This study analyses the evolution of the bibliometric indicators of productivity and repercussion of European Union (EU) research into the respiratory system during the period from 1987–1998, describing the geographical distribution.Using MedLine, a selection was made of those articles by EU authors published between 1987–1998 in 38 respiratory system journals (classification from the Institute for Scientific Information). The journals, country of origin, number of articles and the relation to socioeconomic data, productivity index, visibility index, expected impact factor (EIF) and relative impact factor (RIF) were all analysed.The number of EU publications in respiratory system journals experienced an exponential increase, going from 606 articles (14.3% of world production) in 1987, to 2,325 (33.2%) in 1998. During this same period, the EIF increased from 1,258 to 2,111. The greatest gross productivities were those of the UK, France, Italy and Germany, although when corrected for number of inhabitants, Sweden, the Netherlands, Belgium and Denmark headed the list. The countries with the greatest mean EIF were the Netherlands, the UK, Spain and Belgium.In conclusion, productivity and repercussions of European Union research of the respiratory system experienced an important increase during this period.
In patients with chronic renal failure, renal transplantation improves anemia and the production of erythropoietin. In patients undergoing hemodialysis the administration of recombinant human erythropoietin improves anemia with a decrease in bodily iron stores. Therefore, one would expect a similar decrease after kidney transplantation. We followed the ferric parameters to determine the incidence of iron deficiency anemia in 24 consecutive renal transplant patients for an interval long enough to achieve steady state values of hemoglobin (5.1 +/- 0.8 months). Hematological parameters and serum levels of iron, ferritin and erythropoietin were measured. The patients were divided into 2 groups according to the decrease in serum ferritin: group 1--16 with a decrease in respect to basal values (114 +/- 56 ng./ml.) and group 2--those without modifications (720 +/- 320 ng./ml.). Except for the similar values, group 1 showed greater improvement in anemia (red blood cells 4.3 x 10(6) +/- 1.1 x 10(6) versus 3.7 x 10(6) +/- 1.5 x 10(6)/ml., p < 0.01) and hematocrit index (38.5 +/- 5.2 versus 33.0 +/- 5.1%, p < 0.05). Four patients had microcythemia (mean corpuscular volume 76.6 +/- 1.4 fluid) with lower hemoglobin values than the other patients in group 1 (10.77 +/- 0.42 versus 12.79 +/- 0.42 gm./dl., p < 0.05). Among the 16 patients in group 1, 7 of 8 whose basal serum ferritin was less than 150 ng./ml. achieved ferritin levels of less than 30 ng./ml. In conclusion, our data support that renal transplantation produces a rapid decrease in iron stores and in some cases induces iron deficiency anemia. This fact should be evaluated and treated properly.
Key words: allergic bronchopulmonary aspergillosis; bronchial asthma; bronchoscopy; fungal hyphae; lung cancer; mucoid impaction.. WE report a case of bronchopulmonary aspergillosis (ABPA) that was exceptional because, ®rstly, ABPA was diagnosed in a patient without evidence of asthma, and, secondly, the endobronchial mass found at bronchoscopy led to a misdiagnosis of bronchogenic carcinoma. A 65-year-old man with a smoking history of 20 cigarettes a day from the age of 15 to 45 years had had persistent cough and some mucous expectoration for 5 months. A small in®ltrate in the right upper lobe was seen on the chest roentgenogram, and complete obstruction of the apical and posterior segmental bronchi of the right upper lobe by a whitish irregular mass was detected by ®beroptic bronchoscopy. Microscopic examination of biopsies revealed fragments covered by respiratory epithelium with squamous metaplasia; an in®ltration of lymphocytes, plasma cells, and neutrophils; edema; and focal necrosis. Ziehl-Neelsen and periodic acid-Schiff stains of biopsy samples were negative. A computed tomography (CT) scan of the chest disclosed a nodular mass in the right upper lobe with a peribronchovascular in®ltrate that spread to the hilum. With the diagnosis of bronchogenic carcinoma, a thoracotomy with atypical resection of the apical and posterior segments of the right upper lobe was performed. Bronchi ®lled with abundant mucoid material with areas of mixed in®ltrate that disrupted the bronchial wall were observed on microscopic examination of the surgical specimen, and a diagnosis of bronchiectasis with abscessed bronchopneumonia was made. One year after operation, the patient was readmitted because of persistent cough, expectoration, and systemic symptoms of illness. Laboratory studies were negative except for a serum IgE level of 2370 U/ml. The chest roentgenogram showed bilateral perihilar alveolar in®ltrates, but multiple transbronchial biopsies, and bacteriologic tests were unrevealing. Histopathologic review of the surgically excised lung tissue specimens revealed large bronchial dilations with the bronchial lumen ®lled with mucoid material and an in¯ammatory in®ltrate. In®ltrating cells were mostly eosinophils. Small bronchioles showed disrupted walls and were ®lled with necrotic cellular remnants and an intense mixed in¯ammatory in®ltrate, although without evidence of well-de®ned granulomas. Through the methenamine silver stain, septate hyphae of Aspergillus were clearly observed in the mucous plugs, and the diagnosis of ABPA was established. Precipitating antibodies and immediate skin reactivity to Aspergillus antigen were then observed. Treatment with oral prednisone resulted in a remarkable clinical response and resolution of the pulmonary in®ltrate. Cases of ABPA in nonasthmatic patients have been occasionally reported in the literature. In eight of the 19 cases of ABPA in nonasthmatic patients (1, 3±5), a bronchogenic carcinoma was initially suspected due to abnormalities in the chest roentgenogram (mostly atelecta...
The clinical, hematological, and biochemical characteristics of a new family with heterozygous hemoglobin (Hb) Louisville are described. The family showed a decrease in both oxygen affinity and cooperativity with the normal Bohr effect. This family has the greatest number of affected members reported to date. Among the descendants, two first cousins (III-10 and III-11), both of whom are affected by the heterozygous trait of Hb Louisville, had had three abortions of undetermined causes.
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