion (MPE) (group A), and 33 with inflammatory benign pleural effusion (BPE) (group B). Serum levels of 15 healthy individuals served as control. Concentrations of IL-1alpha were higher in serum compared to pleural fluid in both groups (47.1+/-33.9 vs. 25.9+/-1.7 fmol/ml, p<0.001, in group A; and 39.9+/-30.9 vs. 25.4+/-16.3 fmol/ml, p<0.02, in group B). Similarly, concentrations of IL-1beta and IL-2 were significantly higher in serum compared to pleural fluid in both groups. In contrast, IL-6, IL-8 and TNF-alpha were found at high concentration in MPE in comparison to serum IL-6: 171.8+/-60.4 vs. 7. 2+/-7 fmol/ml (p<0.001), IL-8: 1175.15+/-2385.6 vs. 285.2+/-187.2 pg/ml (p<0.05), TNF-alpha: 204.9+/-82.9 vs. 79.4+/-31.9 fmol/ml (p<0. 001). Similarly, pleural concentrations of IL-6, IL-8 and TNF-alpha were higher in BPE patients in comparison to serum IL-6: 124.3+/-56. 2 vs. 8.6+/-6.4 fmol/ml (p<0.001) IL-8: 2109.2+/-4121.5 vs. 291. 6+/-197.9 pg/ml (p<0.02), TNF-alpha: 183.8+/-28.2 vs. 86.2+/-23.9 fmol/ml (p<0.001). These data suggest that IL-6, IL-8 and TNF-alpha might be secreted locally at the site of active disease both in benign and malignant pleural effusions.

Adenocarcinoma↗
PubMedDate not supplied

Interleukin-6 and its relationships to acute phase proteins in serous effusion differentiation.

The aim of the study was to assess the discriminative power of cytokine interleukin 6 (IL-6) between transudative and exudative pleural and peritoneal effusions, and to compare IL-6 with common acute phase proteins in serous effusion differentiation. One hundred and forty-five consecutive patients with pleural or peritoneal effusion underwent diagnostic parecentesis. Patients were categorized in three groups. Malignant effusion (group A) 56 patients, non-malignant effusion (group B) 46 patients and transudate (group C) 43 patients. Serum and effusion levels of IL-6, C-reactive protein (CRP), alpha2-macroglobuline (alpha2-MG), alpha1-antitrypsin (alpha1-AT) and alpha1-acid glycoprotein (alpha1-AG) were determined. Serum IL-6 levels were significantly higher in groups A and B in comparison to group C (p<0.001 and 0.001, respectively). In addition, serum IL-6 levels were higher in group A compared to group B (p<0.001), while the studied acute phase proteins were not significantly different. All the studied parameters were higher in the effusions of groups A and B compared to group C. At a cut-off value of 72.1 fmol/ml IL-6 had a sensitivity of 82.6-89.3%, specificity of 88.4-90.7% and positive predictive value of 90.7-94.6% among the three groups. Our results suggest that IL-6 at levels > or =72.1 fmol/ml, alpha1-AT at > or =170 mg/dl and alpha1-AG at > or =52.3 mg/ml give strong evidences for malignancy in exudates.

Acute-Phase Proteins↗
PubMedDate not supplied

Evaluation of ferritin, interleukin-6, interleukin-8 and tumor necrosis factor alpha in the differentiation of exudates and transudates in pleural effusions.

In an attempt to define diagnostic criteria for the differentiation of pleural exudates from transudates, we measured ferritin (FER), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) in pleural effusions and blood serum in 84 consecutive patients with pleural effusions of various etiologies. Concentrations of FER, IL-8 and TNF-alpha were significantly higher in serum and pleural effusion in patients with exudates than in patients with transudates. Serum concentrations of IL-6 were not significantly increased in pleural exudate patients (9.78 +/- 17.12 fmol/L) compared to transudate patients (4.05 +/- 2.33 fmol/L), while significant differences were found between pleural exudates and transudates (p < 0.001). Increased levels of FER were found in serum and pleural effusion of cancer patients in comparison to non cancer patients (p < 0.001 and p < 0.001, respectively). Serum concentrations of IL-6, IL-8, and TNF-alpha were not significantly increased in cancer compared to non-cancer patients, while increased concentrations of IL-6 and IL-8 were found in pleural fluid of patients with cancer in comparison to non-cancer patients. Finally/ no statistically significant differences were found in serum and pleural TNF-alpha concentrations among patients with cancer and patients with non-cancer effusion. We conclude that FER, IL-6, IL-8 and TNF-alpha concentrations in pleural effusions are useful markers in differentiating exudates from transudates.

Adult↗
PubMedDate not supplied

Bcl-2 expression as an apoptotic index in non small cell lung carcinomas.

To evaluate the bcl-2 protein expression in non small cell lung carcinomas (NSCLC) as an index of apoptosis of these tumors, in fine needle aspiration biopsies (FNABs) of the lung, we studied thirty-eight cases of NSCLC (25 bronchogenic adenocarcinomas and 13 squamous. carcinomas. Bcl-2 protein was used as the primary antibody (monoclonal, DAKO) by Alkaline-phosphatase method. Very light haematoxylin was performed as the counterstain. The results were compared and confirmed histologically. A cytoplasmatic expression of the bcl-2 protein was found in 72% (18 out of 15) of the bronchogenic adenocarcinomas while 61.54% (8 out of 13) of squamous carcinomas showed bcl-2 expression. For the quantitative analysis of our results, we used the t-test and the difference between those two histologic types was regarded as statistically significant with p < 0.001.

Adenocarcinoma↗