Psychological symptom patterns and vital exhaustion in outpatients with chronic obstructive pulmonary disease

Background

Several studies have reported high prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) outpatients. Moreover, these patients share psychological or psychopathological characteristics that inhibit their ability to cope with the disease. In the present study we aimed to record the prevalence of psychological symptom patterns in a sample of Greek COPD outpatients and to assess which psychological factors (and to which degree) contribute to vital exhaustion (VE).

Methods

The study included 139 COPD outpatients. We used the Symptom Checklist 90 - Revised (SCL-90-R) and the Maastricht Questionnaire (MQ) in order to evaluate psychological symptom patterns and VE, respectively.

Results

The mean MQ score was 19.6, which is significantly higher than the corresponding score in the general population. Regarding the SCL-90-R dimensions, depression was the highest followed by somatization, obsessive-compulsive and anxiety dimensions. Additionally, a positive correlation was observed between the MQ and the SCL-90-R dimensions. MQ failed to demonstrate correlation with age, gender, education level or the severity of the disease. Depression seems to be responsible for 57.9% of the variation of VE, while obsessive-compulsiveness is responsible for an additional 2.4%. All the remaining dimensions of SCL-90-R had no statistically significant contributions.

Conclusions

Our findings suggest the high prevalence of VE, together with high rates in most of the SCL-90-R dimensions with greater depression, somatization, obsessive-compulsiveness and anxiety in a Greek COPD group at various Global Initiative for Chronic Obstructive Lung Disease (GOLD) diagnostic criteria stages. The coexistence of such symptoms should be further assessed as an eventual unfavorable prognostic factor.     

Association of the nitric oxide synthase (eNOS) gene polymorphism with increased risk for both lupus glomerulonephritis and rheumatoid arthritis in a single genetically homogeneous population

Nitric oxide (NO), a short-lived gaseous free radical, synthesized from L-arginine by NO synthases (NOS), is a potent mediator of biologic responses involved in the pathogenesis of autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Most biological necessary NO is produced by the family of three NOS. To date, several functionally relevant genetic polymorphisms in the eNOS gene have been associated with various vascular, infectious and autoimmune diseases. To our knowledge, no study has explored these polymorphisms for both SLE and RA in the same population. The objective of this study was to investigate the influence of the eNOS gene intron 4 a/b VNTR polymorphism (a 27-base-pair tandem repeat-based polymorphism) on susceptibility to SLE and RA in patients living in the island of Crete, a genetically homogeneous population. A group of 145 healthy subjects and 190 SLE patients were included in this study. Similarly, a second group of 235 healthy controls and 202 RA patients were analysed. In both cases, patients and controls were sex- and age-matched. Herein we report that the presence of a/b genotype of the eNOS gene may act as a risk factor not for the presence of SLE but for the development of glomerulonephritis (OR 2.71, 95% CI: 1.4-5.2), while it may be a susceptibility gene for RA (OR: 2.005, 95% CI: 1.31-3.07). Thus, in our population, the a/b genotype of the eNOS gene represents a severity rather than a susceptibility genotype for SLE.     

Chlamydia trachomatis infections in Greece: first prevalence study using nucleic acid amplification tests

The present retrospective study was initiated to determine the prevalence of Chlamydia trachomatis and to assess the risk factors for infection in adult women and men presenting to general practitioners, gynecologists, dermatologists, and family-planning centers in Greece. The study was carried out in four different Greek hospital centers using highly sensitive nucleic acid amplification techniques. Altogether, 16,834 women and 1,035 men were enrolled from October 1998 to April 2004. Two types of specimens were collected from each patient: cervical swabs from women, urethral swabs from men, and first-catch urine from women and men. All specimens were examined with the Cobas Amplicor C. trachomatis polymerase chain reaction assay (Roche Molecular Systems, Branchburg, NJ, USA) or the LC × C. trachomatis ligase chain reaction assay (Abbott Laboratories, Abbott Park, IL, USA). Demographic and behavioral data were collected by clinicians using a standardized questionnaire. A total of 704 (3.9%) patients were infected with C. trachomatis. The prevalence among female patients was 3.5% and that among male patients 11.2%. Among infected patients, 88% were under 30 years of age, 71% reported more than one sexual partner, and 91% reported a new sexual partner within the last year. In conclusion, the prevalence of C. trachomatis infection in Greece is low. Young age and new and multiple sexual partners within the last year were factors consistently associated with an increased risk of chlamydial infection.