The effects of air pollution on pulmonary function and respiratory status was evaluated in 1,626 school aged children from a European Alpine region. Based on measurements of SO2, NO2 and O3 as well as infrared imaging and lichen mapping, three zones of exposure were defined. Results of standardized respiratory questionnaires, medical examinations, and lung function tests were compared among the children in the three different exposure zones. After controlling for age, sex, height, socioeconomic status, and exposure to environmental tobacco smoking, areas of increased SO2 and NO2 as well as areas of increased ozone (max. half hourly mean value, 146 ppb) were significantly associated with decrements of forced expiratory volume in 1 s (FEV1) and flow rates at 50 and 75% of vital capacity (FEF50 FEF75). In addition, areas with increased ozone had a higher prevalence of asthma In all regions, maternal smoking was associated with reduced expiratory flow rates and increased prevalence of asthma. The results provide evidence that outdoor pollution and exposure to passive smoking are risk factors for childhood respiratory health. © 1993 Wiley‐Liss, Inc.

Experience with erythropoietin in the treatment of anemia in predialysis patients is limited. A practical treatment regimen which minimized the number of outpatient visits was investigated. The Austrian multicenter study included 123 patients. At baseline, the treatment protocol mandated once weekly the administration of 10,000 U recombinant human erythropoietin (r-HuEPO) subcutaneously. The follow-up period was 3 months, and dose adjustments were made at monthly intervals. At baseline, the mean values for creatinine were 6.2 +/- 0.2 mg/dl, and for hemoglobin (Hb) 9.0 g/dl. During 3 months of therapy, mean Hb increased to 10.8 g/dl and creatinine to 6.6 mg/dl. The initial r-HuEPO weekly dose was 10,000 U. The mean dose after 3 months was 9,000 +/- 4,000 U. There was no significant alteration of the slope of the reciprocal creatinine curve or of blood pressure values. No side effects occurred during the 3-month treatment period. In conclusion, the results of this multicenter trial demonstrate that using a simple once-weekly subcutaneous treatment regime, r-HuEPO can be administered safely and effectively in predialysis patients.

Thyroid hormone (free and total thyroxine, total 3,5,3'- and 3,3'5'-triiodothyronine, thyroxine-binding globulin, thyrotropin) serum concentrations were measured in 107 uremic patients of 4 hemodialysis centers, in order to study the prevalence of hypothyroidism in hemodialysis patients. In accordance with the clinical impression there was no laboratory evidence of thyroid dysfunction. In spite of the fact that all patients had the expected low-T3 syndrome, there were highly significant differences between the mean thyroid hormone concentrations of the 4 different centers. The center with the highest thyroid hormone levels (all normal except for borderline low 3,5,3'-triiodothyronine) also had the lowest urea levels, indicating the relatively best metabolic control. One center had significantly lower hormone levels than the other 3 centers (all hormones except free thyroxine were below normal) with urea levels that did not differ significantly from one of these centers. A retrospective analysis of patients and of the techniques of dialysis of 3 centers excluded factors like heparin or the length of time on dialysis to be the reason for the low values of this center. Finally, only the significantly higher proportion of unsuccessfully transplanted patients and some technical differences (lack of water treatment, regenerated cellulose as dialyser membrane, and low magnesium content in the dialysate) unique for this center remained as possible factors that may speculatively explain the observed low thyroid hormone values.(ABSTRACT TRUNCATED AT 250 WORDS)