Effect of indoor nitrogen dioxide on lung function in urban environment

BACKGROUND: High levels of indoor NO2 are associated with increased asthma symptoms and decreased expiratory peak flows in children. We investigated the association of exposure to domestic indoor NO2, objectively measured in winter and spring, with respiratory symptoms and lung function in a sample of adolescents from a southern Mediterranean area. METHODS: From a large school population sample (n=2150) participating in an epidemiological survey in the urban area of the City of Palermo (southern Italy), a sub-sample of 303 adolescents was selected which furnished an enriched sample for cases of current asthma. All subjects were evaluated by a health questionnaire, skin prick tests and spiro…

Factors that influence exhaled nitric oxide in Italian schoolchildren

Conflicting results exist about the meaning of exhaled nitric oxide (eNO) in epidemiologic studies, mainly because of the numerous factors that may affect the measurement.To evaluate the role of the factors that influence eNO levels in a sample of schoolchildren with or without respiratory diseases. We studied 335 schoolchildren, ages 10 to 16 years, from 8 schools in Palermo, Italy. After a respiratory questionnaire was completed, spirometry, skin tests, and eNO measurements were performed.Among 335 children, 13.7% reported symptoms of bronchial asthma, 46.9% reported symptoms of rhinitis, and 39.4% were asymptomatic. The ratio of forced expiratory volume in 1 second to forced vital capaci…

Environmental Conditions, Air Pollutants, and Airways

Air pollution is a major problem worldwide, which could be even more serious for athletes who train in urban environments. Exercise increases minute ventilation and exposure to pollutants, but the literature on the effects of air pollution in athletes is relatively scarce, with the exception of chlorine exposure in athletes of aquatic sports and air pollution secondary to ice resurfacing in athletes performing in ice arenas. Although air pollution may exert detrimental effects on athletic performance, little has been published on this topic. The largest body of information regards the impact of air pollution during urban active transport, i.e., walking and cycling in cities, due to the pote…

Relationship among Body Composition, Adipocytokines, and Irisin on Exercise Capacity and Quality of Life in COPD: A Pilot Study

Adipose tissue is an endocrine organ that interferes with the severity of chronic obstructive pulmonary disease (COPD). Although inflammatory markers, body composition, and nutritional status have a significant impact on pulmonary function, the real contribution of adipocytokines and myokines in COPD is still controversial. We aimed to evaluate the role played by the body composition, leptin, adiponectin, haptoglobin, and irisin on the functional exercise capacity, respiratory function, and quality of life (QoL) in COPD. In 25 COPD (20% GOLD-1; 60% GOLD-2; 20% GOLD-3) patients and 26 matched control subjects, we find that leptin, total adiponectin and haptoglobin are significantly increased…

Comorbidities and quality of life in obstructed adults in a primary care setting

Introduction: Comorbidities are known to impair Quality of Life (QoL)in patients with chronic obstruction pulmonary disease. A poor QoL is associated with higher dyspnoea perception. How comorbidities influence QoL in these patients is limited and needs clarification. Aim: To study the role of dyspnoea perception in the relationship between comorbidities number and QoL in obstructed and not obstructed adults in a primary care setting. Methods: Seventeen general practitioners participated to the study: 566 adults, attending the Practitioner9s study for any reason, performed spirometry and fulfilled a respiratory questionnaire between January and June 2014. 259 adults (148 M, aged 40-88) acce…

Assessment of exposure to environmental tobacco smoke in young adolescents following implementation of smoke-free policy in Italy.

We investigated acute and chronic exposure to environmental tobacco smoke (ETS) in a cohort of young adolescents using urinary cotinine and hair nicotine testing after recent implementation of Italian smoke free legislation. Study subjects were 372 Italian young adolescents, between 10 and 16 years of age from the principal city of Sicily, Palermo. Urine and hair samples were collected between November 2005 and May 2006, when the legislation to ban smoking in all the enclosed places of employment (including bars, restaurants, pubs) was completely enforced. An exhaustive questionnaire including sociodemographic characteristics and active and passive exposure to cigarette smoking was complete…

A Simple Cardiovascular Model for the Study of Hemorrhagic Shock

Hemorrhagic shock is the number one cause of death on the battlefield and in civilian trauma as well. Mathematical modeling has been applied in this context for decades; however, the formulation of a satisfactory model that is both practical and effective has yet to be achieved. This paper introduces an upgraded version of the 2007 Zenker model for hemorrhagic shock termed the ZenCur model that allows for a better description of the time course of relevant observations. Our study provides a simple but realistic mathematical description of cardiovascular dynamics that may be useful in the assessment and prognosis of hemorrhagic shock. This model is capable of replicating the changes in mean …

Rhinitis as a risk factor for depressive mood in pre-adolescents: a new approach to this relationship

Background Respiratory allergic symptoms impact on social life and school activities, influencing the patient's mood states. We evaluated the relationships between allergic respiratory diseases and depressive/anxious mood in a large sample of Italian middle school students, using the partial directed acyclic graph (P-DAG). Methods We studied 1283 subjects aged 10–13. A health respiratory questionnaire including questions relevant to socioeconomic status (HCI) and a test for depression and anxiety were administered. All subjects performed spirometry and skin prick tests. Results A causal role of rhinitis on depression was found: the likelihood of being depressed increased from 11.2 to 17.7%,…

Characteristics and Prognostic Value of Morning Dipping of Peak Expiratory Flow Rate in Stable Asthmatic Subjects

Characteristics and prognostic relevance of morning dip of peak expiratory flow rate (PEFR) were evaluated in stable asthmatic subjects. Among 246 outpatients monitored four times daily for two weeks, 38 (group A) showed a significant difference between morning reading of PEFR and each of the others; they were compared to 38 randomly selected patients (group B) not showing morning dip in PEFR. Less frequent seasonal course, extrinsic pathogenesis, and sensitization to mites characterized group A; starting airflow limitation was more severe in those with morning dip, but no significant difference between mean PEFR measured throughout two weeks was found. At 6 to 12 weeks, morning dip was not…

Third-hand smoke exposure and health hazards in children

Smoking still represents a huge public health problem. Millions of children suffer the detrimental effects of passive smoking. An increasing number of countries have recently issued laws to regulate smoking in public places. Instead, homes remain a site where children are dangerously exposed to environmental tobacco smoke (ETS). The combination of tobacco smoke pollutants which remain in an indoor environment, the so-called ‘third-hand smoke’ (THS), represent a new concept in the field of tobacco control. THS consists of pollutants that remain on surfaces and in dust after tobacco has been smoked, are re-emitted into the gas-phase, or react with other compounds in the environment to form se…

Biomarkers of Oxidative Stress in the Upper and Lower Airways of Atopic Children.

ENVIRONMENTAL EFFECTS ON FRACTIONAL EXHALED NITRIC OXIDE IN ALLERGIC CHILDREN

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma and respiratory allergy. Environmental factors, especially indoor and outdoor air quality, may play an important role in triggering acute exacerbations of respiratory symptoms. The authors have reviewed the literature reporting effects of outdoor and indoor pollutants on FeNO in children. Although the findings are not consistent, urban and industrial pollution—mainly particles (PM2.5 and PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2)—as well as formaldehyde and electric baseboard heating have been shown to increase FeNO, whilst ozone (O3) tends to decrease it. Among children exposed to …

The Burden of Rhinitis and Rhinoconjunctivitis in Adolescents

Purpose Rhinitis and conjunctivitis are common diseases worldwide that are frequently associated. Nevertheless, the risk factors for rhinoconjunctivitis are not well-described and the impact of conjunctivitis on rhinitis and asthma in children remains unknown. This study explored the different risk factors and evaluated the burden of rhinoconjunctivitis among adolescents. Methods This was a cross-sectional study conducted on a random sample of schoolchildren, aged 10-17 years, using skin prick tests and a self-administered questionnaire on respiratory health investigating the impact of rhinitis and rhinoconjunctivitis on daily activities. Results A complete evaluation was obtained for 2,150…

Impact of the flame retardant 2,2'4,4'-tetrabromodiphenyl ether (PBDE-47) in THP-1 macrophage-like cell function via small extracellular vesicles

2,2’4,4’-tetrabromodiphenyl ether (PBDE-47) is one of the most widespread environmental brominated flame-retardant congeners which has also been detected in animal and human tissues. Several studies have reported the effects of PBDEs on different health issues, including neurobehavioral and developmental disorders, reproductive health, and alterations of thyroid function. Much less is known about its immunotoxicity. The aim of our study was to investigate the effects that treatment of THP-1 macrophage-like cells with PBDE-47 could have on the content of small extracellular vesicles’ (sEVs) microRNA (miRNA) cargo and their downstream effects on bystander macrophages. To achieve this, we puri…

Predictors of non-invasive ventilation tolerance in amyotrophic lateral sclerosis

Abstract Background The most frequent cause of death in patients with Amyotrophic Lateral Sclerosis (ALS) is respiratory failure. Recently, it has been shown that non-invasive ventilation improves survival and quality of life in ALS patients with respiratory failure, but little is known about predictors of non-invasive ventilation adaptation and tolerance. In this study we evaluated the effect of a comprehensive information about non-invasive ventilation use and a prolonged and intensive monitoring on tolerance to this palliative care. Methods We prospectively monitored all consecutive ALS patients with chronic respiratory failure and indication to non-invasive ventilation between January 2…

Extracellular vesicles from PBDE-47 treated M(LPS) THP-1 macrophages modulate the expression of markers of epithelial integrity, EMT, inflammation and muco-secretion in ALI culture of airway epithelium

Aims: The lung epithelial cells form a physical barrier to the external environment acting as the first line of defence against potentially harmful environmental stimuli. These cells interact with several other cellular components, of which macrophages are some of the most relevant. We analysed the effects of the PBDE-47 on the microRNA cargo of THP-1 macrophage like derived small Extracellular Vesicles (sEVs) and the effects on A549 lung epithelial cells. Main methods: sEVs from M(LPS) THP-1 macrophage-like cells after PBDE-47 treatment (sEVsPBDE+LPS) were characterized by nanoparticle tracking analysis and their microRNA cargo studied by qPCR. Confocal microscopy was applied to study sEVs…

A mathematical model of cardiovascular dynamics for the diagnosis and prognosis of hemorrhagic shock

Abstract A variety of mathematical models of the cardiovascular system have been suggested over several years in order to describe the time-course of a series of physiological variables (i.e. heart rate, cardiac output, arterial pressure) relevant for the compensation mechanisms to perturbations, such as severe haemorrhage. The current study provides a simple but realistic mathematical description of cardiovascular dynamics that may be useful in the assessment and prognosis of hemorrhagic shock. The present work proposes a first version of a differential-algebraic equations model, the model dynamical ODE model for haemorrhage (dODEg). The model consists of 10 differential and 14 algebraic e…

Association between greenspace and lung function in Italian children-adolescents

Background: Few studies have examined the impact of urban greenspace exposure on lung function in children-adolescents, and the available evidence is still inconsistent. The aim of the current study was to verify the hypothesis that the effects of greenspace exposure vary with differing levels of lung function of children-adolescents. Methods: Between November 2005 and May 2006, 2150 children-adolescents (age-range: 10-15 years) living in the city of Palermo were enrolled in a cross-sectional survey. Parents were interviewed through a modified version of the Italian Studies on Respiratory Disorders in Children and the Environment (SIDRIA) questionnaire. All children-adolescents performed sp…

Global Lung Function Initiative 2012 reference values for spirometry in South Italian children

Rationale Despite the widespread use of the Global Lung Function Initiative (GLI) 2012 reference values, there is still the need of testing their applicability in local areas. Objectives The aims of this study are to evaluate applicability of GLI reference equations in a large population-based sample of normal schoolchildren from Sicily, and to compare GLI and previous prediction equations in terms of spirometry test interpretation. Methods GLI equations were evaluated in 1243 normal schoolchildren, 49% males, aged 7–16 years, height 116–187 cm. Normality assumptions for the GLI z-scores (FEV1, FVC, FEV1/FVC) were tested, and bootstrap confidence intervals for the mean (0 expected) and …

Association of Blattella germanica sensitization with atopic diseases in pediatric allergic patients

To cite this article: La Grutta S, Cibella F, Passalacqua G, Cuttitta G, Liotta G, Ferlisi A, Viegi G. Association of Blattella germanica sensitization with atopic diseases in pediatric allergic patients. Pediatr Allergy Immunol 2011; 22: 521–527. Abstract Background:  The extent to which the sensitization to the German cockroach Blattella germanica (BG) affects onset/presence of rhinoconjunctivitis (RC) in children is unknown. Objectives:  The present work was aimed to assess the prevalence of BG sensitization in an outpatient pediatric population from an allergy clinic, the association with allergic diseases, and the effect of age in children with allergic sensitization. Methods:  Five hu…

Non-invasive markers of airway inflammation and remodeling in childhood asthma

To evaluate the relationship between pro-inflammatory and pro-remodeling mediators and severity and control of asthma in children, the levels of IL-8, MMP-9, TIMP-1 in induced sputum supernatants, the number of sputum eosinophils, as well as FeNO, were investigated in 35 asthmatic children, 12 with intermittent (IA) and 23 with moderate asthma (MA), and 9 controls (C). The patients with asthma were followed for 1 yr and sputum was obtained twice during the follow-up. Biomarker levels were correlated with the number of exacerbations. We found that IL-8, MMP-9, TIMP-1 and the numbers of eosinophils in induced sputum, as well as FeNO, were increased in children with IA and MA in comparison to …

Rare earths and trace elements contents in leaves: A new indicator of the composition of atmospheric dust

The relationship between the trace element distribution in atmospheric particles and leaves of some exposed plants in the environment was recently demonstrated. This indication would suggest that the trace element analysis of leaves in these plants could provide information about the composition, nature and origin of the atmospheric dust dispersed in the environment. In order to corroborate this hypothesis, the distribution of trace elements and Rare Earths were studied in leaves of some endemic plants, in the atmospheric fallout and in soils of rural, urban and industrial ecosystems in Sicily. These elements have been chosen to discriminate the source and nature of different source on atmo…

Lung Function Decline in Adult Asthmatics—A 10-Year Follow-Up Retrospective and Prospective Study

Asthma may have an impact on lung function decline but conflicting results are reported in forced expiratory volume in one second (FEV1) decline. We aimed to describe the changes in FEV1 in lifelong non-smoking adult asthmatic outpatients during a 10-year follow-up comparing years 1–5 (1st period) with years 6–10 (2nd period) to assess factors affecting these changes. A total of 100 outpatients performed spirometry every 3 months during a 10-year survey. FEV1/Ht3 slope values of the 2nd period reduced significantly respect to the 1st period (p 1 slopes of years 1–5 and 6–10 were inversely associated with FEV1 at enrolment (p = 0.02, p = 0.01, respectively). Reversibility and variability FEV…

Respiratory Effects of Exposure to Traffic-Related Air Pollutants During Exercise

Traffic-related air pollution (TRAP) is increasing worldwide. Habitual physical activity is known to prevent cardiorespiratory diseases and mortality, but whether exposure to TRAP during exercise affects respiratory health is still uncertain. Exercise causes inflammatory changes in the airways, and its interaction with the effects of TRAP or ozone might be detrimental, for both athletes exercising outdoor and urban active commuters. In this Mini-Review, we summarize the literature on the effects of exposure to TRAP and/or ozone during exercise on lung function, respiratory symptoms, performance, and biomarkers. Ozone negatively affected pulmonary function after exercise, especially after co…

Prevalence of nocturnal asthma in a general population sample: determinants and effect of aging.

Nocturnal asthma (NA) is important because of clinical and prognostic implications. Previous data on prevalence may be overestimated, because they are derived from selected series. Observations on monitoring of peak expiratory flow in elderly asthmatics suggested that prevalence of NA may increase with age. This study was designed to estimate the prevalence of NA-related symptoms in a sample drawn from a general population and evaluate the role of aging. Subjects (1,100, mean age 41.9, SD 22.8 years) were randomly selected from the lists of seven general practitioners. A questionnaire on nighttime and morning NA-associated symptoms was used and frequency of occurrence was rated as never, so…

Urinary leukotriene E4 in the assessment of nocturnal asthma

Urinary leukotriene E4 (LTE4) is a marker of the body's production of cysteinyl LTs, important mediators of airway inflammation. The role of the latter in nocturnal asthma is a topic of increasing interest.This investigation was aimed at determining whether nighttime attacks are associated with increased release of LTs, expressed by urinary LTE4, and the relationship between the two phenomena.Three groups were studied: group A, seven control subjects; group B, nine asthmatic patients without nocturnal attacks; and group C, nine asthmatic patients with a comparable daytime FEV1 but who were experiencing nocturnal exacerbations (morning dips in peak expiratory flow greater than 20%). Urine wa…

Prevalence of physician-diagnosed asthma in patients with suspected obstructive sleep apnea syndrome: A cross-sectional analysis of the ESADA database

It has been reported that bronchial asthma is often associated with obstructive sleep apnea (OSA) and daytime sleepiness. We analyzed the prevalence of physician-diagnosed asthma in 4929 subjects with suspected obstructive sleep apnea (OSA) in the European Sleep Apnea database (ESADA) Cohort. Patients were studied by respiratory polygraphy (PG: n=1624, 66.6% males) or full polysomnography (PSG: n=3305, 70.4% males), and the clinical characteristics of asthmatic (A) and non-asthmatic (non-A) patients were analyzed according to OSA severity. Significance was at p 2 , p=0.0004) and showed more severe daytime sleepiness (Epworth score: 10.4±5.6 vs 9.5±5.3, p=0.0015) and a trend for worse noctur…

An association analysis to identify genetic variants linked to asthma and rhinoconjunctivitis in a cohort of Sicilian children

Abstract Asthma and rhino-conjunctivitis are common chronic diseases in childhood. In this cross-sectional study, we performed a gene association analysis with current asthma and rhino-conjunctivitis in a cohort of Sicilian children aged 10–15 years. Overall, our findings reveal the importance of different genetic variants at 4p14, 16p12.1, 17q12, 6p12.2 and 17q21.1, identifying possible candidate genes responsible for susceptibility to asthma and rhino-conjunctivitis.

Determinants of Allergic Sensitization, Asthma and Lung Function: Results from a Cross-Sectional Study in Italian Schoolchildren

Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7&ndash

Bronchial hyperresponsiveness in children with atopic rhinitis: a 7-year follow-up

Background:  A high prevalence of bronchial hyperresponsiveness (BHR) was found in atopic subjects with rhinitis. Those subjects may be at higher risk for developing bronchial asthma. We evaluated, in a 7-year follow-up, BHR and atopy in a homogeneous population of nonasthmatic children with allergic rhinitis (AR), and their role in asthma development. Methods:  Twenty-eight children (6–15 years) with AR were studied. At enrollment (T0), skin tests, total serum IgE assay, peak expiratory flow (PEF) monitoring and methacholine (Mch) bronchial challenge were performed. BHR was computed as the Mch dose causing a 20% forced expiratory volume (FEV)1 fall (PD20FEV1) and as dose–response slope (DR…

Effect of age upon airway obstruction and reversibility in adult patients with asthma.

In a cross-sectional study we evaluated the effect of aging (separately from that of duration of disease) on airway obstruction and reversibility by comparing two groups of non-smoker patients with asthma.We compared two groups of patients: group A, which had 50 subjects (8 men and 42 women) aged 59.7+/-4.6 years (mean +/- SD), and group B, comprised of 51 subjects (19 men and 32 women) who were 35.7+/-7.4 years old. The groups were selected because of comparable baseline degree of obstruction (FEV1 % of predicted, 67.8+/-20.3 in group A; 73.0+/-19.6 in group B, NS) and duration of the disease (14.0+/-11.7 years vs 11.2+/-9.1, NS). Spirometric examination, with a bronchodilator test, was pe…

A CASE STUDY OF THE INDOOR AIR QUALITY IN SCHOOLS BELONGING TO AN AREA OF THE SICILIAN ISLAND INTERESTED BY THE PRESENCE OF PETROCHEMICAL REFINERIES

The indoor environmental quality is a topic particularly relevant for schools; this category of confined environments is, indeed, occupied by subjects (i.e. children), which are thought to be more vulnerable than adults to the negative health effects of poor indoor air quality, and whose learning process has long been recognized to be influenced by the quality of the indoor environment. This paper presents results of a study concerning the inside air quality of schools in four small towns sited in the southern part of Sicily, interested by the presence of a petrochemical refinery in the surrounding territory. The performed analysis made it possible to highlight the main criticalities regard…

Concentration and reference interval of trace elements in human hair from students living in Palermo, Sicily (Italy).

Trace element contents in specimens of hair collected from 137 children aged 11–13 years old, living in Palermo (Sicily, Italy) were determined by ICP-MS. This work reports analytical data for the following 19 elements: Al, As, Ba, Cd, Co, Cr, Cu, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sr, U, V and Zn. The most abundant chemical elements were zinc and copper (Zn > Cu), with concentrations exceeding 10microg/g (Zn = 189.2microg/g; Cu= 22.9microg/g). Other elements with concentrations greater than 1microg/g were, in order of abundance, Al > Sr > Ba > Pb. The remaining elements were all below 1microg/g. The average elemental concentrations in hair were statistically compared by Kolmogorov–Smirnov’s t…

Comment to the Editorial by KS Park and EW Kang “Is only fixed positive airway pressure a robust tool for kidney protection in patients with obstructive sleep apnea?”

We thank doctors Park and Kang for their editorial that well summarized our article. Our common belief is that one of the possible consequences of untreated obstructive sleep apnea (OSA) is an accelerated deterioration of kidney function, and that more knowledge would be necessary on the possible protective effects of OSA treatments. To our knowledge, so far the only OSA therapy whose effects on renal function have been tested is continuous positive airway pressure (CPAP), and most , although not all studies, have demonstrated its benefits. Our own study, while confirming benefits of fixed CPAP, has demonstrated little effect of auto-adjusting CPAP (APAP). This finding may be of relevance a…

Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test

Background: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) provides detailed information on QoL in asthmatic children, whereas Childhood Asthma Control Test (C-ACT) Questionnaire is the most validated instrument for asthma control. No study assessed the relationship between C-ACT and QoL in children by means of those instruments. The aim of this study was to determine whether a QoL estimation is possible using the C-ACT questionnaire in asthmatic children. Methods: Medical history, spirometry, C-ACT, and PAQLQ were assessed in 144 (60% male) outpatient asthmatic children from September 2011 to November 2014. A generalized linear model (GLM) for the prediction of PAQLQ was obtained t…

Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA

Abstract: BACKGROUND: The impact of treating OSA on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different CPAP modalities. The aim of this study was to evaluate the respective influence of fixed and autoadjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database cohort. METHODS: In patients of the European Sleep Apnea Database, eGFR prior to and after follow-up was calculated by using the Chronic Kidney Disease-Epidemiology Collaboration equation. Three study groups were investigated: untreated patients (n = 14…

Excessive Daytime Sleepiness in Obstructive Sleep Apnea Patients Treated With Continuous Positive Airway Pressure: Data From the European Sleep Apnea Database

Excessive daytime sleepiness (EDS) is a symptom of obstructive sleep apnea (OSA) that resolves under treatment with continuous positive airway pressure (CPAP). In some patients, sleepiness persists despite CPAP treatment. We retrospectively analyzed data on subjective residual EDS, assessed as an Epworth Sleepiness Scale score (ESS) >10, in patients from the European Sleep Apnea Database (n = 4,853, mean age +/- SD 54.8 +/- 11.8 years, 26.1% females), at baseline and at the first visit (median follow-up: 5 months, interquartile range 3-13). An ESS > 10 occurred in 56% of patients at baseline and in 28.2% of patients at follow-up. Residual EDS was analyzed in 2,190 patients (age: 55.1 +/- 12…

Resumption of Ventilation at the End of Obstructive Sleep Apneas is not Determined by Diaphragmatic Fatigue

In patients affected by obstructive sleep apnea syndrome (OSAS) a progressive increase of the force developed by the respiratory muscles is usually observed during the occlusive phase before upper airway patency is resumed (Onal and Lopata, 1986).

Indoor air quality in schools of a highly polluted south Mediterranean area

This study aimed at surveying lower secondary schools in southern Italy, in a highly polluted area. A community close to an industrial area and three villages in rural areas was investigated. Indoor temperature, relative humidity (RH), gaseous pollutants (CO 2 and NO 2 ), selected biological pollutants in indoor dust, and the indoor/outdoor mass concentration and elemental composition of PM 2.5 were ascertained. Temperature and RH were within, or close to, the comfort range, while CO 2 frequently exceeded the threshold of 1000 ppm, indicating inadequate air exchange rate. In all the classrooms, median NO 2 levels were above the WHO threshold value. Dermatophagoides p. allergen concentration…

A cross-sectional study assessing the relationship between BMI, asthma, atopy, and eNO among schoolchildren

Increased body weight may influence airway inflammatory mechanisms.To assess whether overweight-obesity (OW-O), evaluated as increased body mass index, is associated either with exhaled nitric oxide (eNO), a marker of airway inflammation, or with allergic sensitization in a large sample of children and adolescents.A cross-sectional, epidemiological study was performed on a population sample of schoolchildren evaluating 708 subjects (age 10-16 years; BMI 13-39 kg/m(2)) by respiratory health questionnaire, skin prick tests, spirometry, and eNO measure.Prevalence rates were: OW-O 16.4%, asthma ever (A) 11.9%, and rhinoconjunctivitis (RC) 14.8%. Asthma ever and allergic sensitization were signi…

Relationship between domestic smoking and metals and rare earth elements concentration in indoor PM2.5

Cigarette smoke is the main source of indoor chemical and toxic elements. Cadmium (Cd), Thallium (Tl), Lead (Pb) and Antimony (Sb) are important contributors to smoke-related health risks. Data on the association between Rare Earth Elements (REE) Cerium (Ce) and Lanthanum (La) and domestic smoking are scanty. To evaluate the relationship between cigarette smoke, indoor levels of PM2.5 and heavy metals, 73 children were investigated by parental questionnaire and skin prick tests. The houses of residence of 41 "cases" and 32 "controls" (children with and without respiratory symptoms, respectively) were evaluated by 48-hours PM2.5 indoor/outdoor monitoring. PM2.5 mass concentration was determi…

Hypoxemia during Sleep

In most normal subjects arterial oxyhemoglobin saturation (SaO2) remains substantially stable throughout all sleep time: some exceptions however, may be observed especially in elderly subjects, who may show desaturations, sometimes associated with apneas (Block et al., 1979; Krieger et al., 1983; Catterall et al., 1985). Conversely, SaO2 drops during part of, or even the whole sleep time, are a common finding in pathological conditions like obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD).

Multiple IgE recognition on the major allergen of the Parietaria pollen Par j 2

The interaction between IgE antibodies and allergens is a key event in triggering an allergic reaction. The characterization of this region provides information of paramount importance for diagnosis and therapy. Par j 2 Lipid Transfer Protein is one of the most important allergens in southern Europe and a well-established marker of sensitization in Parietaria pollen allergy. The main aim of this study was to map the IgE binding regions of this allergen and to study the pattern of reactivity of individual Parietaria-allergic patients. By means of gene fragmentation, six overlapping peptides were expressed in Escherichia coli, and their IgE binding activity was evaluated by immunoblotting in …

Effects of exercise training and montelukast in children with mild asthma

Data from the general population suggest that habitual exercise decreases bronchial responsiveness, but the possible role of exercise in asthmatics is undefined. The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children. This randomized study in children with mild asthma evaluated the combined effects of aerobic training for 12 wk and montelukast or placebo on bronchial responsiveness (BHR) to methacholine, exercise-induced bronchoconstriction (EIB), inflammatory markers in exhaled breath condensate (EBC), and asthma exacerbations.Fifty children (mean age +/- SD: 10.2 +/- 2.4 yr) with mild stable asthma were random…

Spontaneous gastroesophageal reflux and airway patency during the night in adult asthmatics

Controversies still exist on the role of nighttime gastroesophageal reflux (GER) in precipitating nocturnal asthma. We tested the relationship between GER and nocturnal bronchoconstriction by continuously and simultaneously monitoring both respiratory resistances and esophageal pH in seven asthmatics with moderate to severe GER disease. Twenty-nine GER episodes were found during the study night lasting more than 5 min (LGER) and 72 not longer than 5 min (SGER). Both long (LGER) and short (SGER) gastroesophageal refluxes were able to maintain significantly higher lower respiratory resistances (RLR) at the resolution of each GER episode (RLR(e)) with respect to baseline values. RLR, expressed…

Investigating the Relationship between Parental Education, Asthma and Rhinitis in Children Using Path Analysis.

Parental socioeconomic position (SEP) is a known determinant of a child’s health. We aimed to investigate whether a low parental education, as proxy of SEP, has a direct effect on physician-diagnosed asthma, current asthma and current allergic rhinitis in children, or whether associations are mediated by exposure to other personal or environmental risk factors. This study was a secondary data analysis of two cross-sectional studies conducted in Italy in 2006. Data from 2687 adolescents (10–14 years) were analyzed by a path analysis model using generalized structural equation modelling. Significant direct effects were found between parental education and family characteristics (n…

25-Hydroxyvitamin D, IL-31, and IL-33 in Children with Allergic Disease of the Airways

Low vitamin D is involved in allergic asthma and rhinitis. IL-31 and IL-33 correlate with Th2-associated cytokines in allergic disease. We investigated whether low vitamin D is linked with circulating IL-31 and IL-33 in children with allergic disease of the airways. 25-Hydroxyvitamin D [25(OH) Vit D], IL-31, and IL-33 plasma levels were measured in 28 controls (HC), 11 allergic rhinitis (AR) patients, and 35 allergic asthma with rhinitis (AAR) patients. We found significant lower levels of 25(OH) Vit D in AR and in AAR than in HC. IL-31 and IL-33 plasma levels significantly increased in AAR than HC. IL-31 and IL-33 positively correlated in AR and AAR. 25(OH) Vit D deficient AAR had higher l…

An elevated body mass index increases lung volume but reduces airflow in italian schoolchildren

Background Asthma and obesity are important and growing health issues worldwide. Obesity is considered a risk factor for asthma, due to the induction of changes in airway mechanics and altered airway inflammation. Methods We cross-sectionally investigated the effect of increased weight on pulmonary function in a large population sample of healthy children, aged 10–17 yrs living in Palermo, Italy. Explanatory effect of weight on lung function variables were evaluated by multiple linear regression models, taking into account height, gender, and age-class. Results Among the 2,393 subjects, FVC and FEV1 were positively correlated to weight. Multiple regression models showed that the weight beta…

Effects of sleep apnea and kidney dysfunction on objective sleep quality in nondialyzed patients with chronic kidney disease: an ESADA study

Study Objectives: Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73m2. Methods: Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matche…

Chemical fingerprint of outdoor PM2.5 in Malta

Intro: RESPIRA (EU Funded - Italia-Malta 07-13) indicated that living in Malta is a risk factor for asthma. Aim: To determine the chemical profile of PM2.5 in Malta, and compare with reference values. Methods: Using FAI pumps at 10l/min/48hr, samples were collected on Teflon and Quartz filters from 6 schools and 46 homes in Malta. Total ICP-MS measurement (Residual+extracted), X ray Fluorescence, and thermo-optical methods(TO) were used for analysis by CNR in Rome. Aeroqual IQM60 counters were used for total PM2.5 mass. All data in ng/m3, Mean, (1st to 3rd quartile) of all 48 hour measurements.

Alveolar Gas Mixing in Chronic Pulmonary Hyperinflation

It is well known that in chronic pulmonary hyperinflation defects in intrapulmo-nary gas mixing and in V/Q ratio are likely to occur.