Biomedical subjects

K Spiropoulos

Publications and source records attributed to K Spiropoulos.

25 records · Page 2Linked to original sources

PubMed1986

Specificity and sensitivity of methacholine challenge test in children with normal and hyperreactive airways.

To assess the ability of the methacholine challenge test for separation between normals and patients with clinically apparent mild airway hyperreactivity, the provocative dose of inhaled methacholine required to cause a 20% drop in the forced expiratory volume in one second was evaluated in two selected pediatric populations. On the basis of a standardized respiratory questionnaire, 70 subjects, 4-16 years of age were identified. Included were 49 normal individuals, and 21 individuals with mild airway hyperreactivity who responded to bronchodilators. Methacholine inhalation challenges were performed by use of a standard inhalation procedure. Forty-seven percent of the normals (23/49) had a positive methacholine challenge test while 24% (5/21) of the patients with hyperreactive airways had a negative test by the standard criteria. A wide spectrum of specificity and sensitivity of methacholine challenge was obtained at different doses of methacholine. The greater the sensitivity, the lower the specificity. Therefore, we postulate that the methacholine challenge test can be helpful in making the clinical diagnosis but it does not allow a clear and perfect separation between normal and clinically apparent mildly airway reactive patients in a pediatric age population.

Adolescent↗

PubMedDate not supplied

Fibrin glue for sealing the needle track in fine-needle percutaneous lung biopsy using a coaxial system: Part II--Clinical study.

PURPOSE: Following percutaneous lung biopsy (PLB), we used fibrin glue as a sealant in 26 patients for the purpose of decreasing the incidence of pneumothorax. METHODS: All 26 patients (group A) had chronic obstructive pulmonary disease (COPD). The results for group A were compared with a control group of 32 patients (group B), also with COPD and in whom fibrin glue was not used. All biopsies were conducted under computed tomography (CT) using a coaxial needle system consisting of 19-gauge and 22-gauge needles. RESULTS: Pneumothorax developed in five patients (19.2%) in group A and in one instance, drainage was required (3.8%). In group B, pneumothorax developed in 13 patients (40.6%) and in six instances (18.8%) drainage was required. Comparing the use of chest-tube drainage in the two groups, a statistical significance was observed, p < 0.0025). No adverse reactions related to the fibrin glue were observed. CONCLUSION: Our results indicate that fibrin glue is a safe sealing material for lung PLB and serves to decrease the incidence and, in particular, the severity of pneumothorax, especially in high-risk patients.

Aged↗

PubMedDate not supplied

Evaluation of arterial endothelin-1 levels, before and during a sleep study, in patients with bronchial asthma and chronic obstructive pulmonary disease.

BACKGROUND: Endothelin (ET)-1 has been implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). The ET-1 levels are elevated during exacerbations of asthma and COPD in bronchoalveolar lavage, serum, and sputum, falling with treatment of the exacerbations. OBJECTIVE: The aim of this study was to examine the ET-1 blood levels in stable asthmatic patients and stable COPD patients during alertness and sleep. MATERIALS AND METHODS: We examined 48 COPD and 20 asthmatic patients. All underwent forced spirometry, measurement of SaO2 and of arterial ET-1 levels and nocturnal polysomnography. ET-1 levels were also determined during nocturnal oxyhaemoglobin desaturation. RESULTS: The daytime SaO2 level of our asthmatic patients was higher than that of our COPD patients (p < 0.001). Daytime SaO2 level of our non-desaturator COPD patients was higher than that measured in desaturator COPD patients. Nightime SaO2 level in our asthmatic patients was higher than that in our desaturator COPD patients (p < 0.001). Daytime ET-1 levels in desaturator COPD patients were higher than those observed in normal individuals, in non-desaturator COPD patients and in asthmatic patients. The COPD desaturator patients had higher levels of ET-1 during nighttime than during daytime (p < 0.001). CONCLUSION: Asthmatic patients did not exhibit desaturation of haemoglobin during the night. ET-1 levels are significantly higher in desaturator COPD patients compared with non-desaturator COPD patients, both during the day and during the night. ET-1 levels in stable COPD patients are significantly higher than in patients with stable asthma. These findings are consistent with the hypothesis that ET-1 is implicated in the pathogenesis of COPD and asthma.

Asthma↗

PubMedDate not supplied

Increased levels of albumin in bronchial washing fluid of patients with bronchial carcinoma. Could albumin be considered as a tumor marker?

BACKGROUND: The aim of this study was to evaluate the significance of albumin in bronchial washing fluid (BWF) and its relationship to three tumor markers (CEA, CA 19-9 and NSE). METHODS: Serum and BWF samples were collected in a group of 60 patients. Albumin and tumor markers in the BWF and serum of three groups: a control group (CG), a chronic bronchitis group (CBG) and a lung cancer group (CaG), were analyzed in a prospective cross-sectional study. The diagnostic yields of the tests in each environment (serum and BWF) were evaluated by using as cutoff points the values of the corresponding 90th percentile of CG and CBG taken together. RESULTS: A significant difference in albumin level (p < 0.001) was noted in the BWF of patients with cancer compared with the other two groups. In addition, a significant difference in CEA level (p < 0.001) was observed in the serum of cancer patients compared with the other two groups. The cutoff values for CEA in serum and albumin in BWF were 2.20 ng/mL and 2.00 g/dL, respectively. The areas under the corresponding ROC curves were 93% and 97%. Combination of CEA-serum and albumin-BWF by logistic regression analysis increased their diagnostic value. CONCLUSION: Measurement of albumin levels in BWF could be a useful additional diagnostic tool to differentiate malignant from non-malignant lung diseases. Moreover, the combined measurement of CEA in serum and albumin in BWF could be of aid in the follow-up of lung cancer patients.

Aged↗

PubMedDate not supplied

Recurrent catamenial hemothorax.

Endometriosis is a common cause of chronic pelvic pain and infertility affecting women of reproductive age, but the disease in rare conditions may be extragenital so may be present with a variety of symptoms. This is a report of an unusual case of pelvic endometriosis that presented with a recurrent hemothorax.

Adult↗

PubMedDate not supplied

An unusual presentation of tuberculosis.

We describe a case of a male with no symptoms and normal chest X ray, diagnosed with TB. The chest computed tomography revealed a cavity formation on the upper left lobe.

Adult↗

PubMedDate not supplied

Drug-resistance of Mycobacterium tuberculosis in Patras, Greece.

BACKGROUND: The global distribution of drug resistant tuberculosis reflects the quality of tuberculosis control worldwide and is still a major public health-problem. To our knowledge, no data exists in literature about resistance to anti-tuberculosis drugs in Greece. METHODS: The aim of this study was to determine the prevalence of resistance to the main anti-tuberculosis drugs in newly and previously treated tuberculosis patients, in the region of Patras, in Greece and to evaluate the contribution of foreign-born and human immunodeficiency virus (HIV) positive cases to drug resistance. RESULTS: A total of 207 initial isolates of Mycobacterium tuberculosis were analysed. All clinical specimens submitted for cultural diagnosis were collected before chemotherapy commenced. The age of the patients varied from 16 to 78 years old. Sex distribution was 144 males (69.56%) and 63 females (30.43%). Nineteen patients (9.17%) were recent immigrants in Greece. All the patients were HIV-negative. One hundred-one initial isolates of Mycobacterium tuberculosis (48.79%) were susceptible to all first-line anti-tuberculosis drugs, isoniazid, streptomycin, ethambutol and rifampicin. The prevalence of primary mono- and poly-drug resistance was lower (isoniazid 5.79%, streptomycin 4.34%, ethambutol 1.93%, isoniazid + streptomycin 3.38%, isoniazid + ethambutol 0.9%, isoniazid + streptomycin + ethambutol 1.44%) when compared with the prevalence of secondary (acquired) mono- and poly-drug resistance (isoniazid 8.69%, streptomycin 10.14%, ethambutol 3.86%, isoniazid + streptomycin 3.86%, isoniazid + rifampicin 1.44%, isoniazid + streptomycin + ethambutol 4.83%, isoniazid + streptomycin + rifampicin 1.44%). No primary mono - resistance to rifampicin, or primary multi - drug resistance (defined here as Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin) were observed. CONCLUSIONS: According to our data, overall drug resistance was high. Fortunately, multi-drug resistance tuberculosis was not common but special efforts are needed to monitor the prevalence of drug resistance and to ensure adequate treatment in all the population.

Adolescent↗