Glucagon-like peptide-1 receptor agonists in non-alcoholic fatty liver disease: An update

Non-alcoholic fatty liver disease (NAFLD) is the predominant cause of chronic liver disease worldwide. NAFLD progresses in some cases to non-alcoholic steatohepatitis (NASH), which is characterized, in addition to liver fat deposition, by hepatocyte ballooning, inflammation and liver fibrosis, and in some cases may lead to hepatocellular carcinoma. NAFLD prevalence increases along with the rising incidence of type 2 diabetes mellitus (T2DM). Currently, lifestyle interventions and weight loss are used as the major therapeutic strategy in the vast majority of patients with NAFLD. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in the management of T2DM and do not have major side effects like hypoglycemia. In patients with NAFLD, the GLP-1 receptor production is down-regulated. Recently, several animal and human studies have emphasized the role of GLP-1RAs in ameliorating liver fat accumulation, alleviating the inflammatory environment and preventing NAFLD progression to NASH. In this review, we summarize the updated literature data on the beneficial effects of GLP-1RAs in NAFLD/NASH. Finally, as GLP-1RAs seem to be an attractive therapeutic option for T2DM patients with concomitant NAFLD, we discuss whether GLP-1RAs should represent the first line pharmacotherapy for these patients.

Endoscopic sedation practices of Greek gastroenterologists: a nationwide survey

Background:

Sedation in gastrointestinal endoscopy is rapidly evolving worldwide. However, this has led to significant disagreements, especially regarding the use of propofol by non-anesthesiologists. The aim of this study was to document the practices of Greek gastroenterologists regarding sedation and compare them to previous surveys.

Methods:

The study was conducted in 2 periods, December 2015 and June 2018. In each period, the same online questionnaire regarding endoscopic sedation practices was sent to all registered Greek gastroenterologists (509 and 547 gastroenterologists, respectively).

Results:

The response rates were 38.3% and 47.1%, respectively. In each period, 25.1% and 16.7% of physicians did not use sedation. Most gastroenterologists (approx. 70% in both instances) answered that they “almost never” collaborate with an anesthesiologist during endoscopy. Midazolam was by far the most popular sedation agent, used by almost 90% of physicians in both periods. Propofol was used by 30.8% and 27% of physicians, respectively. Physicians using propofol were significantly more satisfied with the sedation than other physicians, while propofol was the agent selected by most physicians if they were to undergo endoscopy themselves. Most physicians cited medicolegal reasons and inadequate training as chief reasons for not using propofol.

Conclusions:

Sedation use is widespread among Greek gastroenterologists. Although midazolam is the most commonly used agent, propofol is preferred (theoretically) by most physicians and achieves the best satisfaction. The introduction of a strict training curriculum for endoscopic sedation can effectively eliminate the barriers preventing gastroenterologists from administering propofol, while at the same time ensuring optimal patient safety during endoscopy.

Insertion of Long-Term Tunneled Cuffed Hemodialysis Catheters via the External Jugular Vein by using a Simple, Safe and Reliable Surgical Technique

Objective

Description of our technique for the insertion of long-term tunneled cuffed hemodialysis (HD) catheters via the external jugular vein.

Methods

From December 1999 to August 2006, 357 long-term tunneled cuffed HD catheters were inserted in 308 patients, who were referred to us from various hospitals and clinics in Greece. About half of them (168, or 47%) were inserted via the external jugular vein. We describe our surgical technique for the insertion of long-term tunneled cuffed HD catheters via the external jugular vein.

Results

During our study, there was a gradual increase in using the external jugular vein as a method for the insertion of permanent HD catheters. In all cases, the intraoperative catheter blood flow was measured >300 ml/min. No major complications occurred.

Conclusions

Long-term tunneled cuffed HD catheters can be inserted via the external jugular vein by using an easy, simple, safe surgical technique. This procedure provides the possibility of using the internal jugular vein in the future.

Origin of hexavalent chromium in groundwater: The example of Sarigkiol Basin, Northern Greece

Hexavalent chromium constitutes a serious deterioration factor for the groundwater quality of several regions around the world. High concentrations of this contaminant have been also reported in the groundwater of the Sarigkiol hydrological basin (near Kozani city, NW Greece). Specific interest was paid to this particular study area due to the co-existence here of two important factors both expected to contribute to Cr(VI) presence and groundwater pollution; namely the area's exposed ophiolitic rocks and its substantial fly ash deposits originating from the local lignite burning power plant. Accordingly, detailed geochemical, mineralogical, hydro-chemical, geophysical and hydrogeological studies were performed on the rocks, soils, sediments and water resources of this basin. Cr(VI) concentrations varied in the different aquifers, with the highest concentration (up to 120μgL^-1) recorded in the groundwater of the unconfined porous aquifer situated near the temporary fly ash disposal site. Recharge of the porous aquifer is related mainly to precipitation infiltration and occasional surface run-off. Nevertheless, a hydraulic connection between the porous and neighboring karst aquifers could not be delineated. Therefore, the presence of Cr(VI) in the groundwater of this area is thought to originate from both the ophiolitic rock weathering products in the soils, and the local leaching of Cr(VI) from the diffused fly ash located in the area surrounding the lignite power plant. This conclusion was corroborated by factor analysis, and the strongly positively fractionated Cr isotopes (δ⁵³Cr up to 0.83‰) recorded in groundwater, an ash leachate, and the bulk fly ash. An anthropogenic source of Cr(VI) that possibly influences groundwater quality is especially apparent in the eastern part of the Sarigkiol basin.

NATURAL AND ANTHROPOGENIC EFFECTS ON THE SOIL GEOCHEMISTRY OF KAVALA AREA, NORTHERN GREECE

A total of 65 surface soils and 8 rock samples from the area surrounding the city of Kavala, Northern Greece, was collected and analyzed for their contents in 10 major and 32 trace elements. The extraction of the elements from the < 200μm soil fraction was based on the digestion of 0.1g of each sample with 2ml HNO3. The analytical methods used were ICP-OES and ICP-MS and the elements determined were Al, Ca, Cl, Fe, K, Mg, Na, P, S, Si, Ag, As, B, Ba, Cd, Ce, Co, nCr, Cs, Cu, Ga, Ge, Hg, La, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sn, Sr, Th, Ti, U, V, W, Y, Zn and Zr. Comparisons between the concentrations of the surface soil samples and the surrounding rock samples indicate that the majority of major, as well as, of trace elements are found in the surface soils of Kavala with such concentrations that are considered as the product of natural processes such as the weathering of parent rocks and pedogenesis. However, there are some nmajor elements (Cl, Na, S) and trace elements (Ag, As, Pb, V, Zn) that are present in the surface soils of the study area with elevated concentrations that cannot be regarded as the sole product of natural processes, but as the result of both, natural and anthropogenic activities, especially for the samples that are situated inside the industrial area of Kavala.

emoval of malachite green dye from aqueous solutions by diasporic Greek raw bauxite

Raw bauxite from Klisoura mine (Prefecture of Fokida, Greece) containing 72 wt.% diaspore, 16 wt.% hematite, 6 wt.% quartz, 4 wt.% anatase and 2 wt.% calcite, has been used for the removal of malachite green dye from aqueous solutions. The batch type experiments were conducted with 10 ml of solution, at pH = pHZPC = 6.7 and contact time 1 h. The initial concentration of malachite green dye was 10 mg/l, the bauxite quantity was 0.02 g, 0.04 g, 0.06 g, 0.1 g and 0.2 g. The highest adsorption capacity achieved was 4.5 mg/g (90% removal) using 0.02 g bauxite. The removal capacity of raw bauxite is comparable to other non-conventional adsorbents, such as neem sawdust, sugar cane dust and cane root carbon.

Extra-framework cation release from heulandite-type rich tuffs on exchange with NH(4)(+)

The outgoing cations of Greek heulandite-rich tuff samples (heulandite type-III, 91wt.%, mica 4wt.%, feldspar 5wt. %, CEC 2.22meq/g) were analysed upon exchange with ammonium acetate using atomic absorption spectrometry (AAS). The kinetic curves of each cation were investigated over a total time of contact of 720h with sampling at frequent intervals. The materials were examined by powder X-ray diffraction, SEM-EDS, and AAS. The sorption ability was measured using the ammonium acetate saturation method. It was found that Ca(2+) presents an unexpected extra-framework release and a surprisingly high degree of exchange (90%). The exchange of Mg (57%) is also worthy of note whereas the behavior of K(+) showed an expected rapid initial release. The behavior of Na(+) must be similar. However, its lower concentration in the zeolitic material minimizes its overall significance somewhat. On the other hand, Ca(2+) and Mg(2+) release is kinetically much slower, compared to that of alkali metal ions, and this phenomenon indicates that different exchange energies are needed till final equilibrium.

Degree of familiarity ART2 in knowledge-based landmine detection

The self-organizing network ART2 is extended to provide a fuzzy output value, which indicates the degree of familiarity of a new analog input pattern to previously stored patterns in the long-term memory of the network. The outputs of the multilayer perceptron and this modified ART2 provide an analog value to a fuzzy rule-based fusion technique which also uses a processed polarization resolved image as its third input. In real-time situations these two classifier outputs indicate the likelihood of a surface landmine target when presented with a number of multispectral and textural bands. Due to the modifications in ART2 this updated alternative architecture (to that of a previous network in [3]) has improved real-time landmine detection capabilities although the registration of all bands is more critical to the accuracy of results in this case. The real-time fuzzy rule-based system in preliminary tests has detected two of the three landmines and the landmine surrogate with two false alarms. Advanced tests on 30 images using the fuzzy rule-based system further confirmed the distinct advantages of fusion and improved detection rates.

Insertion of long-term tunneled cuffed hemodialysis catheters via the external jugular vein by using a simple, safe and reliable surgical technique

OBJECTIVE

Description of our technique for the insertion of long-term tunneled cuffed hemodialysis (HD) catheters via the external jugular vein.

METHODS

From December 1999 to August 2006, 357 long-term tunneled cuffed HD catheters were inserted in 308 patients, who were referred to us from various hospitals and clinics in Greece. About half of them (168, or 47%) were inserted via the external jugular vein. We describe our surgical technique for the insertion of long-term tunneled cuffed HD catheters via the external jugular vein.

RESULTS

During our study, there was a gradual increase in using the external jugular vein as a method for the insertion of permanent HD catheters. In all cases, the intraoperative catheter blood flow was measured >300 ml/min. No major complications occurred.

CONCLUSIONS

Long-term tunneled cuffed HD catheters can be inserted via the external jugular vein by using an easy, simple, safe surgical technique. This procedure provides the possibility of using the internal jugular vein in the future.

Investigation of the uptake ability of fly ashes produced after lignite combustion

Fly ash samples from the five steam electric power stations of the Lignite Center of Western Macedonia were used in this study. They consisted mainly of anhydrite, lime, quartz and amorphous material as well as feldspars, calcite, micas + clays, portlandite and gehlenite which were all present in minor amounts. Anhydrite, lime and portlandite in the fly ash samples diminished upon treatment with ammonium acetate aqueous solution, whereas quartz, feldspars, gehlenite and amorphous material were enriched. The uptake ability of the fly ash samples ranged from 89 to 101 mequ./100g. The uptake ability of the samples was mainly attributed to the amorphous material and the microporous minerals, micas + clays. The amorphous material content was estimated at between 17 and 20 wt% in the treated fly ashes and may be unburned organic matter and amorphous inorganic material that resulted during the combustion of the lignite. A positive correlation was observed between the uptake ability and the total percentage of amorphous material and micas + clays. The relatively high uptake ability of the fly ash samples could lead to additional industrial and environmental uses of the fly ashes. The environmental advantage of fly ash exploitation will be particularly important for large electric power centers, such as the LCWM.

HEAVY METALS AND TOXIC TRACE ELEMENTS CONTENTS IN SOILS OF SELECTED AREAS OF THE KAVALA PREFECTURE, NORTHERN GREECE

In the present study a total of sixteen samples (3 surrounding rocks and 13 uncultivated topsoils) from the industrial zone east of the city of Kavala, Northern Greece, was collected and analyzed for their content in 41 elements. The extraction of the elements was based on the digestion of 0.1 g of each sample with 2 ml HNO3 and the soil fraction used was the < 20Όμιη. The analytical methods used were ICP-OES for the elements Ca, Mg, Κ, Β, Sr, Fe, Na, Si, S, Ρ, and ΑΙ and ICPMS for the elements Mn, Zn, Cu, Ti, V, Cr, Rb, Ba, Th, La, Ce, As, Sn, Co, Se, Y, Zr, Mo, Cd, Cs, W, Sb, Li, U, Ag, Ni, Hg, Ga, Ge and Pb. The mean element concentrations of the thirteen topsoil samples were compared with the mean values for soil types Fluvisols and Leptosols. The results showed that they are enriched for the elements Ag, As and Pb by 21, 15 and 3 times, respectively. Moreover, the topsoils were compared with the three surrounding rock samples. The results showed that the concentrations of Ca, Mg, Κ, Fe, Si, S, AI, Ρ Na, Β, Ce, Co, Cs, Ga, Ge, Hg, La, Li, Mo, Ni, Rb, Se, Sn, Sr, Th, U and W in the topsoils are mainly influenced by their concentrations in the surrounding rocks. The elements Ag, As, Ba, Cd, Cr, Cu, Mn, Pb, Sb, Ti, Y, V, Zn, and Zr are enriched in the topsoils. The enrichment of Ag, As, Cd, Cr, Cu, Mn, Pb, Sb, and Zn is mainly due to the widespread presence of PBG sulphides, Mn, Cd, and As in the surrounding mineralizations. The enrichment took place, quite possibly, during the formation of Drama and Nestos basins, during Tertiary, and is possibly being continued until today. However, the human activities that take place in the area are also, at least partially, responsible for this enrichment.

ORGANIC POLLUTANTS IN THE INDUSTRIAL AREA EAST OF KAVALA, NORTHERN GREECE

The occurrence and distribution of organic pollutants were studied at in an industrial area situated at the coastal zone east of Kavala, Northeastern Greece. The study focused especially on the area, where the oil facilities of Kavala Oil Co. are located. Three surface water samples were collected and investigated by means of non-target screening analyses to evaluate the level of organic pollution, as well as to reveal molecular markers representing the industrial emissions. The analytical procedure included a sequential extraction of the samples, GC-FID as well as GC/MS analyses (Franke et al., 1995). In the three water samples halogenated compounds, technical additives and synthetic fragrances, phosphates, phthalates, benzothiazoles, esters, ketones, phenols, ethers and PAH's were detected. Quantitative analyses of selected pollutants were additionally performed. Source-specific marker compounds were identified and used to trace different types of emissions throughout the affected environment

Characterisation of zeolitic materials with a HEU-type structure modified by transition metal elements: definition of acid sites in nickel-loaded crystals in the light of experimental and quantum-chemical results

Nickel-loaded HEU-type zeolite crystals have been obtained by well-known synthetic procedures and characterised by X-ray fluorescence (XRF), scanning-electron microscopy/ energy-dispersive spectroscopy (SEM-EDS), FT-IR, diffuse reflectance UV/ Vis spectroscopy (DR(UV/Vis)S) and X-ray photoelectron spectroscopy (XPS) measurements as non-homoionic and non-stoichiometric substances containing exchangeable hydrated Ni2+ ions in the micropores and nickel hydroxide phases supported on the surface. Thermogravimetric analysis/differential gravimetry (TGA/DTG) and differential thermal analysis (DTA) demonstrated that full dehydration below approximately 400 degrees C follows a clearly endothermic process, whereas at higher temperatures the zeolite is amorphised and finally partially recrystallised to Ni(Al,Si) oxides, detected by powder X-ray powder diffraction (XRD). The solid acidity of NiHEU, initially determined by temperature-programmed desorption (TPD) of ammonia to be 8.93 mgg(-1) NH3, is attributed to the weak acid sites (fundamentally Lewis sites) resolved at approximately 183 degrees C, and to the strong acid sites (essentially Brønsted sites) resolved at approximately 461 degrees C in the TPD pattern. A more sophisticated study based on in situ/ex situ FT-IR with in situ/ex situ 27Al MAS NMR and pyridine (Py) as a probe molecule, revealed that the Lewis acid sites can be attributed primarily to Ni2+ ions, whereas the Brønsted ones can probably be associated with the surface-supported nickel hydroxide phases. The spectroscopic measurements in conjunction with powder XRD and 29Si MAS NMR data strongly suggest that distorted Al tetrahedra are formed during the dehydration process and Py chemisorption/complexation (NiHEU-Py), whereas the crystal structure is remarkably well preserved in the rehydrated material (NiHEU-Py/R). The structural, electronic, energetic and spectroscopic properties of all possible nickel(II) aqua and dihydroxy complexes absorbed in the zeolite micropores or supported on the zeolite surface were studied theoretically by density functional theory (DFT). The computed proton affinity, found to be in the range 182.0-210.0 kcalmol(-1), increases with increasing coordination number of the aqua and dihydroxy nickel(II) complexes.