For the first time in Thessaloniki, Greece, 15-year allergenic pollen records were conducted. Clinical observations confirm that the pollen mainly implicated in respiratory allergy symptoms are grasses, olive and wall pellitory.

A pollen calendar has been constructed for the area of Thessaloniki and relationships between pollen transport and meteorological parameters have been assessed. Daily airborne pollen records were collected over a 15-year period (1987-2001), using a Burkard continuous volumetric pollen trap, located in the centre of the city. Sixteen allergenic pollen types were identified. Simultaneously, daily records of five main meteorological parameters (mean air temperature, relative humidity, rainfall, sunshine, wind speed) were made, and then correlated with fluctuations of the airborne pollen concentrations. For the first time in Greece, a pollen calendar has been constructed for 16 pollen types, from which it appears that 24.9% of the total pollen recorded belong to Cupressaceae, 20.8% to Quercus spp., 13.6% to Urticaceae, 9.1% to Oleaceae, 8.9% to Pinaceae, 6.3% to Poaceae, 5.4% to Platanaceae, 3.0% to Corylus spp., 2.5% to Chenopodiaceae and 1.4% to Populus spp. The percentages of Betula spp., Asteraceae (Artemisia spp. and Ambrosia spp.), Salix spp., Ulmaceae and Alnus spp. were each lower than 1%. A positive correlation between pollen transport and both mean temperature and sunshine was observed, whereas usually no correlation was found between pollen and relative humidity or rainfall. Finally, wind speed was generally found to have a significant positive correlation with the concentrations of 8 pollen types. For the first time in the area of Thessaloniki, and more generally in Greece, 15-year allergenic pollen records have been collected and meteorological parameters have been recorded. The airborne pollen concentration is strongly influenced by mean air temperature and sunshine duration. The highest concentrations of pollen grains are observed during spring (May).

Weight loss has been recognized as a feature of advanced emphysema and a factor of poor prognosis, but its mechanisms remain obscure. Studies have demonstrated high serum concentrations of TNF-a (cachexin) in chronic obstructive pulmonary disease (COPD) patients with emphysema. Pink puffers (PP) COPD patients have worse tissue oxygenation when compared with blue bloaters (BB) COPD patients. Consequently, PP patients would become cachectic, whereas BB patients with better tissue oxygenation would not. The aim of this study is to test the hypothesis that malnutrition in emphysema is a cytokine-mediated marker of chronic progressive tissue hypoxia. Thirty male COPD patients, without clinical or laboratory evidence of infection and severe air way obstruction (FEV1 < 1.5 l) were allocated: 16 as pink puffers (PP) and 14 as blue bloaters (BB). Lung function measurements included FEV1, FVC, RV, TLC, DLCO and arterial blood gases on room air. TNF-a serum levels were measured by immunoenzymic method (ELISA). Tissue oxygenation was assessed from oxygen delivery (DO2), PvO2 and oxygen extraction ratio (O2ER) obtained after right heart catheterization with Swan Ganz catheter. PP patients demonstrated lower DLCO and higher TLC, FRC and PaO2 from BB. We found that oxygen delivery was better in our BB than in PP patients (CI 2.9 +/- 0.2 vs 2.5 +/- 0.4 l/min/m2--P < 0.01, DO2 16.1 +/- 2.1 vs 13.1 +/- 0.2 ml/min/kg--P < 0.001) and the same was found for tissue oxygenation (PvO2 34.6 +/- 2.9 vs 31.2 +/- 3.8 mmHg--P < 0.01, O2ER 0.27 +/- 0.02 vs 0.34 +/- 0.06%--P < 0.001). The TNF-a values were higher in PP (31.3 +/- 26 pg/ml vs 15.2 +/- 9.9 pg/ml--P < 0.05) and their percent fat-free mass (%FFM) was 49.6 +/- 11.5 vs 42 +/- 8%--P < 0.001. We found that COPD patients with lower DO2 had increased TNF-a levels; but the correlations between TNF-a serum levels and PvO2 or O2ER were not statistically significant. TNF-a levels were elevated in PP patients with tissue hypoxia and may be a factor contributing to the weight loss of these patients.

The effects of PEEPe on iso-volume flow and hence on lung mechanics and hemodynamics, depend on many factors, such as airways resistances, lung volumes and airway characteristics, making the patient response to PEEPe unpredictable.