Effects of traffic air pollution and hornbeam pollen on adult asthma hospitalizations in Zagreb.

BACKGROUND: Environmental factors play an important role in asthma morbidity, although the contribution of individual pollutants or pollens in exacerbating asthma is not completely elucidated. Despite the evidence of importance of the hornbeam pollen in inducing allergic sensitization, its role in provoking asthma exacerbation has not been evaluated. The aim of the present study was to investigate effects of traffic pollutants on adult asthma hospitalization adjusting for pollens including hornbeam. METHODS: During a 3-year period, health and environmental data were collected and analyzed. Daily asthma hospitalizations were regressed on pollutants and potential confounding variables using an autoregressive Poisson model. RESULTS: The risk of asthma hospitalization was associated significantly with the 95th to 99th percentile increase in levels of nitrogen dioxide (RR = 1.22; 95% CI: 1.05-1.40), carbon monoxide (RR = 1.25; 95% CI: 1.01-1.55) and hornbeam pollen (RR = 1.21; 95% CI: 1.11-1.30). The effect of nitrogen dioxide was delayed by 5 days. No statistically significant increase in the risk of asthma hospitalization was found for PM(10) particles. A comparison among the standardized regression coefficients and their respective p values indicates that the most important risk factor for asthma hospitalization is associated with hornbeam pollen levels. No statistically significant interactions between pollutants and pollens were detected. CONCLUSIONS: The current results suggest that traffic-related air pollution is associated with increased risk of adult asthma hospitalization. Nonetheless, the most significant risk for asthma hospitalization is associated with hornbeam pollen levels in the city of Zagreb.

Lymphomatoid granulomatosis in a 23-year-old man--cytological and histological typing and rapid response to steroid and cyclophosphamide combination therapy.

Lymphomatoid granulomatosis (LG) is currently called as extranodal angiocentric and angiodestructive immunoproliferative disorder with various degrees of histological differentiation and disease severity. Histological grading and clinical manifestations are due to number of atypical large EBV + B-lymphatic cells. We report the case of a 23-year-old man clinically presented with fever, sweating, and physical intolerance, and bilateral pulmonary infiltrates of nodular type and destructive changes on the chest X-ray, previously treated with antituberculotics for 1.5 month. As the disease showed progression, diagnostic procedures extended to transbronchial lung biopsy and percutaneous fine needle aspiration with cytological and histological analysis of collected specimens, all being not conclusive enough. LG was confirmed by open lung biopsy, followed by induction of corticosteroids and cyclophosphamide therapy. Very good clinical, functional and radiomorphologic improvement was achieved in a few weeks, and remission of disease maintained in long term follow-up.

[Paraneoplastic syndrome associated with antiphospholipid antibodies]. / Paraneoplasticki sindrom povezan s antifosfolipidnim protutijelima.

In patients with malignant tumour signs and symptoms develop that cannot be explained on the basis of the mass effect produced by either primary tumour or its metastases, production of a hormone associated with tissue type giving rise to the malignant tumour, or patients' immune status. These symptom complexes are known as paraneoplastic syndrome. It is known that the patients with malignant tumours are prone to develop venous thromboembolism in any stage of their disease. It is suggested that thromboembolic manifestations in cancer patients may be part of the secondary antiphospholipid syndrome (APS) and an example of the paraneoplastic autoimmunity, eg., paraneoplastic syndrome. Antiphospholipid antibodies (APA), e.g., anticardiolipin antibodies (ACA) and circulating lupus anticoagulant (LAC) are known to predispose to venous and arterial thromboses. The growing number of clinical reports on the association of APA and malignant tumours suggests that APA may be one of contributory factors in the paraneoplastic thromboembolism occurring in malignancy.