A study of the evolution of the third COVID-19 pandemic wave in the Athens metropolitan area, Greece, through two cross-sectional seroepidemiological surveys: March, June 2021.

We studied the third coronavirus disease 2019 (COVID-19) pandemic wave in Athens metropolitan area (3 738 901 inhabitants) through two seroepidemiological surveys. Persons presenting in 12 healthcare facilities across Athens in March and June 2021 were studied (764 and 901, respectively). Immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein were measured by a chemiluminescent microparticle immunoassay. In March the seroprevalence rate was 11.6%, meaning that 435 208 residents of Athens had evidence of immunity. The respective values in June were 55.7% and 2 082 568 residents. The highest seroprevalence rates attributed to SARS-CoV-2 infection were recorded in persons <18 years (16.3% in March and 31.6% in June), while immunity was mainly vaccine-induced in persons 18-64 years and >65 years. Infection-attributed immunity also increased in older-age groups. Wide ranges in seroprevalence rates were noted across areas in March and June. The highest seroprevalence rates were recorded in Piraeus (47.2%) and West Attica (37.5%). However, the highest increase (>5 times) occurred in Piraeus and the South Section of Athens, which are among the most densely populated areas in Athens. In both study periods, history of COVID-19 or febrile episode, and having a cohabitant with COVID-19 were associated with increased risk for seropositivity among unvaccinated persons (p values <0.001 for all). Residing in Piraeus, the South Section or West Attica was associated with increased risk for seropositivity in June (p values <0.001). Wide heterogeneity in seroprevalence rates was found across areas in Athens, which is mainly attributed to population density. The impact of population mobility and socioeconomic status should be explored.

Prevalence and Prognostic Factors of Stress Hyperglycemia in a Pediatric Population with Acute Illness in Greece-A Prospective Observational Study.

Background: stress hyperglycemia (SH) is a relatively frequent finding in pediatric patients. The purpose of this prospective observational study was to identify the prevalence of pediatric SH and its associated risk factors in Greece. Methods: A total of 1005 patients without diabetes who were admitted consecutively for acute illness in a Pediatric Emergency Department were included in the study. Medical history, anthropometric measurements, blood glucose levels, and the medication administered were recorded. A questionnaire was distributed to parents regarding medical and perinatal history and sociodemographic characteristics. Results: There were 72 cases of SH on admission (7.2%) and 39 (3.9%) during hospitalization. Mean age was 6.4 years; 50.3% were male. SH on admission was associated with oral corticosteroid therapy (21.1% vs. 4.7%, p < 0.001), inhaled corticosteroids (12.7% vs. 3%, p < 0.001), and inhaled ß2-agonists (30.6% vs. 10.7%, p < 0.001). In-hospital hyperglycemia was associated with oral corticosteroids (adjusted OR = 3.32), inhaled corticosteroids (OR = 10.03) and inhaled ß2-agonists (OR = 5.01). Children with asthma were 5.58 and 7.86 times more likely to present admission and in-hospital hyperglycemia, respectively. Conclusions: This is the first report of SH prevalence in pediatric patients in Greece. Asthma, corticosteroids, and ß2-agonists significantly increase the risk of SH. No parental factors seem to predispose to SH.

Prevalence of target organ damage in hypertensive subjects attending primary care: C.V.P.C. study (epidemiological cardio-vascular study in primary care).

BACKGROUND: Except for the established risk factors, presence of target organ damage has an important role in the treatment of hypertensive subjects. The aim of the present study was to estimate the prevalence of target organ damage in primary care subjects. METHODS: This multi-centre, cross-sectional survey of 115 primary care physicians recruited 1095 consecutive subjects with hypertension: 611 men (55.8%); and 484 women (44.2%). A detailed history for the presence of cardiovascular disease and a thorough clinical examination was performed to each subject. RESULTS: Of the total study population, 44.5% (n = 487) had target organ damage (33.0% had left ventricular hypertrophy, 21.8% increased carotid intima media thickness, 11.0% elevated plasma creatinine levels and 14.6% microalbuminuria). Target organ damage was more prevalent in males than in females (P = 0.05). In addition, males had more often increased carotid intima media thickness than females (P = 0.009). On the contrary, females had more often microalbuminuria (P = 0.06) than males. No differences were observed between the two genders regarding left ventricular hypertrophy (P = 0.35) and elevated plasma creatinine levels (P = 0.21). Logistic regression analysis showed associations between target organ damage and dyslipidemia (P < 0.001), presence of metabolic syndrome (P = 0.005), diabetes (P < 0.001) and coronary artery disease (P < 0.001). CONCLUSION: A significant proportion of hypertensive subjects in primary care had documented associated target organ damage, with left ventricular hypertrophy being the most prevalent target organ damage.

Stress Hyperglycemia in Children and Adolescents as a Prognostic Indicator for the Development of Type 1 Diabetes Mellitus.

Hyperglycemia is a common manifestation in the course of severe disease and is the result of acute metabolic and hormonal changes associated with various factors such as trauma, stress, surgery, or infection. Numerous studies demonstrate the association of adverse clinical events with stress hyperglycemia. This article briefly describes the pathophysiological mechanisms which lead to hyperglycemia under stressful circumstances particularly in the pediatric and adolescent population. The importance of prevention of hyperglycemia, especially for children, is emphasized and the existing models for the prediction of diabetes are presented. The available studies on the association between stress hyperglycemia and progress to type 1 diabetes mellitus are presented, implying a possible role for stress hyperglycemia as part of a broader prognostic model for the prediction and prevention of overt disease in susceptible patients.

Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study.

BACKGROUND: Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece. METHODS: The study included data from 1,139 randomly selected adults (545 men/594 women, mean age +/- SD: 56.2 +/- 19.8 years), who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire. RESULTS: Use of antibiotics within the past 12 months was reported by 888 participants (77.9%). 508 individuals (44.6%) reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%). The antibiotics most frequently used for self-medication were amoxicillin (18.3%), amoxicillin/clavulanic acid (15.4%), cefaclor (9.7%), cefuroxim (7.9%), cefprozil (4.7%) and ciprofloxacin (2.3%). Fever (41.2%), common cold (32.0%) and sore throat (20.6%) were the most frequent indications for the use of self-medicated antibiotics. CONCLUSION: In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold.

Screening for colorectal cancer: the role of the primary care physician.

In recent years, the role of primary care physicians (PCPs) in the diagnosis and management of gastrointestinal disorders, including screening for colorectal cancer (CRC), has been recognized as very important. The available data indicate that PCPs are not adequately following CRC screening guidelines because a number of factors have been identified as significant barriers to the proper application of CRC screening guidelines. These factors include lack of time, patient reluctance, and challenges related to scheduling colonoscopy. Further positive engagement of PCPs with CRC screening is required to overcome these barriers and reach acceptable levels in screening rates. To meet the expectations of modern medicine, PCPs should not only be able to recommend occult blood testing or colonoscopy but also, under certain conditions, able to perform colonoscopy. In this review, the authors aim to provide the current knowledge of the role of PCPs in increasing the rate and successfully implementing a screening program for CRC by applying the relevant international guidelines.

Effect of Infliximab and Adalimumab on Experimental Colitis Following Orally Supplemented Iron.

BACKGROUND: Orally administered iron can induce colonic inflammation in healthy animals and aggravate experimental colitis. AIM: To investigate the influence of the biologic agents infliximab and adalimumab on the severity of TNBS colitis following orally supplemented iron. MATERIALS-METHODS: 204 Wistar rats were allocated into 14 groups. Colitis was induced by TNBS. Iron was administered via a mouth catheter at a dose of 0.027, 0.3, and 3%/kg diet per day, respectively. Infliximab was subcutaneously administered on the 2nd and 6th day in a dose of 5 mg/kgBW, while adalimumab was administered on the 2nd day in a dose of 2 mg/kgBW. On the 8th day, all animals were euthanatized. Activity of colitis and extent of tissue damage were assessed histologically. Tissue Tumor Necrosis Factor-α (t-TNF-α) and malondialdehyde (t-MDA) were estimated. RESULTS: In normal rats both agents significantly worsen the degree of inflammation induced by moderate or high iron supplementation despite the disappearance of t-TNF-α, and reduction of t-MDA. In the groups of TNBS colitis and moderate or high iron administration, both agents again significantly worsen the degree of inflammation despite the significant reduction in the t-TNF-α and t-MDA. CONCLUSION: Adalimumab and infliximab do not ameliorate the inflammation in TNBS-induced colitis aggravated by orally administered iron. These findings might be clinically relevant in patients with active IBD under concurrent treatment with biologic agents and per oral iron.

Seropositivity to Chlamydia pneumoniae or Helicobacter pylori and coronary artery disease.

Our aim was to investigate the relationship between the serologic status concerning Chlamydia pneumoniae and Helicobacter pylori with the presence of coronary artery disease (CAD), which remain a controversial issue in literature. We studied 208 patients with CAD and 94 controls with no evidence of obstructive CAD; all of them angiographically confirmed. The seropositivity to C. pneumoniae was 91% in patients with CAD vs 86% in controls (P>0.05). The H. pylori seroprevalence rates were 77% and 68%, respectively (P>0.05). The multivariate analysis, adjusting for age, sex, educational level, diabetes, hypertension, obesity, smoking, family history of CAD and lipids, confirmed the results of univariate analysis. Therefore, this study adds evidence against the association of seropositivity to C. pneumoniae and H. pylori with angiographically documented CAD.

Prevalence of Major Cardiovascular Risk Factors and Coronary Heart Disease in a Sample of Greek Adults: The Saronikos Study.

BACKGROUND: Comprehensive data regarding prevalence of coronary heart disease (CHD) and associated factors in different geographical regions are very important to our understanding of global distribution and evolution of CHD. The aim of this study was to assess the current prevalence of self-reported risk factors and CHD in Greek adult population. METHODS: A community-based cross-sectional study was conducted in May 2014, during an election day, among residents of Saronikos municipality (Attica region). Data were collected from face-to-face interviews. The study sample included 2636 subjects (men, 49.5%; mean age, 50.5; range 20-95 years), with similar age and sex distribution to the target population. RESULTS: The age-standardized prevalence rates of five major risk factors were as follows: type 2 diabetes 11.1%, hypercholesterolemia (cholesterol>240 mg/dl or using cholesterol-lowering medication) 23.8%, hypertension 27.2%, current smoking 38.9% and physical inactivity 43%. Of the participants, only 21% were free of any of these factors. Clustering of two to five risk factors was more frequent among persons aged 50 years and older as compared with younger ones (60% vs 27%, P=0.000). The age-adjusted prevalence of CHD was 6.3% (in men, 8.9%; in women, 3.8%) and that of myocardial infarction was 3.6% (in men, 5.2%; in women, 2.1%). According to multivariate analysis age, gender, education level, obesity, diabetes, hypercholesterolemia, hypertension and ever smoking were strongly associated with CHD. CONCLUSION: Classic risk factors are highly prevalent and frequently clustered, especially in adults aged 50 years and older. These findings raise concerns about future trends of already increased rates of CHD. Multifactorial and integrated population-based interventions need to be applied to reduce the burden of cardiovascular conditions.

Acute ST-segment elevation myocardial infarction after amoxycillin-induced anaphylactic shock in a young adult with normal coronary arteries: a case report.

BACKGROUND: Acute myocardial infarction (MI) following anaphylaxis is rare, especially in subjects with normal coronary arteries. The exact pathogenetic mechanism of MI in anaphylaxis remains unclear. CASE PRESENTATION: The case of a 32-year-old asthmatic male with systemic anaphylaxis, due to oral intake of 500 mg amoxycillin, complicated by acute ST-elevation MI is the subject of this report. Following admission to the local Health Center and almost simultaneously with the second dose of subcutaneous epinephrine (0.2 mg), the patient developed acute myocardial injury. Coronary arteriography, performed before discharge, showed no evidence of obstructive coronary artery disease. In vivo allergological evaluation disclosed strong sensitivity to amoxycillin and the minor (allergenic) determinants of penicillin. CONCLUSION: Acute ST-elevation MI is a rare but potential complication of anaphylactic reactions, even in young adults with normal coronary arteries. Coronary artery spasm appears to be the main causative mechanism of MI in the setting of "cardiac anaphylaxis". However, on top of the vasoactive reaction, a thrombotic occlusion, induced by mast cell-derived mediators and facilitated by prolonged hypotension, cannot be excluded as a possible contributory factor.

Favorable response to subcutaneous administration of infliximab in rats with experimental colitis.

AIM: To investigate the influence of infliximab (Remicade) on experimental colitis produced by 2,4,6,trinitrobenzene sulfonic acid (TNBS) in rats. METHODS: Thirty-six Wistar rats were allocated into four groups (three groups of six animals each and a fourth of 12 animals). Six more healthy animals served as normal controls (Group 5). Group 1: colitis was induced by intracolonic installation of 25 mg of TNBS dissolved in 0.25 mL of 50% ethanol and infliximab was subcutaneously administered at a dose of 5 mg/kg BW; Group 2: colitis was induced and infliximab was subcutaneously administered at a dose of 10 mg/kg BW; Group 3: colitis was induced and infliximab was subcutaneously administered at a dose of 15 mg/kg BW; Group 4: colitis was induced without treatment with infliximab. Infliximab was administered on d 2-6. On the 7(th) d, all animals were killed. The colon was fixed in 10% buffered formalin and examined by light microscopy for the presence and activity of colitis and the extent of tissue damage. Tumor necrosis factor-alpha (TNF-alpha) and malondialdehyde (MDA) were also measured. RESULTS: Significant differences concerning the presence of reparable lesions and the extent of bowel mucosa without active inflammation in all groups of animals treated with infliximab compared with controls were found. Significant reduction of the tissue levels of TNF-alpha in all groups of treated animals as compared with the untreated ones was found (0.47+/-0.44, 1.09+/-0.86, 0.43+/-0.31 vs 18.73+/-10.53 respectively). Significant reduction in the tissue levels of MDA was noticed in group 1 as compared to group 4, as well as between groups 2 and 4. CONCLUSION: Subcutaneous administration of infliximab reduces the inflammatory activity as well as tissue TNF-alpha and MDA levels in chemical colitis in rats. Infliximab at a dose of 5 mg/kg BW achieves better histological results and produces higher reduction of the levels of TNF-alpha than at a dose of 10 mg/kg BW. Infliximab at a dose of 5 mg/kg BW produces higher reduction of tissue MDA levels than at a dose of 15 mg/kg BW.

Helicobacter pylori infection in hospital workers over a 5-year period: correlation with demographic and clinical parameters.

BACKGROUND: We aimed to determine whether any of various groups of medical and nonmedical staff in a large acute care hospital were at increased risk of acquiring Helicobacter pylori infection over a 5-year period, and we also aimed to identify risk factors or symptoms related to H. pylori positivity and seroconversion. METHODS: A total number of 437 subjects, aged 36.8 +/- 7.7 years (range, 23-60 years)-employees of our hospital-were tested by immunoassay for serum IgG antibodies against H. pylori. Subjects were assigned to four main groups: (I) nursing staff ( n = 249; aged 34.7 +/- 7 years); (II) administrative and technical staff ( n = 127; aged 39.2 +/- 8.1 years); (III) medical staff ( n = 31; aged 42.4 +/- 4.9 years); and (IV) paramedical staff (blood donor department) ( n = 30; aged 37.6 +/- 8.5 years). Differences in age and educational level between these four groups were statistically highly significant ( P < 0.0001). Each subject completed a questionnaire containing several clinical and demographic parameters. The same cohort of individuals was tested 5 years later. RESULTS: The overall seroprevalence of H. pylori infection was 45.5%, and in each group (I, II, III, and IV) being 48.6%, 44.1%, 41.9%, and 30% respectively. Logistic regression analysis revealed that the risk of infection by H. pylori was significantly higher in group I compared with group II (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.04-3.52; P = 0.037). The H. pylori positivity increased with age: 40.6% for those aged 23-40 years and 57.5% for those aged 41-60 years ( P = 0.001). The level of education was inversely associated with H. pylori infection ( P = 0.001). During the 5-year observation, 59 of 238 (24.8%) subjects initially negative for H. pylori infection became positive, thus giving an annual seroconversion rate of 4.95%. Logistic regression analysis revealed that the seroconversion rate was significantly higher in group I compared with group II (28.1% vs 21.1%; OR, 2.34; 95% CI, 1.08-5.07; P = 0.03). The rate of seroconversion was higher in subjects aged 35-55 years compared with subjects aged 23-34 years (32% vs 17.5%; P= 0.009). Subjects who were positive for H. pylori infection in both examinations had a higher percentage of heartburn ( P = 0.029), regurgitation ( P = 0.023), and nausea ( P= 0.037) compared with those who were negative in both examinations. Differences between those who were continuously negative for H. pylori infection and those who seroconverted during the observation period were not significant. CONCLUSIONS: In this longitudinal study of workers in a large acute care hospital in Greece it was found that nursing staff had a significantly higher risk of infection compared with administrative and technical staff. Age was significantly positively related both to H. pylori infection and to seroconversion. The level of education was strongly related to the prevalence, but not to the incidence of H. pylori infection. The presence of infection over the time was associated with a higher percentage of heartburn, regurgitation, and nausea compared with subjects who were continuously negative for H. pylori infection.

Prevalence, and associated risk factors, of self-reported diabetes mellitus in a sample of adult urban population in Greece: MEDICAL Exit Poll Research in Salamis (MEDICAL EXPRESS 2002).

BACKGROUND: The continuous monitoring and future prediction of the growing epidemic of diabetes mellitus worldwide presuppose consistent information about the extent of the problem. The aim of this study was to determine the prevalence of diagnosed diabetes and to identify associated risk factors in a sample of adult urban Greek population. METHODS: A cross-sectional population-based survey was conducted in municipality of Salamis, Greece, during an election day (2002). The study sample consisted of 2805 participants, aged 20-94 years. Data were collected using a standardized short questionnaire that was completed by a face-to-face interview. Multiple regression analyses were performed to evaluate the association of diabetes with potential risk factors. RESULTS: The overall prevalence of diagnosed diabetes was 8.7% (95% CI 7.7-9.8%). After age adjustment for the current adult population (2001 census) of Greece, the projection prevalence was calculated to 8.2%. Multivariate logistic regression analysis identified as independent risk factors: increasing age (odds ratio, OR = 1.07, 95% CI 1.06-1.08), male sex (OR = 1.43, 95% CI 1.04-1.95), overweight and obesity (OR = 1.97, 95% CI 1.29-3.01 and OR = 3.76, 95% CI 2.41-5.86, respectively), family history of diabetes (OR = 6.91, 95% CI 5.11-9.34), hypertension (OR = 2.19, 95% CI 1.60-2.99) and, among women, lower educational level (OR = 2.62, 95% CI 1.22-5.63). The prevalence of overweight and obesity, based on self-reported BMI, were 44.2% and 18.4%, respectively. Moreover, the odds for diabetes in obese subjects with family history were 25-fold higher than those with normal weight and without family history of diabetes, while the odds in overweight subjects with family history of diabetes were 15-fold higher. CONCLUSIONS: Our findings indicated that the prevalence of diabetes is high in Greek population. It is suggested that the main modifiable contributing factor is obesity, whose effect is extremely increased upon positive heredity presence.

Relation between Helicobacter pylori infection, thyroid hormone levels and cardiovascular risk factors on blood donors.

The aim of this study was to assess the relationship between Helicobacter pylori (Hp) infection, serum thyroid hormone levels and certain cardiovascular risk factors in normal volunteers. In 110 blood donors (85 men, 25 women, aged 35.6 +/- 9.76) the serum levels of IgG antibodies against Hp were estimated using a sensitive immunoassay. Serum estimation of T3, T4, TSH, FT3, FT4, thyroid (microsomial) autoantibodies, C-Reactive-Protein, a1-acid-glycoprotein, vitamin B12, folic acid, cholesterol, triglycerides, total lipids, HDL, LDL, and antibodies against hepatitis A, was also carried-out. In all subjects a number of clinicoepidemiological parameters including body mass index, smoking habits, educational level, number of siblings and presence of symptoms from the digestive system were carefully recorded. Statistical analyses were performed using the SPSS statistical package. Helicobacter pylori infection was found in 54 subjects (49.1%). On univariate analysis, significant differences between subjects positive and negative for Helicobacter pylori infection were found for FreeT3 (3.11 +/- 0.5 pmol/ vs. 3.42 +/- 0.8 pmol/l, P=0.025), FreeT4 (1.04 +/- 0.2 ng/dl vs. 1.17 +/- 0.3 ng/dl, P=0.025), and thyroid autoanti bodies (23.65 +/- 24 vs. 14.97 +/- 8, P=0.018). Significant differences were also found for Cholesterol (207.8 +/- 39 mg/dl vs. 193.3 +/- 40 md/dl, P=0.05), LDL (133.2 +/- 32 mg/dl vs. 119.6 +/- 40 mg/dl, P=0.05) and folic acid (7.66 +/- 3.7 ng/ml vs. 6.39 +/- 2.5 ng/ml, P=0.038). A significantly positive correlation of Hp infection with age and number of siblings and a negative one with educational level were noticed. No differences concerning the levels of acute phase proteins, vitamin B12, antibodies against hepatitis A, body mass index, and smoking habits were found. On logistic regression analysis, significant differences remained only for thyroid autoantibodies (Odds ratio for titer ?30: 7.8, P=0.012), age (Odds Ratio for those aged >40 years vs those aged <40 years: 3.8, P=0.022) and educational level (Odds ratio for elementary 8.7 and moderate 5.1 vs higher education, P=0.003 and P=0.011 respectively). It is concluded that a relationship exist between Hp infection and the presence of high titers of thyroid autoantibodies in blood donors. There are no indications of the existence of a relationship between Hp infection with thyroid hormone levels, lipid concentrations and other cardiovascular risk factors.

The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases.

Chronic gastrointestinal disorders are a source of substantial morbidity, mortality, and cost. They are common in general practice, and the primary care physician (PCP) has a central role in the early detection and management of these problems. The need to make cost-effective diagnostic and treatment decisions, avoid unnecessary investigation and referral, provide long-term effective control of symptoms, and minimize the risk of complications constitute the main challenges that PCPs face. The literature review shows that, although best practice standards are available, a considerable number of PCPs do not routinely follow them. Low rates of colorectal cancer screening, suboptimal testing and treatment of Helicobacter pylori infection, inappropriate use of proton pump inhibitors, and the fact that most PCPs are still approaching the irritable bowel disease as a diagnosis of exclusion represent the main gaps between evidence-based guidelines and clinical practice. This manuscript points out that updating of knowledge and skills of PCPs via continuing medical education is the only way for better adherence with standards and improving quality of care for patients with gastrointestinal diseases.

Effect of mesalamine and prednisolone on TNBS experimental colitis, following various doses of orally administered iron.

BACKGROUND: Experimental data suggest that oral iron (I.) supplementation can worsen colitis in animals. AIM: To investigate the influence of various concentrations of orally administered I. in normal gut mucosa and mucosa of animals with TNBS colitis, as well as the influence of Mesalamine (M.) and Prednisolone (P.) on the severity of TNBS colitis following orally administered I. METHODS AND MATERIALS: 156 Wistar rats were allocated into 10 groups. Colitis was induced by TNBS. On the 8th day, all animals were euthanatized. Activity of colitis and extent of tissue damage were assessed histologically. The levels of tissue tumor necrosis factor- α (t-TNF- α ) and tissue malondialdehyde (t-MDA) were estimated in all animal groups. RESULTS: Moderate and high I. supplementation induced inflammation in the healthy colon and increased the activity of the experimentally induced TNBS colitis. Administration of M. on TNBS colitis following moderate iron supplementation (0.3 g/Kg diet) resulted in a significant improvement in the overall histological score as well as in two individual histological parameters. M. administration, however, did not significantly reduce the t-TNF- α levels (17.67 ± 4.92 versus 14.58 ± 5.71, P = 0.102), although it significantly reduced the t-MDA levels (5.79 ± 1.55 versus 3.67 ± 1.39, P = 0.000). Administration of M. on TNBS colitis following high iron supplementation (3.0 g/Kg diet) did not improve the overall histological score and the individual histological parameters, neither reduced the levels of t-TNF- α (16.57 ± 5.61 versus 14.65 ± 3.88, P = 0.296). However, M. significantly reduced the t-MDA levels (5.99 ± 1.37 versus 4.04 ± 1.41, P = 0.000). Administration of P. on TNBS colitis after moderate iron supplementation resulted in a significant improvement in the overall histological score as well as in three individual histological parameters. P. also resulted in a significant reduction in the t-TNF- α levels (17.67 ± 4.92 versus 12.64 ± 3.97, P = 0.003) and the t-MDA levels (5.79 ± 1.54 versus 3.47 ± 1.21, P = 0.001). Administration of P on TNBS colitis after high I. supplementation resulted in a significant improvement of the overall histological score and three individual histological parameters and significantly reduced the levels of t-TNF- α (16.6 ± 5.6 versus 11.85 ± 1.3, P = 0.001). CONCLUSION: I. can induce colonic inflammation and aggravate TNBS colitis. M. and P. can significantly improve the inflammatory process in the colonic mucosa in TNBS colitis aggravated by orally administered I. P. has a stable anti-TNF- α effect. These findings suggest that the harmful.

Psychological factors and stress in inflammatory bowel disease.

The role of psychological distress and personality as predisposing factors for the development of inflammatory bowel disease (IBD) remains controversial. Attempts to investigate the role of psychological factors in IBD exhibited rather conflicting results. Among the studies concerning the effects of stress or depression on the course of IBD, the majority suggest that stress worsened IBD, the rest giving either negative or inconclusive results. However, application of strategies, including avoidance of coping and training patients in problem solving or emotion-oriented, could influence the course of IBD. Large controlled clinical trials are needed in order to clarify the impact of psychological interventions on the quality of life and the course of disease.