[Antioxidative features of ambroxol--usefulness in COPD].
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Biomedical subjects
Publications and source records attributed to D Nowak.
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BACKGROUND: A cross-sectional study was performed to determine the prevalence of respiratory symptoms in farmers and to assess occupational risk factors for respiratory symptoms in this population. METHOD: A questionnaire on respiratory symptoms and occupation was mailed to a sample of 1,191 farmers with descriptive analysis of the symptoms and multivariate analysis through logistic modeling to assess the different risk factors. RESULTS: 1,164 workers answered the questionnaire (response index 98.2%) and 808 subjects were finally included in the study after discarding non exposed workers. The highest prevalences of asthma symptoms (39.2%) and symptoms of nasal allergy (31.6%) were found in poultry workers (p < 0.001, chi square). Sheep workers showed the highest prevalences of chronic phlegm (38.5%), work-related symptoms (53.9%) and symptoms of organic dust toxic syndrome (35.9%) (p < 0.005, chi square). At multivariate analysis, adjusting for age, gender, smoking and other occupational exposures, poultry work was a risk factor for asthma symptoms (OR 2.1; IC 95% 1.2-3.8) and symptoms of nasal allergy (OR 2.3, IC 95% 1.3-4.2), and dairy farming a risk factor for chronic phlegm (OR 1.8, IC 95% 1.1-2.9). Agriculture was not associated with respiratory symptoms. CONCLUSION: In our study risk factors for respiratory symptoms in Spanish farmers were poultry and dairy farming.
When we move grasped objects, our grip force precisely anticipates gravitational and inertial loads. We analysed the control of grip forces during very substantial load changes induced by parabolic flights. During these flight manoeuvres, the gravity varies between hypergravity associated with a doubling of normal terrestrial gravity and a 20-s period of microgravity. Accordingly, the contribution of the object's weight to the load changed from being twice the normal value to being absent. Two subjects continuously performed vertical and horizontal movements of an object equipped with grip force and acceleration sensors. Whereas, during vertical movements performed under normal and hypergravity, a load force maximum occurred at the lower turning point and a minimum at the upper turning point, the load force pattern was completely changed under microgravity. In particular, the upper turning point was also associated with a load force maximum. Analysis of the grip forces produced by the two subjects revealed that the grip forces underwent the same characteristic changes as the load forces. Thus, subjects were able to adjust grip forces in anticipation of arm movement-induced fluctuations in load force under different and novel load conditions. Adaptation to changing levels of gravity was also obvious when the vertical and horizontal movements were compared: grip forces depended heavily on movement direction during normal and hypergravity but not during microgravity. The predictive coupling of grip force and load force was observed even during transitions between gravity levels, indicating rapid adaptation to changing load conditions. To account for the striking preservation of the normal characteristics of grip force control, we suggest that a highly automatized, extremely flexible sensorimotor mechanism firmly implemented within the central nervous system can cope with even massive changes in the environmental conditions.
The influence of Cefodizime (CDZ) on in vitro activity of polymorphonuclear leukocytes (PMNL) from healthy subjects was assessed. Preincubation with CDZ enhanced phagocytosis and intracellular killing of Staphylococcus aureus by PMNL. Contrary to numerous clinical reports, no significant effect of CDZ preincubation on PMNL response to n-formyl-methionyl-leucyl-phenylalanine was found with respect to intracellular calcium changes, degranulation, hydrogen peroxide production, and chemiluminescence. These results suggest that augmented microbicidal activity of PMNL is not related to the enhanced production of reactive oxygen species in healthy subjects.
Type II pneumocytes (T II pneumocytes) produce hydrogen peroxide (H(2)O(2)), which may be potentially dangerous for the lung. These cells in culture differentiate to type I-like pneumocytes and it may reflect the differentiation which follows the injury of alveolar epithelium. This work was undertaken to estimate the H(2)O(2) release by T II pneumocytes, freshly isolated and cultured up to 8 days. The light and electron microscopy evaluation confirmed the differentiation of T II pneumocytes to type I-like cells. The release of H(2)O(2), estimated spectrofluorimetrically as homovanillic acid oxidation product obtained in the presence of horseradish peroxidase, was significantly higher at day 4 (0.63+/-0. 68nmol/mg protein/min, P</=0.02) and 6 (0.46+/-0.31, P</=0.001) compared to fresh cells (0.15+/-0.08). Phorbol esters increased H(2)O(2) release at day 2 (0.39+/-0.22 vs 0.16+/-0.08, P</=0.02) and the inhibition of protein kinase C resulted in the decrease at day 2 (0.14+/-0.06 vs 0.07+/-0.02, P</=0.025), day 6, (0.49+/-0.25 vs 0. 15+/-0.08, P</=0.005) and 8 (0.76+/-0.63 vs 0.23+/-0.29, P</=0.02). Inhibition of intracellular catalase resulted in a significant increase only at day 2 (0.23+/-0.1 vs 0.15+/-0.09, P</=0.05). Inhibition of mitochondrial respiratory chain decreased H(2)O(2) release at day 2 (0.13+/-0.11 vs 0.07+/-0.07, P</=0.002) and 4 (0. 75+/-0.88 vs 0.61+/-0.85, P</=0.002). These results indicate that alveolar epithelium may be a source of potentially dangerous ROS and that the cell differentiation is accompanied by the increase of H(2)O(2) production. Both mitochondrial respiratory chain and membrane-bound NADPH-oxidase may be responsible for the production of H(2)O(2) by T II pneumocytes.
BACKGROUND: The aim of the present study was to determine the distribution of mite allergens in pig-farming environments in comparison to urban homes and the relationship between exposure to mite allergens and sensitization to the respective allergens in 100 pig farmers with work-related respiratory symptoms. METHODS: The concentration of storage mite (Lep d 2) and house-dust-mite (Der p 1, Der f 1, and Der 2) allergens in dust collected from five different sampling sites (floor, wall, grain mill, transit area between confinement house and farmer's kitchen, and farmers' mattresses) was studied in relationship to the respective sensitization rates. Allergen concentrations in the mattresses were compared to those determined in mattresses from 22 urban dwellers. RESULTS: Median concentrations of Der p 1 and Der 2 in the mattresses of the farmers were significantly higher than in the urban dwellers' samples (53.4 microg/g dust vs 1.05 microg/g dust, P=0.001; 19.6 microg/g dust vs 2.2 microg/g dust, P<0.0001, respectively). Allergen concentrations in the transit areas were strongly related to bedroom exposure. In a multiple logistic regression model, a weak but significant relationship between Der p 1 exposure and sensitization to Der p 1 was found. Despite these findings, the prevalence of sensitization to mite allergens in the farmers (18%) was comparable to the prevalence in the general population. CONCLUSIONS: Allergen exposure at the workplace is strongly related to the concentration of allergens in farmers' beds. Exposure to domestic mite allergens should be taken into account when assessing occupational exposure to allergens and the respiratory health of farmers.
BACKGROUND: Three workers engaged in the manufacture of natural thickener products (Cassia spp., guar, and tamarind flour) were occupationally sensitized to Cassia spp. Therefore, a cross-sectional study on the prevalence of sensitization among and respiratory health of the employees of this plant was conducted. METHODS AND RESULTS: Sixty-two workers (36 with high, 26 with low exposure) participated in the survey. Skin prick tests and specific IgE tests with extracts of these components revealed that 11.3% were sensitized to Cassia spp. and 9.7% to at least one species of storage mites, with a significantly higher portion of atopic subjects in the sensitized group. Overall, 55% of the subjects reported work-related symptoms (upper and lower airways, eyes, or skin). FVC % pred. was significantly lower in highly exposed workers, while RV % pred. and RV%TLC % pred. were significantly higher in this group. In the multivariate model, sensitization was not a risk factor for impairment of lung function. CONCLUSIONS: Dust exposure to flours may not only cause allergic sensitization but also induce chronic changes in lung function.
Smoking is a high-risk behaviour affecting health and economic welfare of society. Thus it is important to quantify the economic burden smoking places on social institutions in Germany. Approximately 33.4% of the male and 20.4% of the female population are current smokers. This study investigates the health care costs of smoking based on 1996 figures, focusing on the seven most frequent diseases associated with the inhalation of tobacco smoke: chronic obstructive pulmonary disease (COPD, international classification of diseases (ICD) 490-491); lung cancer (ICD 162); stroke (ICD 434-438); coronary artery disease (ICD 410-414); cancer of the mouth and larynx (ICD 140-149, 161) and artherosclerotic occlusive disease (ICD 440). A data search was carried out on MEDLINE, the German Institute for Medical Documentation and Information, and the Internet as well as in databases of health insurance companies and the German Federal institute of statistics. Direct and indirect costs were calculated separately. The results estimate the total smoking related health care costs (attributable fraction due to smoking) for COPD to be 5.471 billion EURO (73%), for lung cancer 2.593 billion EURO (89%), for cancer of the mouth and larynx 0.996 billion EURO (65%), for stroke 1.774 billion EURO (28%), for coronary artery disease 4.963 billion EURO (35%) and for atherosclerotic occlusive disease 0.761 billion EURO (28%). The economic burden of smoking related health care costs for Germany is 16.6 billion EURO. Smoking is therefore responsible for 47% of the overall costs of these diseases (35.2 billion EURO). In the view of the high costs for smoking, of which almost 50% are due to respiratory disease, pneumologists should enhance their effort in primary, secondary and tertiary prevention.
BACKGROUND: Several recent studies have shown that growing up on a farm confers significant protection against the development of atopy. These findings point particularly towards the importance of exposure to stable dust and farm animals. It has furthermore been reported that endotoxin, an intrinsic part of the outer membrane of gram negative bacteria, is abundant in environments where livestock and poultry is kept. The aim of this study was therefore to measure the level of environmental endotoxin exposure in homes of farmers' children, children with regular contact to livestock and control children with no contact to farm animals. METHODS: Eighty-four farming and nonfarming families were identified in rural areas in Southern Germany and Switzerland. Samples of settled and airborne dust were collected in stables, and of settled dust indoors from kitchen floors and the children's mattresses. Endotoxin concentrations were determined by a kinetic Limulus assay. RESULTS: Endotoxin concentrations were highest in stables of farming families, but were also significantly higher indoors in dust from kitchen floors (143 EU/mg vs 39 EU/mg, P < 0.001) and children's mattresses (49479 EU/m2 vs 9383 EU/m2, P < 0.001) as compared to control children from nonfarming families. In addition, endotoxin levels were also significantly higher in mattresses and dust from kitchen floors in households where children had regular contact to farm animals (38.6 EU/mg and 23340 EU/m2, respectively) as compared to control subjects. CONCLUSION: We propose that the level of environmental exposure to endotoxin and other bacterial wall components is an important protective determinant for the development of atopic diseases in childhood.
H2O2 is elevated in the exhaled air condensate in several inflammatory disorders of the lung, including bronchial asthma, and thus may reflect inflammatory processes in the airways. Exhaled H2O2 may be used to guide the anti-inflammatory treatment of patients with asthma. Therefore in this study we analysed the effect of inhaled glucocorticosteroid beclomethasone for 4 weeks on H2O2 level in the exhaled air condensate. Seventeen asthmatics and 10 healthy subjects were included to the study. Eleven patients were given inhaled beclomethasone and six were given placebo (3M Health Care). In all patients pulmonary function tests were performed. H2O2 in the expired air condensate was measured spectrofluorimetically (homovanillic acid method). Inhaled beclomethasone significantly decreased H2O2 in the expired air condensate in the active-treatment group, with a fall from baseline on day 1 which remained on day 43 (follow-up) (P<0.05). Exhaled H2O2 in the active-treatment group was significantly lower than that in placebo group (P<0.05). A negative correlation between H2O2 and forced expiratory volume in 1 sec (FEV1) on day 29 was observed. The decrease in exhaled H2O2 in the active-treatment group was accompanied by an improvement in pulmonary function tests results. Inhaled glucocorticoids reduce the level of H2O2 in the expired air condensate of asthmatic patients over a 4-week period and this may reflect their anti-inflammatory activity in lung diseases.
Lipid peroxidation, as a well-known index of reactive oxygen species activity, not only in lung biochemistry, is an oxidative process associated with membrane lipid destruction. Also, the oxidative modification of nucleic acids by reactive oxygen species is of remarkable biological importance as it may contribute to malignant conversion, but its exact role in lung cancer biology is still not clear. Our study aimed to investigate the level of lipid peroxidation ex vivo in tumour tissue and lung parenchyma obtained from patients with lung cancer. Forty-two patients with lung cancer were enrolled into the study. During a surgical resection, tumour tissue and lung parenchyma were obtained and concentration of lipid peroxidation products, thiobarbituric acid-reactive substances and Schiff bases, and spontaneous generation of hydrogen peroxide, were measured. The concentration of thiobarbituric acid-reactive substances (P<0.001) in the tumour tissue was higher than that in lung parenchyma. In small cell lung cancer as well as in squamous cell carcinoma patients, a positive correlation between spontaneous generation of hydrogen peroxide in tumour tissue and clinical stage (r = 0.43; r = 0.46; respectively) was found. Our results prove enhanced lipid peroxidation in cancer tissue as compared with matched-lung parenchyma. In small cell lung cancer and squamous cell carcinoma patients, the high level of oxidative stress, expressed as a spontaneous generation of hydrogen peroxide in tumour tissue, was associated with clinical progression of tumour's stage.
The present study was conducted to evaluate characteristics of pig houses that are associated with the development of respiratory morbidity in 100 swine producers with work-related respiratory symptoms. A standardized questionnaire for farm characteristics was used, and lung function was assessed immediately before and after feeding the pigs. Exposure to dust and endotoxin was determined by personal sampling. Among these farmers, baseline lung function results were shown to be negatively associated with duration of employment, number of pigs on the farm, manual feeding, and ventilation. The decrease in forced vital capacity and forced expiratory volume in 1 second over the feeding period was negatively correlated with air velocity, whereas respirable dust concentrations were shown to be significant predictors of maximal midexpiratory flow (MMEF25/75) decline. In conclusion, among symptomatic pig farmers, those with higher numbers of pigs and longer duration of employment are at highest risk for developing functional impairment.
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OBJECTIVES: Gemstone cutters are potentially exposed to various carcinogenic and fibrogenic metals such as chromium, nickel, aluminium, and beryllium, as well as to lead. Increased beryllium concentrations had been reported in the air of workplaces of beryl cutters in Idar-Oberstein, Germany. The aim of the survey was to study the excretion of beryllium in cutters and grinders with occupational exposure to beryls--for example, aquamarines and emeralds--to examine the prevalence of beryllium sensitisation with the beryllium lymphocyte transformation test (BeLT), to examine the prevalence of lung disease induced by beryllium, to describe the internal load of the respective metals relative to work process, and to screen for genotoxic effects in this particular profession. METHODS: In a cross sectional investigation, 57 out of 100 gemstone cutters working in 12 factories in Idar-Oberstein with occupational exposure to beryls underwent medical examinations, a chest radiograph, lung function testing (spirometry, airway resistance with the interrupter technique), and biological monitoring, including measurements of aluminium, chromium, and nickel in urine as well as lead in blood. Beryllium in urine was measured with a newly developed direct electrothermal atomic absorption spectroscopy technique with a measurement limit of 0.06 microgram/l. Also, cytogenetic tests (rates of micronuclei and sister chromatid exchange), and a BeLT were performed. Airborne concentrations of beryllium were measured in three factories. As no adequate local control group was available, the cutters were categorised into those with an exposure to beryls of > 4 hours/week (group A) and < or = 4 hours/week (group B). RESULTS: Clinical, radiological, or spirometric abnormalities indicating pneumoconiosis were detected in none of the gemstone cutters. Metal concentrations in biological material were far below the respective biological limit values, and beryllium in urine was only measurable in subjects of group A. Cytogenetic investigations showed normal values which were independent of the duration of beryllium exposure. In one subject, the BeLT was positive. Beryllium stimulation indices were significantly higher in subjects with detectable beryllium in the urine than in those with beryllium concentrations below the detection limit (p < 0.05). In one factory, two out of four measurements of airborne beryllium concentrations were well above the German threshold limit value of 2 micrograms/m3 (twofold and 10-fold), and all gemstone cutters working in this factory had measurable beryllium concentrations in urine. CONCLUSION: No adverse clinical health effects were found in this cross sectional investigation of gemstone cutters working with beryls. However, an improvement in workplace hygiene is recommended, accompanied by biological monitoring of beryllium in urine.
Crop farming as a risk factor for respiratory symptoms of obstructive lung disease was assessed. Random samples of crop farmers from four European countries were studied following a cross-sectional design. A questionnaire on respiratory symptoms and occupation was administered to determine prevalences, and the roles of the various crops as risk factors for respiratory symptoms were assessed through logistic regression modeling. The 4,793 crop farmers included in the study (response rate: 85.3%) reported the following respiratory symptoms: wheezing (14.9%), asthma (3.3%), nasal allergy (14.4%), chronic phlegm (12.4%), organic dust toxic syndrome (ODTS) (15.2%), and symptoms at work (22.0%). In the multivariate analysis, adjusting for age, sex, smoking, country, and exposure to other plants or livestock, flower growing was a risk factor for asthma (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.1-3.9) and cultivating oil plants was associated with ODTS (OR 1.5, 95% CI 1.3-1.9), symptoms at work (OR 1.4, 95% CI 1.2- 1.7), and chronic phlegm (OR 1.3, 95% CI 1.1-1.6). Working inside greenhouses was a marginal risk factor for asthma (OR 2.1, 95% CI 0.9-4.5). We conclude that flower and oil plant production is associated with increased risk of respiratory symptoms in European crop farmers.
OBJECTIVE: To examine the dynamics of oxidative stress in patients with hyperthyroidism before and during the treatment with methimazole using the measurement of conjugated dienes, malondialdehyde, and Schiff bases in blood serum. METHODS: In eight female patients with diagnosed Graves disease and 8 healthy control subjects (7 females and one male) several parameters of oxidative stress (the level of conjugated dienes [CD], malondialdehyde [MDA] and Schiff bases [SB]) were estimated before and during the treatment with methimazole (Metizol -POLFA) as well as by hormonal and immunological tests. In addition, serum levels of TSH, free thyroxine (FT4), free triiodothyronine (FT3), antibodies against thyroperoxidase (anti-TPO) and thyroglobulin (anti-Tg) and low density lipoprotein-cholesterol fraction (LDL-Ch) were estimated. RESULTS: We observed increased concentrations of free thyroxine (FT4) and free triiodothyronine (FT3), as well as of antithyroperoxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies. At the same time, TSH level was significantly suppressed. The concentrations of thyroid hormones and of TSH normalised after the methimazole treatment. The examined parameters, i.e., CD, MDA, and SB, were evaluated as proportions of each of them to the level of low density lipoproteins-cholesterol fraction (LDL-Ch). This fraction of cholesterol contains many polyunsaturated fatty acids, being a substrate for the peroxidation of lipids. Additionally, the CD/MDA ratio was calculated. CONCLUSIONS: The increase of the CD/LDL ratio in Graves hyperthyroidism and its normalisation in the course of the treatment with methimazole suggests that the drug can be protective against the oxidative stress induced by overproduction of thyroid hormones. The ratio of CD/MDA decreased in all the patients, as compared to the control group, showing a high speed of lipid peroxidation.
This paper presents studies on the genotoxicity of two aminophenazines: 2,3-diaminophenazine (DAP) and 2-amino-3-hydroxyphenazine (AHP). The genotoxic activities of these compounds were evaluated with human lymphocytes using the alkaline single cell gel electrophoresis (SCGE) assay and two cytogenetic assays (chromosome aberrations (CA) and sister chromatid exchange (SCE) analysis). Results show that these chemicals elicited an increase in DNA and chromosomal damage under the studied ranges of concentration. Concentration-response curves were similar and there was a positive correlation between the damage observed at the DNA and chromosomal levels. DAP was more genotoxic than AHP and this agreed with the genotoxic potencies reported in bacterial systems.
BACKGROUND: The aim of this cross-sectional study was to investigate the prevalence of respiratory symptoms among Northern German farmers in relation to cattle farming characteristics. METHODS: 1735 farmers were visited on their farms and were interviewed using a standardized questionnaire on work-related respiratory symptoms and farming details. RESULTS: 84.6% of the farmers were cattle farmers. The prevalence of work-related respiratory symptoms was 40.3%. In a multiple logistic regression model adjusting for response rate, age, gender, and smoking habits, work-related respiratory symptoms were shown to be significantly associated with the ventilation of the cattle house (OR (ventilation via the wall): 0.57), feeding management (OR (feeding once daily): 0.53), and plant crop (OR: 0. 75). Farmers, living inland, showed a significant higher prevalence of work-related respiratory symptoms (OR: 1.34). CONCLUSIONS: The use of ventilation via the wall might be recommended for new cattle houses in regions with warm winters.