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Z D Daniil E Zintzaras T Kiropoulos A I Papaioannou A Koutsokera A Kastanis K I Gourgoulianis 《The European respiratory journal》2007,30(5):957-964
Pleural effusion is a common complication of various diseases. Conventional methods are not always capable of establishing the cause of pleural effusion, so alternative tests are needed. The aim of this study was to explore means of discriminating between different pleural effusion groups, malignant, parapneumonic and tuberculous, based on the combined function of seven biological markers. Adenosine deaminase (ADA), interferon-gamma, C-reactive protein (CRP), carcinoembryonic antigen, interleukin-6, tumour necrosis factor-alpha and vascular endothelial growth factor concentration levels were measured in pleural fluid from 45 patients with malignant, 15 with parapneumonic and 12 with tuberculous pleural effusion. Receiver operating characteristic curve analysis, multinomial logit modelling and canonical variate analysis were applied to discriminate the pleural effusion groups. The three groups could be discriminated successfully using the measured markers. The most important parameters for discrimination were ADA and CRP concentration levels. An individual with an ADA concentration level of >45 U.L(-1) and a CRP concentration of <4 mg.dL(-1) was more likely to belong to the tuberculous pleural effusion group, whereas one with an ADA concentration level of <40 U.L(-1) and a CRP concentration of >6 mg.dL(-1) was more likely to belong to the parapneumonic pleural effusion group, and one with a CRP concentration of <4 mg.dL(-1) to the malignant pleural effusion group. The combination of adenosine deaminase and C-reactive protein levels might be sufficient for discriminating between the three different groups of exudative pleural effusion: malignant, tuberculous and parapneumonic. 相似文献
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Introduction: The current study examined cultural differences in explanatory models of depression in a community‐based sample of mid to older aged Greek‐born and Italian‐born immigrants living in Melbourne, Australia. Methods: Participants took part in a 1‐h face‐to‐face interview with a bilingual interviewer. During this interview, information related to the participant's explanatory model of depression were examined, including causes, important symptoms, course and development, consequences and treatment. Results: Overall, participants followed a “social” based as opposed to a “disease” based model to describe depression. The Italian‐born participants were also found to hold concurrent beliefs for the course and treatment of depression. Discussion: The clinical and service implications of these results are discussed. 相似文献
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K. Tanou A. Koutsokera T. S. Kiropoulos M. Maniati A. I. Papaioannou K. Georga S. Zarogiannis K. I. Gourgoulianis K. Kostikas 《Clinical and experimental allergy》2009,39(3):345-353
Background Accumulating evidence confirms the presence of pan‐airway inflammation in allergic rhinitis patients. Smoking is known to affect the asthmatic airway inflammation. However, no study has evaluated the impact of smoking on airway inflammation of allergic rhinitis patients. Objective The aim of the present study was to evaluate the impact of smoking on inflammatory and oxidative stress biomarkers in patients with seasonal allergic rhinitis, using non‐invasive methods for sample collection. Methods Forty patients with seasonal allergic rhinitis (20 smokers and 20 non‐smokers) and 30 healthy subjects (15 smokers and 15 non‐smokers) were recruited for the study during pollen season. All subjects were submitted to measurement of the fraction of exhaled NO (FeNO), exhaled breath condensate (EBC) collection, nasal lavage collection, pre‐ and post‐ bronchodilation spirometry and metacholine bronchial challenge testing. pH, leukotriene B4 (LTB4) and 8‐isoprostane were determined in EBC and nasal lavage samples. Results Patients with allergic rhinitis presented higher LTB4 and 8‐isoprostane levels in nasal lavage (P<0.0001 for both comparisons), with no significant differences between smokers and non‐smokers. Patients with allergic rhinitis also presented higher LTB4 levels and lower pH in EBC (P<0.001 and P=0.004, respectively), with prominent differences between smokers and non‐smokers (P<0.0001 and P=0.003, for LTB4 and pH, respectively). A significant correlation between nasal lavage and EBC LTB4 values was observed (rs=0.313, P=0.048). Conclusions Patients with allergic rhinitis present increased LTB4 and 8‐isoprostane in their nasal cavity, however, with no significant differences between smokers and non‐smokers. In contrast, smokers with allergic rhinitis present higher LTB4 levels and lower pH in EBC, suggesting that these patients may be more susceptible to the deleterious effects of smoking, compared with non‐smokers. 相似文献
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Zimmerman DD Gosselink MP Mitalas LE Delemarre JB Hop WJ Briel JW Schouten WR 《Diseases of the colon and rectum》2005,48(6):1228-1232
ABSTRACT Transanal advancement flap repair has been advocated as the treatment of choice for transsphincteric perianal fistulas, because it enables the healing of almost all fistulas without sphincter damage and consequent continence disturbance. After initial promising reports, recently less favorable results have been reported. It remains unclear why there is such a large variety in the reported healing rates. Recently, it has been suggested that impaired wound healing caused by a diminished rectal mucosal perfusion in patients who smoke may lead to the breakdown of the advancement flap in patients undergoing flap repair for perianal fistulas. This study was designed to investigate the difference in blood flow in rectal mucosa between patients who smoke and those who do not smoke. Furthermore, we assessed the impact of the creation of a mucosa advancement flap and the difference in blood flow in the flap between smoking and nonsmoking patients. Between July 2001 and July 2002, 23 consecutive patients (19 males; median age, 46 (range, 26–69) years) with a perianal fistula of cryptoglandular origin underwent surgery for a perianal fistula. Among them were 13 patients who smoked cigarettes. All patients underwent intraoperative laser Doppler flowmetry. Median blood flow before transanal advancement flap repair was 35 (range, 8–70) volts in patients who did not smoke. In patients who smoked the median blood flow before transanal advancement flap repair was 18 (range, 7–35) volts. Blood flow was significantly lower in patients who smoked (P = 0.018; Mann-Whitney). In conclusion, it seems likely that impaired wound healing caused by a diminished rectal mucosal perfusion is a contributing factor in the breakdown of advancement flaps in patients who smoke cigarettes.Read at the meeting of The American Society of Colon and Rectal Surgeons, New Orleans, Louisiana, June 21 to 26, 2003.Reprints are not available. 相似文献
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Kiropoulos LA Klimidis S Minas H 《The Australian and New Zealand journal of psychiatry》2004,38(9):714-724
OBJECTIVE: To compare depressive and anxiety illness in an older-aged sample of Greek-born (GB) immigrants who were likely to have been excluded from the National Survey of Mental Health and Wellbeing due to their lack of fluency in the English language and for whom rates of mental disorder are unknown, with a comparably recruited sample of Anglo-Australians (AA). METHOD: One hundred and forty-six GB and 146 AA respondents with a mean age of 68 years living in Melbourne and recruited through social clubs, completed the Beck Depression Inventory-II (BDI-2) and the State-Trait Anxiety Inventory (STAI) in addition to socio-demographic and other background questions. RESULTS: Greek-born respondents exhibited higher depression and anxiety scores and reported more depressive and anxiety symptomatology than the AA respondents. More GB respondents (17.1%) were likely to be included in the moderate to severe BDI-2 depression categories than AA (4.1%). Greek-born respondents (43.1%) were more likely to be included in the higher anxiety categories (i.e. score 41-80) of the STAI than the AA (15.8%). However, when controlling for health, economic and social factors there was no difference in the BDI-2 measures between the two groups. Despite controlling for these factors the GB still scored more highly on STAI measures than AA respondents. CONCLUSIONS: No differences were found between groups on measures of depression once controlling for age, education and occupational level, current financial status, marital status, household composition, current work status, physical health and stress. Such factors were also shown to influence group-differences anxiety but they not entirely explain group differences. Higher anxiety in GB respondents were likely to have been determined through the effects of additional but unmeasured cultural and immigrant status factors. Psychological morbidity in immigrants is best accounted for by considering the influence of social, health and other living conditions in addition to the effects of culture or immigrant status. 相似文献
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This paper examines the experiences of family members who have previously been primary carers of residents of residential aged care services to identify factors, which have encouraged them to remain involved in a caring role. The context for this study was a residential aged care facility in Western Australia that was selected on the basis of its reputation of being highly sought after by relatives requiring formal care for older family members and also having a high level of ongoing involvement of relatives. Findings from the study provide evidence of the importance of staff developing relationships with relatives, supporting relatives through the change process and developing care partnerships where relatives could define new caring roles in providing social and emotional support for residents. This study is part of a larger study investigating relational quality in aged care environment. 相似文献
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Litza E. Mitalas Jan J. van Wijk Martijn P. Gosselink Pascal Doornebosch David D. E. Zimmerman W. Rudolph Schouten 《International journal of colorectal disease》2010,25(12):1499-1502