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  • Tobacco use is the single most important preventable health risk in the developed world, and an important cause of premature death worldwide. Smoking causes a wide range of diseases, including many types of cancer, chronic obstructive pulmonary disease, coronary heart disease, stroke, peripheral vascular disease, and peptic ulcer, while it also affects fetal and neonatal growth and development. Many of the adverse health effects of smoking are reversible, and smoking cessation treatments represent some of the most cost effective of all health care interventions. In order to improve smoking cessation rates effective behavioral and pharmacological treatments, together with professional counseling and advice are required. Since smoking duration is the major risk factor for smoking - related morbidity the treatment goal should be early cessation and prevention of relapse. Nowadays, guidelines from national and worldwide medical organizations promote treatment for tobacco dependence. Pharmacological treatment is an essential cornerstone of treatment for tobacco dependence. Nicotine replacement therapy and sustained released bupropion are recommended as first line treatment in the updated guidelines, in conjunction with behavioral intervention for the management of smoking cessation. Pneumon 2005, 18(3):245-262.
     
  • Pneumococcus is a major cause of community-acquired infections and the most common cause of death due to CAP. Today, efficacy of empiric treatment is doubtful because of the rapid escalation of pneumococcus resistance to â-lactams and macrolides, as well as, of its multi-drug resistance, that is, the additional resistance to various other common agents. Therefore, microbiologists must work according to international recommendations, in order to provide accurate information about pneumococcus resistance, while clinicians must be alert, adopting laboratory results in order to avoid treatment failures. The incidence of resistance to â-lactams and macrolides is highly variable among countries. Specifically, penicillin resistance is higher in SW and NE Europe, as well as in S. Africa, while erythromycin resistance has escalated dramatically, especially in the countries of NE Asia. Finally, pneumococcus multi-resistance, higher among pneumococcal strains displaying penicillin resistance, provides new limitations in antibiotic treatment efficacy. Geographical variations and risks for treatment failure address the need for clinical trials at national level and in all countries in order for useful empiric schemes to be developed. Pneumon 2005, 18(3):265-276.
     
  • lung, respiration, oxygen
    Knowledge about lung anatomy and respiratory function appearing in Greek texts of the 18th and early 19th century is presented. It is documented that new knowledge about the critical role of oxygen in the function of respiration was quickly transferred in the Greek region by medical texts translated in the Greek language. Pneumon 2005, 18(3):279-282.
     
  • Lung cancer is amongst the most frequent and malignant of neoplasms. Its mortality rates place it first of all types of cancer with more than 1.000.000 deaths annually worldwide. It is characterized by a series of biological and clinical features that position it in the epicenter of current research efforts. To this end, it is noted that this cancer responds poorly to various immunotherapeutic interventions as opposed to other malignancies.
     
  • Floros J., Tina L.
    Red cells' transfusions are a cornerstone of critical care practice. By the day 3 in the ICU, most of the patients are anemic, due to phlebotomy or due to their clinical condition. A restrictive strategy of red cell transfusion for Hgb values <7gr/dl is effective and well tolerated, with the possible exception of patients with cardiovascular diseases. The age of red 'blood cells transfused is related to the outcome and oxygen delivery of ICU patients. It is not clear if blood transfusions improve the outcome related to mechanical ventilation, even if there are some studies that show improvement in the weaning process of severe COPD patients. The use of EPO reduces the number of blood transfusions and helps to achieve higher Hgb levels. Pneumon 2005, 18(3):298-304.
     
  • Oxidative stress due to increased production of oxygen free radicals has been reported in various respiratory diseases including asthma and pneumonia. An imbalance between oxidant and antioxidant production has also been proposed in these patients. In the present study, serum total antioxidant status (TAS) was measured in patients with severe exacerbation of bronchial asthma or community-acquired pneumonia; a possible correlation between TAS and disease severity was investigated. Twenty patients (10 men, 10 women; mean age 41±20 years) admitted to hospital for severe exacerbation of asthma and thirty patients (22 men, 8 women; mean age 48±21 years) with community-acquired pneumonia were studied. Ten healthy non-smokers (44±16 years of age) were also included in the study. On days 1 and 7, serum total antioxidant status was measured using a colorimetric method in 600 nm. At the same time, clinical and laboratory severity criteria were recorded in both groups of patients. In the first measurement, TAS values were found statistically significantly lower in both asthma and pneumonia patients compared to normal subjects (0.98±0.08 vs 1.19±0.09 mmol/L, p<0.001; and 0.84±0.13 vs 1.19±0.09 mmol/L, p<0.001, respectively). TAS values obtained on day 1 were also lower compared to the respective values on day 7 in both groups of patients (0.98±0.08 vs 1.12±0.17 mmol/L, p<0.001; 0.84±0.13 vs 1.00±0.17 mmol/L, p=0.0001, respectively). In asthmatic patients, TAS changes correlated with FEV1 changes (r=0.58, p=0.007). In pneumonia patients, TAS changes were associated with factors predisposing to pneumonia (p>0.001), complications (p=0.005), and pneumonia caused by Gram(-) bacteria (p=0.008). Additionally, TAS changes correlated with white blood count (r=0.39, p=0.03), especially polymorphonuclear cell count (r=0.36, p=0.05). Finally, the comparison between TAS values in asthma and pneumonia showed statistically significantly lower values in pneumonia in both measurements (0.84±0.13 vs 0.98±0.08 mmol/L, p<0.001; 1.00±0.17 vs 1.12±0.17 mmol/L, p<0.001, respectively). We concluded that serum total antioxidant status in patients with severe exacerbation of bronchial asthma or community-acquired pneumonia is relatively low at the onset of the disease. In the course of the disease, an increase in total antioxidant status is consistent with clinical and laboratory improvement. Total antioxidant status changes are associated with respective changes in parameters related to disease severity in both asthma and pneumonia patients. Pneumon 2005, 18(3):315-324.
     
  • Oxidative stress due to increased production of oxygen free radicals has been reported in various respiratory diseases including asthma and pneumonia. An imbalance between oxidant and antioxidant production has also been proposed in these patients. In the present study, serum total antioxidant status (TAS) was measured in patients with severe exacerbation of bronchial asthma or community acquired pneumonia; a possible correlation between TAS and disease severity was investigated. Twenty patients (10 men, 10 women; mean age 41±20 years) admitted to hospital for severe exacerbation of asthma and thirty patients (22 men, 8 women; mean age 48±21 years) with community-acquired pneumonia were studied. Ten healthy non-smokers (44±16 years of age) were also included in the study. On days 1 and 7, serum total antioxidant status was measured using a colorimetric method in 600 nm. At the same time, clinical and laboratory severity criteria were recorded in both groups of patients. In the first measurement, TAS values were found statistically significantly lower in both asthma and pneumonia patients compared to normal subjects (0.98±0.08 vs 1.19±0.09mmol/L, p<0.001; and 0.84±0.13 vs 1.19±0.09mmol/L, p<0.001, respectively). TAS values obtained on day 1 were also lower compared to the respective values on day 7 in both groups of patients (0.98±0.08 vs 1.12±0.17 mmol/L, p<0.001; 0.84±0.13 vs 1.00±0.17 mmol/L, p=0.0001, respectively). In asthmatic patients, TAS changes correlated with FEV1 changes (r=0.58, p=0.007). In pneumonia patients, TAS changes were associated with factors predisposing to pneumonia (p>0.001); complications (p=0.005); and pneumonia caused by Gram (-) bacteria (p=0.008). Additionally, TAS changes correlated with white blood count (r=0.39, p=0.03), especially polymorphonuclear cell count (r=0.36, p=0.05). Finally, the comparison between TAS values in asthma and pneumonia showed statistically significantly lower values in pneumonia in both measurements (0.84±0.13 vs 0.98±0.08 mmol/L, p<0.001; 1.00±0.17 vs 1.12±0.17 mmol/L, p<0.001, respectively). We concluded that serum total antioxidant status in patients with severe exacerbation of bronchial asthma or community-acquired pneumonia is relatively low at the onset of the disease. In the course of the disease, an increase in total antioxidant status is consistent with clinical and laboratory improvement. Total antioxidant status changes are associated with respective changes in parameters related to disease severity in both asthma and pneumonia patients. Pneumon 2005, 18(3):305-314.
     
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