Evaluation of the Paris System in atypical urinary cytology.

OBJECTIVE: Our aim was to evaluate the Paris System for reporting urinary cytology, especially in the field of atypia. METHODS: During the last year, 104 urinary cases had atypical cytology. These cases were reviewed and reclassified by three cytopathologists using the Paris criteria. Cyto-histological correlation was performed in 47 cases. Additionally, all cytology diagnoses were correlated with double immunocytochemistry for p53 and CK20 result. Interobserver consistency was also evaluated. RESULTS: Out of 104 atypical cases, 30 were classified as benign, 49 atypical and 25 suspicious for high-grade urothelial carcinoma (HGUC). Diagnostic consistency between the three observers reached 93.27%. Using the new criteria, only 47.1% of the cases remained in the atypical category. The rate of HGUC histology was 14.3%, 26.7% and 96% in the benign, atypical and suspicious for HGUC cytological categories, respectively. Immunocytochemistry positivity was observed in 25.9%, 41.8% and 80% of the cases in the three diagnostic groups. CONCLUSIONS: The Paris System for reporting urinary cytology provides clear, easy to adopt criteria, which lead to diagnostic categories with clinical significance, facilitating patient management decisions.

Interrelationships of metal transfer factor under wastewater reuse and soil pollution.

The transfer of heavy metals under soil pollution wastewater reuse was studied in a Greenhouse experiment using a randomized block design, including 6 treatments of heavy metals mixtures composed of Zn, Mn, Cd, Co, Cu, Cr, Ni, and Pb, where each metal was taking part in the mixture with 0, 10, 20, 30, 40, 50 mg/kg respectively, in four replications. The Beta vulgaris L (beet) was used as a test plant. It was found that the metal transfer factors were statistically significantly related to the: (i) DTPA extractable soil metals, (ii) the soil pollution level as assessed by the pollution indices, (iii) the soil pH, (iv) the beet dry matter yield and (v) the interactions between the heavy metals in the soil. It was concluded that the Transfer Factor is subjected to multifactor effects and its real nature is complex, and there is a strong need for further study for the understanding of its role in metal-plant relationships.

Evaluation of double immunocytochemical staining for CK20 and P53 as a potential adjunct to cytology for urothelial cancer diagnosis.

OBJECTIVE: To evaluate double immunocytochemical staining with p53 and CK20, as a tool for improving the accuracy of urinary cytology. The aim of the present study was to clarify the diagnostic significance of the expression of these markers and to investigate the possibility of using this information for better monitoring of bladder cancer patients during follow-up. MATERIAL AND METHODS: One hundred and twenty-five urine cytology cases were retrieved with corresponding histology from our files. One ThinPrep® smear was available for each of them and dual immunocytological staining for p53 and CK20 was performed. Eleven cases were excluded from the study because of hypocellularity. The material comprised 58 malignant, 36 atypical and 20 negative for malignancy cases. Immunocytochemistry was evaluated by two cytopathologists, blinded to the histological diagnosis or follow-up data. A cut-off threshold of five stained atypical cells, according to the literature, was used for evaluation. RESULTS: Fifty-two out of 58 malignant cases were positive for at least one of the markers (89.6%). In the atypical and negative groups, 18 (50%) and 5 (25%) cases were positive, respectively. Accuracy parameters evaluation for cytology versus the combination of cytology with immunocytological staining were: sensitivity 73.4% versus 91.1%, specificity 100% versus 74.3%, positive predictive value (PPV) 100% versus 88.9% and negative predictive value (NPV) 62.5% versus 78.8%. CONCLUSIONS: Double immunocytochemical staining for p53 and CK20 is easy to perform and evaluate and can improve cytology sensitivity. It is helpful in establishing a diagnosis of malignancy and may be used as a triage tool to select patients that require cystoscopy during clinical follow-up.

Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis.

AIM: Antioxidants, such as vitamin A, C and E, selenium and ß-carotene, have been proposed as possible agents in the chemoprevention of colorectal cancer and have been the subject of recent trials and reviews. This review aimed to assess the present evidence on the effect of antioxidants on the incidence of colorectal neoplasms in the general population. METHOD: A systematic review of randomized controlled trials was undertaken comparing antioxidants alone or in combination with other agents vs placebo. The following databases were searched for published and unpublished literature: Cochrane Library, MEDLINE, PreMEDLINE, CINAHL, EMBASE, Web of Science, and Biological Abstracts and Research Registers. Studies were quality appraised and extracted. Meta-analysis was performed. RESULTS: Twelve studies were identified as relevant. In the nine comparing antioxidants with no antioxidants (n=148 922), there was no difference in the incidence of colorectal cancer [relative risk (RR) 1.00, 95% confidence interval (CI) 0.88-1.13]. One study assessed the effect of antioxidants on adenoma formation (n=15 538) and did not demonstrate a statistically significant effect (RR 1.47, 95% CI 0.97-2.23). Of 14 discrete analyses for different combinations of antioxidants, only one reported a statistically significant increase in relative risk of adenoma formation in participants receiving vitamin E (RR 1.74, 95% CI 1.09-1.79, P=0.02) or vitamin E plus ß-carotene (RR 1.63, 95% CI 1.01-2.63, P=0.04). Effectiveness did not seem to differ between healthy populations, participants with cardiovascular risk factors or populations exposed to smoking or asbestos. CONCLUSION: The review demonstrates that antioxidants (vitamin A, C and E, selenium and ß-carotene), as single agents, in combination with other antioxidants or in combination with other agents, are not effective in the chemoprevention of colorectal neoplasia in the general population. This questions their involvement in future randomized controlled trials of chemoprevention in colorectal cancer.

Factors associated with outcomes for looked-after children and young people: a correlates review of the literature.

In 2008, the Department of Health made a referral to the National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence to develop joint public health guidance on improving the physical and emotional health and well-being of children and young people looked after by the local authority/state. To help inform the decision-making process by identifying potential research questions pertinent to the outcomes of looked-after children and young people (LACYP), a correlates review was undertaken. Iterative searches of health and social science databases were undertaken; searches of reference lists and citation searches were conducted and all included studies were critically appraised. The correlates review is a mapping review conducted using systematic and transparent methodology. Interventions and factors that are associated (or correlated) with outcomes for LACYP were identified and presented as conceptual maps. This review maps the breadth (rather than depth) of the evidence and represents an attempt to use the existing evidence base to map associations between potential risk factors, protective factors, interventions and outcomes for LACYP. Ninety-two studies were included: four systematic reviews, five non-systematic reviews, eight randomized controlled trials, 66 cohort studies and nine cross-sectional studies. The conceptual maps provide an overview of the key relationships addressed in the current literature, in particular, placement stability and emotional and behavioural factors in mediating outcomes. From the maps, there appear to be some key factors that are associated with a range of outcomes, in particular, number of placements, behavioural problems and age at first placement. Placement stability seems to be a key mediator of directional associations. The correlates review identified key areas where sufficient evidence to conduct a systematic review might exist. These were: transition support, training and support for carers and access to services.

Effect of benzoic acid and combination of benzoic acid with a probiotic containing Bacillus cereus var. Toyoi in weaned pig nutrition.

The purpose of this study was to assess the efficacy of a probiotic containing Bacillus cereus var. Toyoi spores (Toyocerin) and benzoic acid (VevoVitall) on growth performance and diarrhoea in weaning pigs, against negative controls. The trial groups were as follows: (a) NC group (Negative Controls): No treatment (b) TOYO group: Same feed as in the controls plus Toyocerin at a dose of 1 x 10(9) Bacillus cereus var. Toyoi spores/kg feed, (c) BA group: Same feed as in the controls plus VevoVitall at a dose of 5 g/kg feed (5000 ppm benzoic acid) and (d) TOYO+BA group: Same feed as in the controls plus Toyocerin at a dose of 1 x 10(9) Bacillus cereus var. Toyoi spores and VevoVitall at a dose of 5 g/kg feed. In conclusion, the results of this study indicated that administration of Bacillus cereus var. Toyoi spores at 1 x 10(9)/kg feed or benzoic acid at a dose of 5000 ppm or the combination of 1 x 10(9) Bacillus cereus var. Toyoi spores and 5000 ppm of benzoic acid/kg feed, improved the growth performance parameters and reduced the severity of diarrhoea in weaning pigs.

Investigation of pharmaceutical and personal care product interactions of soil and beets (Beta vulgaris L.) under the effect of wastewater reuse.

Although, several recent greenhouse studies are beginning to address the uptake of pharmaceuticals and personal care products (PPCPs) by a variety of crops, few studies have assessed the effects of exposure to complex, realistic wastewater effluents on uptake. Hence, in this study, a greenhouse experiment was conducted in order to study the interactions occurring exclusively between PPCPs in soil, and in the edible plant part of beets (Beta vulgaris) after exposure to treated wastewater effluent. According to the findings, the interactions between the pharmaceuticals caffeine (CFN) with bisoprolol (BSP), carbamezapine (CMZ), clarithromycin (CMC), metoprolol (MPL), sulfamethoxazole (SMX), and trimethoprim (TMP) occurring in soil were almost 99% synergistic; it was noted variability in the interactive capacity of the pharmaceuticals; the concentrations of pharmaceuticals which measured did not affect unfavorably beet yield; interactions between the PPCPs via the PPCPs contribution in plant and soil affect the qualitative and quantitative characteristics of the beets.

Trioxsalen derivatives with lipoxygenase inhibitory activity.

Trioxsalen (TRX) is a 4,5',8-trimethylated psoralen analog presenting interesting biological activities when irradiated with UVA light. A series of TRX derivatives, which where obtained by its chemical modification and incorporation of a variety of unsaturated functions at position 4' of the psoralen ring-system, were evaluated for their antioxidant activity and their inhibitory activity on soybean lipoxygenase (LOX) and lipid peroxidation. The reducing properties of the compounds were evaluated using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay and found to be very low, in the range 0-14%, with the exception of the hydroxamic acid 6 which showed almost identical activity to BHT. TRX derivative 3 significantly inhibited LOX, with IC(50) 9.4 muM. With the exception of TRX, all tested analogs inhibited lipid peroxidation in the range of 35-91%. The most potent compound, namely TRX derivative 3, was studied for its anti-inflammatory activity in vivo on rat paw edema induced by carrageenan, and was found to be of almost identical activity to indomethacin. The results of the biological tests are discussed in terms of structural characteristics.

Effect of Origanum vulgaris and Allium sativum extracts for the control of proliferative enteropathy in weaning pigs.

The aim of the present trial was to investigate the efficacy of Virbamix PE (Virbac SA, France) an appetite enhancer and feed flavouring material containing plant extracts of Origanum vulgaris and Allium sativum, added to the feed at one single dose in the control of proliferative enteropathy (PE) in weaning pigs, in comparison to reference treatment with tiamulin (Tiamutine 6.5 Premix/Ceva Animal Health) group and a negative control group. The trial was conducted on a farm with a previous history of ileitis outbreaks. At weaning day (25 +/- 3 days old / day 0 of the trial) a total of 288 (144 male + 144 female) piglets were selected and allocated into three experimental groups, each group comprising of four pens with 24 piglets in each pen. Group 1 (T1 group) served as negative control group (unmedicated), group T2 received medication in feed at the dose of 1 kg Virbamix PE per tonne of feed and T3 group received 32 ppm of tiamulin. Treatments lasted for six weeks (up to the age of 67 +/- 3 days), and no other antibacterial or growth promoter was added to the feed or drinking water in the same period. Administration of Virbamix PE was found to be effective for the control of PE, as shown by the reduction of prevalence of Lawsonia intracellularis in the intestine at the end of the treatment period, as determined by PCR method comparatively with the T1 group, while no significant difference was found between T2 and T3 groups. The diarrhoea score (DS) was significantly higher (P < 0.05) in the control group in comparison with T2 and T3 groups. However, no significant differences were noticed between T2 and T3 groups during the treatment period (P > 0.05). Treatment of piglets with Virbamix PE and Tiamutine 6.5 Premix resulted in significantly higher body weight and average daily gain (ADG) than in T1 group for the total treatment period (P < 0.05). Conclusively, the results of present study indicate that the use of Virbamix PE, could be an alternative and economic method for the control of PE. Moreover, the use of this product is in accordance with the contemporary consumer demands for more environmentally friendly pig production, satisfying at the same time the producer needs for increased and cost-effective performance.

The dynamics of the pharmaceutical and personal care product interactive capacity under the effect of artificial enrichment of soil with heavy metals and of wastewater reuse.

A greenhouse experiment was conducted, using a randomized block design, including twelve heavy metal (Mn, Zn, Cu, Cd, Co, Cr, Ni, Pb) mixture treatments, with each metal participating in the treatment with 0, 2, 4, 6, 8, 10, and 12 mg/kg, respectively. Common beet (Beta vulgaris L.) was chosen as test plant. The plants were irrigated with treated municipal wastewater taken from the Wastewater Treatment Plant of the town of Amaliada, N.W., Peloponnese, Greece. The experiment aimed at studying the interactions between heavy metals and macro-microelements, and pharmaceuticals and personal care products (PPCPs). The basic scope was to shed some light on the potential environmental implications, of these interactions on the soil PPCPs for a more effective monitoring of these emerging contaminants in the plants and soil continuum. It was found that the PPCPs have a very high potential interactive capacity, having interacted with all the studied metals, and metalloids, as well as with plant macro elements (P, and K). The uptake of PPCPs by plants was statistically significantly related with their respective content in the soil. The general inference is that the interactive relations between heavy metals, macro-, microelements, and emerging contaminants, being mainly antagonistic, which contribute to the decrease the uptake of soil PPCPs.

Evaluation of the efficacy and safety of infliximab on psoriatic nails: an unblinded, nonrandomized, open-label study.

BACKGROUND: Despite advances in the treatment of skin psoriasis during the last years, therapy of psoriatic nails remains a challenge. Objectives The objective of this unblended, nonrandomized, open-label study was to evaluate the efficacy and safety of infliximab on nail psoriasis. PATIENTS/METHODS: Eighteen psoriatic patients with nail involvement, consecutively selected among patients scheduled to start infliximab infusions were included in the study. Thirteen of these patients had psoriatic arthritis and five had severe plaque type psoriasis. Outcome measures were assessed at baseline and at weeks 14, 22, 30 and 38 using the nail psoriasis severity index (NAPSI). Patients also filled in a Greek translation of the international onychomycosis-specific questionnaire to assess improvement in quality of life after improvement of psoriatic nail signs. RESULTS: All 18 patients completed the study. Significant improvement was noted in most patients after the third infusion as shown by the reduction of mean NAPSI (NAPSIm) from 55.8 at baseline to 29.8 at week 14. Evaluation after six infusions, at week 38, showed an almost complete resolution of psoriatic nail involvement (NAPSIm: 3.3). No adverse event was observed. All patients reported satisfaction with the results and significant improvement in their quality of life with reduction of the score of the international quality of life questionnaire from 66.3 at baseline to 19.1 at week 38. CONCLUSIONS: Alphalthough there is no control group, this data suggests that infliximab is effective for psoriatic nail disease in the context of severe skin and joint involvement.

Pimecrolimus 1% cream in non-specific inflammatory recurrent balanitis.

BACKGROUND: Non-specific balanitis is a common inflammatory dermatosis with frequent relapses and considerable impact on male sexual life. OBJECTIVE: To evaluate the efficacy and safety of pimecrolimus 1% cream in recurrent non-specific balanitis. METHODS: Twenty-six patients with recurrent flares of non-specific balanitis were randomly assigned to 1 group applying pimecrolimus cream 1% and 1 group applying placebo on the glans twice daily for 7 days. The patients were assessed on day 14. They were instructed to continue applying the agent whenever symptoms initialized for the following 90 days and take account of the cumulative days with symptoms. RESULTS: Seven out of the 11 (63.6%) patients in the pimecrolimus group and 1 out of 11 (9%) in the control group were free of all symptoms and lesions after 14 days, 3 (27.3%) in both groups reported improvement, while 1 (9.1%) in the pimecrolimus and 7 (63.6%) in the control group remained unaffected. (chi(2) = 9.0, d.f. = 2, p = 0.011). Days with symptoms during the 90-day follow-up period were 7.50 +/- 3.02 for the pimecrolimus and 17.62 +/- 4.40 for the control group (p = 0.000064). CONCLUSIONS: Pimecrolimus 1% cream is promising in relieving symptoms and signs of non-specific balanitis during flares and controlling the disease during long-term follow-up.

Subtype C1 persistent infection of HHV-8 in a PEL patient.

PEL, a rare type of lymphoma constituting less than 5% of NHLs, has been recently identified as a distinct clinical and pathological entity among the B-cell lymphomas, with characteristic morphologic, immunophenotypic, molecular and viral features. ICC, PCR, RT-PCR and sequencing were carried out in biologicals samples from a 44-year-old, non-smoker Caucasian male patient of Greek nationality, HIV-1 negative and HCV positive. The ICC results showed CD30 + , Vimentin + , EMA + , Ki67 + , Pankeratin- and negative to B and T antibodies. In addition, HHV-8 was detected in pleural fluid. Examination of blood samples of the patient over a period of nearly two years showed a persistent infection of HHV-8. Phylogenetic analysis revealed a close relation to the C1 variant of HHV-8. The samples was also found EBV negative by PCR. Using a combination of clinical, morphological, immunohistochemical features and molecular biology techniques in this study we document a PEL case with persistent HHV-8 of genotype C1 infection.

The role of natural and synthetic zeolites as feed additives on the prevention and/or the treatment of certain farm animal diseases: A review.

The present review comments on the role of the use of zeolites as feed additives on the prevention and/or the treatment of certain farm animal diseases. Both natural and synthetic zeolites have been used in animal nutrition mainly to improve performance traits and, based on their fundamental physicochemical properties, they were also tested and found to be efficacious in the prevention of ammonia and heavy metal toxicities, poisonings as well as radioactive elements uptake and metabolic skeletal defects. During the last decade, their utilization as mycotoxin-binding adsorbents has been a topic of considerable interest and many published research data indicate their potential efficacy against different types of mycotoxins either as a primary material or after specific modifications related to their surface properties. Ingested zeolites are involved in many biochemical processes through ion exchange, adsorption and catalysis. Recent findings support their role in the prevention of certain metabolic diseases in dairy cows, as well as their shifting effect on nitrogen excretion from urine to faeces in monogastric animals, which results in lower aerial ammonia concentration in the confinement facilities. Moreover, new evidence provide insights into potential mechanisms involved in zeolites supporting effect on animals suffered from gastrointestinal disturbances, including intestinal parasite infections. All the proposed mechanisms of zeolites' effects are summarized in the present review and possible focus topics for further research in selected areas are suggested.

An improved solid-phase immunoassay for anti-GBM antibodies.

A solid-phase immunoassay has been developed for the detection of anti-glomerular basement membrane (GBM) antibodies in the circulation of patients with Goodpasture's syndrome and one form of rapidly progressive glomerulonephritis. The procedure involves the formation of a covalent linkage between the antigen and a solid support disc. Antibodies bound to the antigen are then detected on a fluorometer using fluorescein-labeled antisera to human immunoglobulins. The assay is easy to perform, fast, inexpensive and has been optimized with respect to sensitivity, range and reproducibility.

Study of serum beta-2 microglobulin levels in breast cancer patients.

Serum beta-2 microglobulin levels were measured in normal individuals and in breast cancer patients. It was observed that there was a significant rise in levels especially in advanced stages of the disease. It was concluded that patients with a beta-2 microglobulin/creatinine ratio of greater than 3.8 were likely to have metastatic breast cancer.

Blood donor behaviour in Greece: implications for health policy.

Blood donation behaviour was studied in 809 residents of the Greater Athens area to identify socio-economic and attitudinal factors and level of knowledge about blood donation related to donor behaviour. The sample was randomly selected and consisted of men and women aged 18-65, the legally defined age for donation. According to stepwise regression analysis, blood donation (40.8% of the study population) was found to be correlated with gender, place of birth, occupation and knowledge about donation. Donors were more likely to be men than women; students and military recruits than professionals and scientists; and those with higher knowledge scores regarding donation. In our factor analysis of the social attitudes related to blood donation, three factors emerged as important regarding donation: health-related incentives for the donor, structural incentives (organization of blood donation education and management of facilities) and the creation of social and economic incentives. With respect to the affective measures those who expressed feelings of guilt when presented with hypothetical, emotionally charged situations dramatizing the need for donor blood were more likely to be donors. The results of the data are discussed within a larger socio-cultural context and suggestions for health policy are made.

Asymptomatic sensitisation to grapes in a sample of workers in the wine industry.

AIMS: To assess the prevalence of sensitisation to grapes (Vitis vinifera var. agiorghitiko) in a population with repeated exposure to grape allergens through direct cutaneous contact as well as through the gastrointestinal tract. METHODS: One hundred and twenty subjects were enrolled in each of four groups: grape harvesters, winery workers in selection of grapes, winery workers operating de-stemming/crushing/pressing machines, and administrative personnel. Sensitisation to grapes was examined by skin prick-to-prick tests with fresh fruit and juice. RESULTS: Eight harvesters and five workers in grape selection had positive reaction to the grapes tested. No machine operators or administrative personnel had positive tests. The likelihood of sensitisation was estimated at 3.7% per year of occupation by logistic regression analysis. None of the employees reported symptoms associated with sensitisation to grapes. CONCLUSION: Asymptomatic sensitisation to grapes was detected only in workers handling the fruit, suggesting that sensitisation is more likely to occur through cutaneous exposure and/or minor wounding than through the gastrointestinal tract. Prevalence rates were high and the clinical impact needs to be further investigated.

Arterial calcifications in beta-thalassemia.

The purpose of this study was to define the incidence of arterial calcifications in patients with beta-thalassemia. Beta-thalassemia patients have been shown to present a high prevalence of angioid streaks and skin lesions characteristic of pseudoxanthoma elasticum (PXE). Given the fact that vascular involvement in the form of arterial calcifications is also a common manifestation of PXE, the authors investigated radiographically the presence of arterial calcifications in beta-thalassemia patients. They studied 40 patients with beta-thalassemia over 30 years of age. Forty healthy, age- and sex-matched subjects were chosen as a control group. Radiographs of the tibias were performed in order to disclose arterial calcifications. The occurrence of PXE skin lesions and of angioid streaks (AS) was also investigated. Arterial calcifications were detected in the posterior tibial artery in 22 (55%) beta-thalassemia patients and in six (15%) controls (P < 0.01 for the comparison). PXE skin lesions and AS were found in eight (20%) and 21 (52%) patients respectively. A total of 34 patients (85%) had at least one of the three lesions, namely, arterial calcifications, angioid streaks, and/or PXE-like skin lesions. Stepwise logistic regression analysis did not reveal prognostic value in independent variables such as transfusions, chelation therapy, pseudoxanthoma elasticum skin lesions and/or angioid streaks, diabetes, hemoglobin, serum ferritin, and uric acid. It was concluded that arterial calcifications are common in older beta-thalassemia patients. This finding could be a manifestation of an acquired PXE syndrome associated with beta-thalassemia, and consequently, vascular events complicating PXE should be expected in these patients.

A field study on the effect of in-feed inclusion of a natural zeolite (clinoptilolite) on health status and performance of sows/gilts and their litters.

The study was conducted to evaluate the effect of the long-term dietary use of a natural zeolite (clinoptilolite, NZ) on health status and reproductive performance of sows/gilts and performance of their litters, along with its compatibility with antibacterials (chlortetracycline, CTC) periodically used in medication programmes. Two hundred and forty sows/gilts and their litters were assigned to two main experimental groups and four subgroups, depending on the inclusion of NZ and CTC in their feed. During the trial, frequent sampling of pregnancy feed for mycotoxicological analysis revealed a high contamination level with zearalenone. No adverse or side effects attributed to NZ were noticed. Furthermore, the combined use of NZ and CTC revealed no clinically apparent interactive effect on the availability of the latter. Reproductive performance was significantly improved by the dietary inclusion of both NZ and CTC. The results also suggested that the beneficial effect of NZ could be additionally considered as an indicator of the amelioration of zearalenone exposure consequences.