The Clinical Significance of Pollen and Fungi Concentrations for Allergic Rhinitis: A Three-Year Study.

INTRODUCTION: The relationship between disease severity and exposure to allergens in allergic rhinitis (AR) patients is not fully clarified presently. We aimed to detect the correlation between airborne pollen and fungi concentrations in a Mediterranean region with symptom scores. METHODS: A total of 98 patients suffering from AR rated their symptoms at the time of exacerbation using the Total 5 Symptoms Score (T5SS) and the Visual Analogue Scale (VAS). Patients' quality of life (QoL) was estimated by using either disease-specific (Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and mini-RQLQ) or generic (Short-Form 36 (SF-36) and Beck Depression Inventory (BDI)) questionnaires. All patients' responses were correlated with aerobiological data. Skin prick tests (SPTs) were used to detect sensitivities to the most common registered pollen and fungi species. RESULTS: A significant positive correlation between total pollen and fungi counts and disease-specific questionnaires was found only for the RQLQ. Accordingly, a significant positive correlation was found between total pollen and fungi counts and T5SS (r = 0.655, p = 0.021), with breathing (r = 0.620, p = 0.032) and sneezing (r = 0.660, p = 0.020) being strongly affected. Moreover, a tendency toward a higher VAS score was found as total pollen and fungi counts increased (r = 0.523, p = 0.081). CONCLUSION: We found a significant correlation between patients' symptoms and pollen and fungal air concentrations. Our results emphasize the clinical significance of pollen and fungi maps in everyday clinical practice.

A Rare Case of a Giant Sialolith Within Wharton's Duct.

Sialolithiasis is a common disease characterized by the formation of calculi within the salivary glands or their ducts. Although many cases of large stones located within the submandibular gland have previously been reported, the presence of a giant stone within Wharton's duct is extremely rare. We report the case of a patient who presented with an unusually large stone measuring about 6 cm in the greatest dimension located within Wharton's duct and causing local swelling and pain. The sialolith was successfully removed intraorally indicating that a minor procedure under local anesthesia can be a successful treatment modality even in the case of a giant sialolith.

"How Do Greeks Sleep?" A Cross-Sectional Study among Indigenous and Minority Populations.

Objective: To investigate sleep habits and their potential relationship with several sociodemographic, lifestyle and health related characteristics among indigenous and minority populations in Northeastern Greece. Materials and methods: Nine hundred fifty seven adults aged 19 to 86 years were enrolled in this cross-sectional study. Self-reported structured questionnaires were utilized. Results:The reported mean sleep duration on a weekly basis was 6:26±1:10 hours (range, 04:00 to 10:00 hours); sleep duration was 26 min longer on weekends (p < 0.001). In multivariate linear regression analysis, older age (ß=-26.7 min, p=0.010), being divorced or widowed (ß=-29.0 min, p < 0.001), high alcohol (ß=-39.7 min, p < 0.001) or coffee (ß=-36.9 min, p=0.006) consumption, screen exposure before bedtime for 1-2 hours (ß=-18.9 min, p=0.004) or > one hour (ß=-34.4 min, p < 0.001), having a child aged under six years (ß=-62.3 min, p < 0.001), napping for > 30 min during the day (ß=-35.2 min, p < 0.001) and morbidity (ß=-21.5 min, p < 0.001) were independently associated with short sleep duration and lower sleep efficiency. Moreover, a tendency towards short sleep duration was associated with anxiety (ß=-8.8 min, p=0.078) and depression (ß=-12.8 min, p=0.029). Obesity (ß=10.7 min, p=0.047), being a university student (ß=41.0 min, p=0.002), high financial status (ß=16.6 min, p=0.037) and high adherence to Mediterranean diet (ß=15.4 min, p=0.002) were associated with long sleep duration. Conclusion:This study illustrates the association of sleep disturbances with several sociodemographic and health-related factors and dictates conduction of larger scale prospective studies to evaluate causality on the relationship between sleep patterns and lifestyle factors.

Invasive Fungal Rhinosinusitis in the Era of COVID-19: Is It an Emerging Association?

Invasive fungal rhinosinusitis (IFRS) typically affects immunocompromised patients. The coronavirus disease 2019 (COVID-19) pandemic may be associated with rare opportunistic fungal infections, probably as a result of immune dysregulation. The COVID-19 infection is characterized by low levels of CD4+T and CD8+T cells which could increase the risk of co-infections from Mucor or Aspergillus species. An invasive fungal infection should be suspected in patients who have recently recovered from COVID-19 pneumonia and present with acute destructive rhinosinusitis. There are few cases of IFRS reported in Europe during the pandemic of COVID-19. We describe the case of a 67-year-old patient with diabetes who received corticosteroids during the treatment for COVID-19 infection and was readmitted a few days later for radiologically and clinically suggested IFRS. Aspergillus niger was identified, and the patient received pharmacological and surgical treatment.

Lip angioedema after indirect contact with a sea anemone.

Sea anemones are marine animals that can produce toxins causing severe angioedema. Swimmers and divers should be aware of sea anemone species that can cause local and systemic toxic reactions and avoid indirect or direct skin contact. High index of suspicion, full laboratory workup, and treatment with steroids and antibiotics are imperative for an uneventful recovery.

Alendronate effect in esophagus, stomach and liver: an animal based pathological study.

Bisphosphonates are commonly used in clinical practice. Their effectiveness is indisputable, however their adverse effects, especially in the GI tract, are still controversial. In our report, we demonstrate pathological findings of the effect of systematic alendronate administration in esophagus, stomach and the liver of an in-vivo animal model of 15 Wistar rats. Light microscopy with immunohistochemistry and electron microscopy were used. Microscopic findings of inflammation of the stomach and mild hepatic dysfunction were observed. Conclusively, alendronate can potentially affect gastric mucosa and liver function on this animal experimental model.

Cytotoxicity and genotoxicity induced in vitro by solvent-extractable organic matter of size-segregated urban particulate matter.

Three organic fractions of different polarity, including a non polar organic fraction (NPOF), a moderately polar organic fraction (MPOF), and a polar organic fraction (POF) were obtained from size-segregated (<0.49, 0.49-0.97, 0.97-3 and >3 µm) urban particulate matter (PM) samples, and tested for cytotoxicity and genotoxicity using a battery of in vitro assays. The cytotoxicity induced by the organic PM fractions was measured by the mitochondrial dehydrogenase (MTT) cell viability assay applied on MRC-5 human lung epithelial cells. DNA damages were evaluated through the comet assay, determination of the poly(ADP-Ribose) polymerase (PARP) activity, and the oxidative DNA adduct 8-hydroxy-deoxyguanosine (8-OHdG) formation, while pro-inflammatory effects were assessed by determination of the tumor necrosis factor-alpha (TNF-α) mediator release. In addition, the Sister Chromatid Exchange (SCE) inducibility of the solvent-extractable organic matter was measured on human peripheral lymphocyte. Variations of responses were assessed in relation to the polarity (hence the expected composition) of the organic PM fractions, particle size, locality, and season. Organic PM fractions were found to induce rather comparable Cytotoxicity and genotoxicity of PM appeared to be rather independent from the polarity of the extractable organic PM matter (EOM) with POF often being relatively more toxic than NPOF or MPOF. All assays indicated stronger mass-normalized bioactivity for fine than coarse particles peaking in the 0.97-3 and/or the 0.49-0.97 µm size ranges. Nevertheless, the air volume-normalized bioactivity in all assays was highest for the <0.49 µm size range highlighting the important human health risk posed by the inhalation of these quasi-ultrafine particles.