Skin and lung fibrosis induced by bleomycin in mice: a systematic review.

OBJECTIVE: Scleroderma, or systemic sclerosis (SSc), is a chronic autoimmune connective disease with an unknown etiology and poorly understood pathogenesis. The striking array of autoimmune, vascular, and fibrotic changes that develop in almost all patients makes SSc unique among connective tissue diseases. Although no animal model developed for SSc to date fully represents all features of human disease, some animal models that demonstrate features of SSc may help to better understand the pathogenesis of the disease and to develop new therapeutic options. In this review, we aimed to evaluate skin fibrosis and lung involvement in a bleomycin (BLM)-induced mouse model and to evaluate the differences between studies. METHODS: A systematic literature review (PRISMA guideline) on PubMed and EMBASE (until May 2023, without limits) was performed. A primary literature search was conducted using the PubMed and EMBASE databases for all articles published from 1990 to May 2023. Review articles, human studies, and non-dermatological studies were excluded. Of the 38 non-duplicated studies, 20 articles were included. RESULTS: Among inducible animal models, the BLM-induced SSc is still the most widely used. In recent years, the measurement of tissue thickness between the epidermal-dermal junction and the dermal-adipose tissue junction (dermal layer) has become more widely accepted. CONCLUSIONS: In animal studies, it is important to simultaneously evaluate lung tissues in addition to skin fibrosis induced in mice by subcutaneous BLM application, following the 3R (replacement, reduction, and refinement) principle to avoid cruelty to animals.

The feasibility of T2 mapping in the assessment of hepatic steatosis, inflammation, and fibrosis in patients with non-alcoholic fatty liver disease: a preliminary study.

AIM: To determine the feasibility of magnetic resonance imaging T2 mapping in the quantification of liver steatosis in patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and to assess the effect of inflammation and fibrosis on T2 values of the liver. MATERIAL AND METHODS: Twenty-three consecutive patients with biopsy-proven NAFLD who underwent T2 mapping between December 2013 and September 2014 were included in this study. All patients underwent fast spin echo multi-echo sequence with eight echoes for T2 measurements. RESULTS: The mean liver T2 value and percentage of histological steatosis was 64.9 ± 7.4 ms and 46.5 ± 27.6%, respectively. There was a good correlation between the liver T2 value and histology-determined steatosis (r = 0.780, p<0.001) and grade of steatosis (rs = 0.779, p<0.001). The mean T2 value in patients with definitive non-alcoholic steatohepatitis (NASH) was significantly higher in comparison with patients without NASH (69 ± 7.37 versus 61.73 ± 5.99 ms, p=0.016). The correlation between T2 value and NAFLD activity score (NAS) was significant (rs = 0.443, p=0.034); however, the correlation disappeared after adjustment for hepatic steatosis and fibrosis (r=0.131, p=0.572). There was a close inverse correlation between T2 value and fibrosis stage after adjusting for hepatic steatosis (r=-0.536, p=0.012). CONCLUSION: T2 mapping can be used for quantification of hepatic steatosis, as there is a close correlation between T2 relaxation values and histology-determined steatosis. Patients with definite NASH have increased T2 values and there is an inverse correlation between the T2 value and fibrosis stage of the liver. T2 mapping in NAFLD may be a useful clinical tool for disease assessment and prognostication.

Effects of mouthwashes on color stability and surface roughness of three different resin-based composites.

OBJECTIVE: The aim of this study is to evaluate the effects of different types of mouthwashes (Klorhexidin, Curasept ADS 205, Meridol, Listerine Cool Citrus) on the surface roughness and color changes of a microhybrid (Point 4), a bulk fill (SonicFill), and a nanohybrid (Nova Compo-N) resin-based composite (RBC). MATERIALS AND METHODS: Disk-shaped specimens were prepared from tested RBCs and divided into four subgroups which immersed in four different types of mouthwashes. The specimens were subjected to immersion cycles in the mouthwashes and artificial saliva (n = 8). Each cycle consisted of complete immersion in a mouthwash for 21 min and afterwards in saliva for 12 h at 37°C, and this cycle was repeated 8 times. The surface roughness was evaluated using a profilometer and coloration was evaluated using a spectrophotometer before and after immersion time. One-way analysis of variance (ANOVA) for the evaluation of surface roughness data was performed, and interrelation between groups was identified with the Sheffe's multiple comparison test. RESULTS: There were no significant differences between the Ra values of the RBCs before and after immersion in mouthwashes (P > 0.05). There were significant differences between ΔE value of the SF and NCN groups before and after immersion time (P < 0.05). CONCLUSION: Mouthwashes contribute to oral health, especially in patients at high risk of caries. However, in such patients, patient-specific recommendations should be made when using mouthwashes due to the large number of composite fillings.

Effects of different metabolic states and surgical models on glucose metabolism and secretion of ileal L-cell peptides: results from the HIPER-1 study.

AIM: To compare the impact of four surgical procedures (mini-gastric bypass, sleeve gastrectomy, ileal transposition and transit bipartition) vs medical management on gut peptide secretion, ß-cell function and resolution of hyperglycaemia in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: A mixed-meal tolerance test was administered 6-24 months after each surgical procedure (mini-gastric bypass, sleeve gastrectomy, ileal transposition and transit bipartition; n=30 in each group) and the results were compared with those obtained in matched lean (n=30) and obese (n=30) people with type 2 diabetes undergoing medical management. RESULTS: Participants in the mini-gastric bypass and ileal transposition groups had a greater increase in plasma glucose concentration after the mixed-meal tolerance test than those in the sleeve gastrectomy and transit bipartition groups. Participants in the mini-gastric bypass group exhibited the greatest increase in the incremental area under the curve of plasma glucose concentration above baseline (P<0.0001). Insulin sensitivity was similar across surgical groups, and statistically greater in participants in the surgical groups than in obese participants in the non-surgical group (P<0.0001). ß-cell responsiveness to glucose was greater in participants in the sleeve gastrectomy and transit bipartition groups than in the mini-gastric bypass and ileal transposition groups (P<0.001) despite a smaller incremental increase above baseline in the area under the plasma glucagon-like peptide-1 concentration curve relative to ileal transposition. Postoperative ß-cell function was the strongest predictor of hyperglycaemia resolution. CONCLUSIONS: The present study showed that the level of ß-cell function after bariatric surgery is the strongest predictor of hyperglycaemia resolution. The study also demonstrates a disconnect between postprandial GLP-1 levels and ß-cell function among the studied surgical procedures.

[How well are patients with inflammatory rheumatic diseases protected against measles?] / Wie gut sind Patienten mit entzündlich rheumatischen Erkrankungen gegen Masern geschützt?

BACKGROUND: Patients with inflammatory rheumatic diseases have an increased risk of infections due to the autoimmune disease but also due to the immunosuppressive medication. Although vaccinations are known to be effective in the primary prophylaxis of infections, the vaccination rate in Germany is generally too low. Due to the recently increasing, sometimes epidemic-like occurrence of measles, the administration of live vaccine against measles has recently become required by law. OBJECTIVE: How many patients with inflammatory rheumatic diseases are currently sufficiently protected against measles? METHOD: Between December 2017 and October 2018 patients with inflammatory rheumatic diseases at the Ruhrgebiet Rheumatism Center were prospectively and consecutively included. Data on the disease and treatment at the level of substance classes, patient history of vaccination and infections were collated. All information on vaccinations were controlled in the vaccination certificate. Antibodies against measles were determined using ELISA. The threshold for sufficient protection against measles was set at 150 mIU/ml. RESULTS: Out of 975 patients 540 (55.4%) could present a vaccination certificate. In 201 patients with a certificate (37.2%) vaccination had been documented since birth. Overall, 45 out of 267 patients born after 1970 (16.9%) had sufficient protection against measles. The patient history of measles in childhood showed no differences between patients with and without protective measles IgG antibodies. Protective measles IgG antibodies were detected in 901 out of 928 patients with measurement of the measles IgG antibody level (97.1%). The different principles of action of the current immunosuppressive treatments had no influence on this. CONCLUSION: These data show that at least 2.9% of the patients did not have sufficient protection against measles. Interestingly, the majority of patients born after 1970 had protective antibodies despite the lack of vaccination against measles. The efforts in primary and also in the specialist medical care should be urgently strengthened in order to be able to guarantee an adequate infection prophylaxis in particularly endangered patients.

The microstructure in the placenta is influenced by the functional diversity of HLA-G allelic variants.

The main expression sites of HLA-G are human extravillous trophoblast cells. The interaction of HLA-G with uterine NK cells promotes their maturation and differentiation into decidual NK (dNK) cells. dNK cells secrete chemokines, cytokines, and proangiogenic factors in favor of a vascular remodeling and an immune suppressive microenvironment of the decidua. HLA-G is the most polymorphic member of the oligomorphic non-classical HLA molecule family; yet, the impact of polymorphic differences is not comprehensively understood. sHLA-G levels in embryo culture medium correlate with successful pregnancy; however, it remains questionable if HLA-G allelic diversity impacts on the outcome of dNK cell development. We utilized synthetic sHLA-G*01:01, 01:03, and 01:04 molecules and transduced K652/mHLA-G*01:01, 01:03, and 01:04 cells to study the biological interaction between HLA-G alleles and primary NK cells of human term placenta. Despite its low frequency, HLA-G*01:04 and not the most prevalent allele HLA-G*01:01 appear to be strong catalysts of dNK cell proliferation. Concluding, this study illustrates novel insights into the impact and binding efficiency of the three most common variants of HLA-G on primary placental NK cells.

9.4 T small animal MRI using clinical components for direct translational studies.

BACKGROUND: Magnetic resonance is a major preclinical and clinical imaging modality ideally suited for longitudinal studies, e.g. in pharmacological developments. The lack of a proven platform that maintains an identical imaging protocol between preclinical and clinical platforms is solved with the construction of an animal scanner based on clinical hard- and software. METHODS: A small animal magnet and gradient system were connected to a clinical MR system. Several hardware components were either modified or built in-house to achieve compatibility. The clinical software was modified to account for the different field-of-view of a preclinical MR system. The established scanner was evaluated using clinical QA protocols, and platform compatibility for translational research was verified against clinical scanners of different field strength. RESULTS: The constructed animal scanner operates with the majority of clinical imaging sequences. Translational research is greatly facilitated as protocols can be shared between preclinical and clinical platforms. Hence, when maintaining sequences parameters, maximum similarity between pulses played out on a human or an animal system is maintained. CONCLUSION: Coupling of a small animal magnet with a clinical MR system is a flexible, easy to use way to establish and advance translational imaging capability. It provides cost and labor efficient translational capability as no tedious sequence reprogramming between moieties is required and cross-platform compatibility of sequences facilitates multi-center studies.

Effects of imparting planned health education on hot flush beliefs and quality of life of climacteric women.

OBJECTIVE: The aim of the present study was to determine the effect of imparting planned health education to climacteric women on their beliefs related to hot flushes and on their quality of life. METHODS: The research was conducted using pretest and post-test semi-experimental models along with a control group. Of 450 women, 255 were randomly selected and invited to participate in the study. Five people did not agree to participate in the study. Three people were also excluded from the study because they did not complete training. The research sample was comprised of 247 climacteric women (121 women in the experimental group and 126 women in the control group) who were <65 years (the average ages of the participants in the experimental group were 50.61 ± 5.54 years and in the control group 50.94 ± 6.03 years), had experienced hot flushes within the past month, were going through the menopause and postmenopause, were not using hormone replacement therapy, and had agreed to participate in the study. Participants were asked to complete a Sociodemographic Questionnaire, the Hot Flush Beliefs Scale, and The Menopause-Specific Quality of Life Questionnaire. Three educational sessions at 2-week intervals were given to the women in the experimental group. The research was supported with an educational booklet prepared by the researchers. Training was not given to the women in the control group. After the education of the experimental group (after about 6 months), women in both groups recompleted the data collection forms, and post-test data were collected. RESULTS: On all the subscales, the total of the Hot Flush Beliefs Scale, and the average post-test score, the women in the experimental group scored lower than the women in the control group (the average post-test total score in the experimental group was 26.22 ± 10.09 and in control group it was 52.25 ± 15.04; p < 0.001). While the women in the experimental group developed positive beliefs about their hot flushes, the beliefs of the women in the control group remained unchanged. The average post-test score on all the subscales of the Menopause-Specific Quality of Life Questionnaire for the women in the experimental group was lower than that for the women in the control group (p < 0.001; the average post-test score in the experimental group for the vasomotor subscale was 1.78 ± 0.88, for the psychosocial subscale 1.50 ± 0.75, for the physical subscale 1.69 ± 0.63, and for the sexual subscale 2.91 ± 2.06; the average post-test score in the control group for the the vasomotor subscale was 3.80 ± 1.88, for the psychosocial subscale 2.79 ± 1.08, for the physical subscale 3.10 ± 1.04, and for the sexual subscale 2.25 ± 2.11). While the quality of life of the women in the experimental group showed an upward trend, that of the women in the control group remained the same. CONCLUSION: It was found that planned health education about the climacteric period reduced women's negative beliefs about hot flushes and enhanced their quality of life.

HE4: really a novel biomarker for ovarian cancer?.

Ovarian cancer forms 4% of all cancers and approximately 23% of all gynecological cancers in women and is responsible for the 47% of deaths related to cancers of the genital tract of women. Tumor markers are the biochemical substances which can be detected in the presence of tumors. Generally they are either the products of tumoral tissues or secreted from the normal cells which are in the inter- action with tumoral ones. The present authors attempted to determine the efficacy of the tumor marker CA- 125 and HE4 to differentiate the malign cases from the benign adnexal masses. A total of 76 patients with the appropriate criteria were included in the study. They were divided into three groups; healthy control group (n=3 1), ones with benign masses (n=23), and ones with malign ovarian masses (n=22). In the study, when the cut-off values were accepted as 55I U/ml for CA-125 and 150 pM for HE4 in differentiation of benign and malign groups, the sensitivity was found as 59.09%, specificity 91.3%, PPV 86.67% and NPV 70% LR = +6.8. This combination gives one false positive result to every five positive cases which were detected as high. With the combination of CA-125 and HE4, the value of sensitivity was found decreased as expected, although the value of the specificity increased.

SERUM IRISIN LEVEL INCREASES THROUGHOUT THE GESTATIONAL PERIOD AND IT DOES NOT PLAY A ROLE IN DEVELOPMENT OF GESTATIONAL DIABETES MELLITUS.

INTRODUCTION: Irisin is a recently discovered novel adipomyokine that induces an increase in total body energy expenditure, improves insulin sensitivity and glucose tolerance. It has been shown that circulating levels of irisin are low in patients with obesity, diabetes mellitus and impaired glucose tolerance. However, the information about the level of circulating irisin in gestational diabetes mellitus (GDM) is controversial. MATERIAL AND METHODS: Serum irisin was measured by an ELISA in a longitudinal prospective cohort study in 221 women. There were 156 healthy pregnant and 65 women with GDM. RESULTS: Circulating irisin levels were significantlly higher in the middle pregnancy compared with early pregnancy levels in healthy pregnant women and in women with GDM. Serum irisin levels were found to be lower in GDM compared to healthy pregnant women during first trimester but the difference was not observed throughout the pregnancy and it was comparable in middle pregnancy. There was a significant inverse correlation of BMI with serum irisin (r = -0.193, p = 0.004) and between HbA1c and mean glucose of OGTT with serum irisin (r =-0.377, p =0.0001) and (r = -0.147, p:0.03) in the early pregnancy of pregnant women repectively. CONCLUSIONS: The present study shows that serum irisin level increases throughout the gestational period from early to middle pregnancy in women with GDM, but there is no effect of irisin on the development of GDM.

Comparison of the histopathological results of the endometrial thickness detected by transvaginal ultrasound of symptomatic and asymptomatic postmenopausal women.

OBJECTIVE: The purpose of the study was to assess the reliability of transvaginal ultrasound (TVUSG) in endometrial pathologies by comparing the ultrasonographic and histopathologic findings in symptomatic and asymptomatic postmenopausal women. MATERIALS AND METHODS: In this retrospective study the data of 129 postmenopausal women that underwent dilatation and curettage was reviewed by dividing them two groups as symptomatic and asymptomatic. Symptomatic group was divided into subgroups according to the value of endometrial thickness obtained by TVUSG. RESULTS: Among all subjects the cancer rate was found statistically 3.043 times higher in patients with the endometrial thickness of 15 mm and greater and atrophic endometrium rate was 75% in patients with the endometrial thickness of less than five mm. Endometrial thickness was found significantly higher in cancer patients than the others (p < 0.05). Among the patients with endometrial thickness of 15 mm and greater, the cancer rate was found higher in symptomatic group than in the asymptomatic group. The cancer rate was found statistically higher in patients with bleeding compared to asymptomatic ones with the endometrial thickness between 5-14.99 mm (p < 0.05). Cancer was not detected in any of the symptomatic patients with the endometrial thickness of less than five mm. CONCLUSION: Postmenopausal patients with the symptom of bleeding should undergo detailed gynecological and ultrasonographic examination. The authors believe that this study may be a strong support to the success of TVUSG as a screening method in both symptomatic and asymptomatic postmenopausal women. Furthermore if the patient is symptomatic with a thick endometrium, to exclude the malignancy, endometrial biopsy must be performed.

Management of a Benign Phyllodes Tumor in a 13-Year-Old Girl with Trans-position of the Nipple Areola Complex and Breast Reconstruction.

Phyllodes tumor is a rare primary tumor of the breast. In children and adolescents, it is even rarer with only 20 cases, treatment of which vary in the literature. Herein we report the case of a 13-year-old female patient with a giant benign phyllodes tumor eroding the bottom of the breast skin and causing nipple retraction. We performed breast conservative surgery by mobilizing the areola, using skin flaps and inserting an implant. Breast malignancy, including phyllodes tumor (PT), is very rare in adolescents. PT, previously called cystosarcoma phylloides, consists of leaf-like fronds, from which the tumor gets its name (1, 2). Although PT is most often seen in the fourth decade of life, almost 20 cases have been reported in the adolescent period, most of which are benign. The histologic types are benign, borderline, and malignant, depending on the mitotic rate of the tumor (3, 4).

Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections.

The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7%): colistin-carbapenem (CC), 69 (32.2%): colistin-sulbactam (CS), and 43 (20.1%: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality.

Liver involvement in patients with brucellosis: results of the Marmara study.

Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with ≥5 times of the upper limit of normal for aminotransferases, total bilirubin level ≥2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.

Paediatric and adolescent traumatic gastrointestinal injuries: results of a European multicentre analysis.

AIM: Paediatric gastrointestinal injuries (GIIs) are rare, and the aim of this multicentre study was to evaluate their outcomes in a large cohort. METHODS: Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010. RESULTS: Ninety-seven patients with a median age of 9 years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs. Initial diagnostics in 90 patients led to correct diagnosis in 71%. Diagnostics were delayed in 26 patients (median 24 h). Eighty-two patients required surgery (67 laparotomy, 12 laparoscopy and three other approaches). There was a 50% conversion in the laparoscopic group. Median hospital stay was 10 days (range 1-137 days), with longer duration influenced by associated injuries (n = 41). Diagnosis <24 h was associated with significantly shorter hospital stay compared to more than 24 h (p = 0.011). In one-third of patients, morbidities were not related to a diagnostic delay or type of injury. There were five lethal outcomes, four due to associated injuries. CONCLUSION: Initial diagnostics in traumatic paediatric GIIs provide false negatives in one-third of patients. Diagnostic delay <24 h is associated with a significantly shorter hospital stay. Although laparoscopy is associated with a conversion rate of 50%, it can be used for diagnosis in suspected cases to avoid nontherapeutic laparotomy.

Effects of cisplatin and panobinostat on human mesothelial (Met-5A) and malignant pleural mesothelioma (MSTO-211H) cells.

New therapeutic approaches are still needed for effective malignant pleural mesothelioma treatment. The use of classical chemotherapy agents in combination with newly developed molecules may shed light on new therapeutic approaches. We aimed to determine the efficacy of panobinostat, alone and in combination with cisplatin, on cell survival and mRNA expression of FOXO3A, CCND1, and CASP9 genes in both mesothelioma and healthy mesothelial cell lines. Cells were treated with 1-100 µM cisplatin and 25-1000 nM panobinostat. Methylthiazol tetrazolium assays were performed to determine cell viability. mRNA expression levels of genes were analyzed with quantitative real-time polymerase chain reaction. Cisplatin and panobinostat exposure of the cells for 24 h resulted in decreased cell survival. The combined treatment was found to be more effective. No significant changes were observed with respect to CCND1 expression after exposure to agents alone or in combination. However, agents in combination resulted in upregulation of FOXO3A and CASP9 in MSTO-211H cells. Gene expression levels were not affected by any agents in healthy cells. Use of cisplatin in combination with new chemotherapeutic agents may reduce the toxic effects of cisplatin in normal cells and result in more effective removal of tumor cells.

Analysis of airborne pollen fall in Nicosia (Cyprus).

Airborne pollen distribution in the city of Nicosia (Cyprus) was measured volumetrically during two consecutive years 2007-2008 on weekly basis using Lanzoni trap (Lanzoni VPPS 2000). A total of 7,880 pollen grains/m(3) belonging to 44 taxa, in 2007 were 3,593 pollen grains/m(3) and in 2008 it was 4,287 pollen grains/m(3), were determined. Out of these, 25 belonged to the arboreal and 19 to the non-arboreal taxa. At the end of 2 years, total pollen counts were 78.76% arboreal, 19.32% non-arboreal, and 1.92% unidentified taxa. The number of pollen in the arboreal plants followed the trend as Pinaceae (29.96%), Cupressaceae/Taxaceae (18.33%), Olea europaea L. (6.92%), and Quercus spp. (4.92%), and for non-arboreal representatives, these were Poaceae (8.46%), Chenopodiaceae/Amaranthaceae (2.61%), Plantago spp. (1.69%), and Parietaria spp. (1.51%). The distribution of pollen in the atmosphere of Nicosia followed the trend as March, April, May, and June.

Does intestinal obstruction influence hypo-albuminemia: assessment of the physio-pathogenesis of protein-losing enteropathy with literature review.

BACKGROUND: Non-steroidal anti-inflammatory drug (NSAID) use may cause diaphragm-like lesions in the bowel. Although NSAID-enteropathy is among the causes of protein-losing enteropathy (PLE), intractable hypoalbuminemia is rare. CASE REPORT: Here, we discuss a case of NSAID-enteropathy with a diaphragm-like disease that presented with Protein Losing Enteropathy (PLE) rather than obstruction. The hypoalbuminemia recovered immediately after resection of the obstructive segment, despite ongoing annular ulcerations in the early postoperative period. Thus, it was not clear whether obstructive mechanisms influenced resistant hypoalbuminemia besides the ulcers. We also reviewed the English-written literature for "diaphragm-type lesion, NSAID-enteropathy, obstruction, and protein-losing enteropathy". We noted that the role of obstruction in the pathophysiology of PLE was not clear. CONCLUSIONS: As our case and a couple of cases reported in literature, slow-onset obstructive pathology seems to contribute to well-known factors: inflammatory response, exudation, tight-junction dysfunction, and increase in permeability in the physiopathology of NSAID-induced PLE. Factors such as distention-induced low-flow ischemia and reperfusion, cholecystectomy-related continuous bile flow, bacterial overgrowth-related bile deconjugation and concomitant inflammation are among other potential influencers. The possible role of a slow-onset obstructive pathology in the physiopathology of NSAID-induced and other PLE needs to be further elucidated.