Occupational exposure and the risk of new-onset chronic rhinosinusitis â€" a prospective study 2013-2018.

BACKGROUND: The aetiology behind chronic rhinosinusitis (CRS) is still poorly understood. The aim of this study was to investigate the association between the onset of CRS and several common occupational exposures over time. METHODOLOGY: An adult random population from Telemark, Norway, comprising 7,952 subjects, who answered a comprehensive respiratory questionnaire including questions on CRS and occupational exposure first in 2013 and again in 2018. RESULTS: New-onset CRS during the five-year follow-up was independently associated with occupational exposure to hair-care products, cleaning agents among women, super glue, strong acids, cooking fumes and wood dust. CONCLUSION: In this random population cohort from Norway, exposure to several common occupational agents, such as hair-care products, super glue and wood dust, was associated with the onset of CRS. It is important that physicians who see patients with CRS inquire about workplace exposure.

Recruitment of CD34+ cells during large-volume leukapheresis.

Mobilized peripheral blood stem and progenitor cells (PBPCs) are increasingly used to restore hematopoiesis after myeloablative treatment. To obtain a sufficient number of CD34(+) cells, many studies have focused on the improvement of the collection technique during the leukapheresis procedure (LP), and so-called large-volume leukapheresis (LVL) procedures have been developed. Such procedures can be performed by extending the duration of the LP and/or by increasing the inlet flow rate. However, no previous studies have compared the efficiency of these procedures. In the present study, we compared the kinetics of PBPCs recruitment (including CD34(+) cell subsets), the PBPCs yield, and the collection efficiency as well as the overall feasibility of the procedures during a single LVL performed by standard (group I) (median 85 ml/min; range 50-97 ml/min) and high inlet flow rates (group II) (median 130 ml/min; range 110-150 ml/min). Seven patients with hematological malignancies were enrolled and allocated to each group. The patients' blood volumes (BV) were processed four times. The apheresis product (AP) was collected in four separate bags, which were changed every time one BV had been processed. The CD34(+) cell number and CD34(+) cell subsets were assessed in the four collection bags and in peripheral blood (PB) before every time one BV had been processed and after the leukapheresis. The CD34(+) cell yield exceeded the pre-apheresis CD34(+) cell number per ml BV in 6 out of 7 patients in group I and in 3 out of 7 patients in group II. In group II, the recruitment of CD34(+) cells from the bone marrow (BM) to PB starts in the second collection period--as early as 30-60 min after initiating the procedure. No exhaustion in the recruitment was observed in the two groups for at least 5 h during the leukapheresis, and all CD34(+) cell subsets were recruited at a steady rate. However, the collection efficiency in group II was only half of that in group I. In addition, we experienced many technical problems during the leukapheresis in group II. Thus, in 4 out of 7 patients in this group, it was not possible to perform the maximal inlet flow rate because of catheter problems. In conclusion, due to the technical problems associated with the high inlet flow rate procedure and the fact that the relative number of CD34(+) cells harvested and recruited during the leukapheresis was higher in group I than II and, also reflected an approximately two-fold higher collection efficiency, we recommend that LVL be performed by standard inlet flow rate.

Bacterial vaginosis treated with metronidazole. Effects on the vaginal microbiology by a single dose versus a five days regimen.

The microbiological vaginal flora was studied in 42 women with clinical findings consistent with the concept bacterial vaginosis (BV). The women and their consorts were treated with metronidazole (Flagyl), either a single dose of 2,000 mg or 400 mg three times daily for five days. Effect of treatment was assessed four weeks after its initiation. Clinical cure was attained in more than 80% of the cases and was the same irrespective of treatment. The microbiologic flora changed by treatment in direction to normal, i.e. lactobacilli regained predominance and reduction of Gardnerella vaginalis and anaerobic grampositive cocci was evident. There was no difference evident in the microbiological changes induced by the two treatment regimens. The findings support previous conclusions that BV represents a disorder of the vaginal milieu and is not the result of an infection with pathogenic microorganisms.

Can Gardnerella vaginalis and anaerobic curved rods attach to vaginal epithelial cells in vitro, resulting in clue cells?

Vaginal epithelial cells were taken from asymptomatic patients and from patients with non-specific vaginosis. Four bacterial species-Gardnerella vaginalis, Wolinella succinogenes and short and long anaerobic curved rods-were tested in vitro regarding attachment to the epithelial cells. In most experiments the curved rods and W. succinogenes attached to the cells. Less often, incubation with G. vaginalis resulted in cell attachment. There was no difference in attachment ability between the short and long rods. Clue cells were not often produced in these in vitro experiments.