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Abstract: Background: Endoscopic biliary sphincterotomy followed by endoscopic papillary balloon dilation is a promising method for large stones. However, there are no data on the optimal duration of papillary balloon dilation after a biliary sphincterotomy. Aims: To compare the effectiveness and complications of the endoscopic papillary balloon dilation for 60s versus 30s after endoscopic biliary sphincterotomy. Methods: A total of 124 patients with bile duct stones, submitted for endoscopic biliary sphincterotomy plus endoscopic papillary balloon dilation, were prospectively randomized to either the 60-s dilation group (G60, n =60) or the 30-s dilation group (G30, n =64). Results: The complete removal of bile duct stones was similar: group G30, 55/64 (86%) versus group G60, 51/60 (85%); p =0.9. The rates of post-endoscopic retrograde cholangio-pancreatography pancreatitis were also similar: 2 (3.1%) in group G30 versus 2 (3.3%) in group G60, p =0.9. Post-procedural bleeding occurred in 2 cases (3.1%) in group G30 versus 4 (6.6%) in group G60, (p =0.17). Two perforations of moderate severity were observed, one in each group. Conclusions: 30-s papillary balloon dilation, performed after endoscopic biliary sphincterotomy for the management of bile duct stones, was equally effective to the 60-s papillary balloon dilation. [Copyright &y& Elsevier]

Purpose: Time changes in plasma concentrations of six different cytokines were investigated to evaluate the inflammatory response to renal artery stent placement. Materials and Methods: A total of 22 patients (17 men; mean age, 66 years ± 13) with ostial renal artery stenosis and poorly controlled hypertension treated with stent placement were studied. Blood samples were collected at baseline and at 24 hours and 6 months after the intervention. Plasma concentrations of (i) tumor necrosis factor–α, (ii) interleukin-6 (IL-6), (iii) monocyte chemoattractant protein–1, (iv) intercellular adhesion molecule–1, (v) vascular cell adhesion molecule–1, and (vi) regulated upon activatin normal T-cell expressed presumed secreted were measured. Restenosis diagnosed with imaging follow-up at 6 months was recorded. Plasma concentrations of the aforementioned cytokines were compared between patients with and without restenosis. Results: IL-6 concentration increased significantly 24 hours after stent placement (8.3 pg/mL ± 1.24 vs. 2.76 pg/mL ± 1.27 at baseline) and returned to baseline levels (2.6 pg/mL ± 1.77) at 6-month follow-up (P < .0001). No significant changes occurred in the concentrations of any other cytokines at the three time points. Baseline and 6-month concentrations of IL-6 were significantly higher in patients with restenosis than in those without restenosis (8.13 pg/mL ± 4 vs 0.75 pg/mL ± 0.47 [P < .005] and 9.55 pg/mL ± 6.5 vs 0.42 pg/mL ± 0.35 [P < .02], respectively). Conclusions: Renal artery angioplasty with stent placement induces an inflammatory response, as evidenced by increased IL-6 production. Additionally, IL-6 seems to identify patients prone to develop restenosis; therefore, it might be used as an early predictor of restenosis after renal angioplasty with stent placement. However, larger studies are required to confirm IL-6 as a potential predictor of restenosis. [Copyright &y& Elsevier]

Abstract: This article presents a case of familial adenomatous polyposis (FAP) complicated with desmoid tumours and adenocarcinoma of the large bowel, followed-up for a fourteen-year period by a series of abdominal computed tomography scans. It is of particular interest that the patient under discussion refused to receive the medical treatment suggested, providing us with the opportunity to observe the natural evolution of the disease. Special attention is given to the mesenteric and abdominal-wall desmoid tumours and their possible clinical outcomes. [Copyright &y& Elsevier]

This study examines the concentrations and characteristics of carbonaceous aerosols (including saccharides) and inorganic species measured by PM 2.5 filter sampling and a multi-wavelength Aethalometer during two campaigns in a mountainous, medium-sized, Greek city (Ioannina). The first campaign was conducted in summer and used as a baseline of low concentrations, while the second took place in winter under intensive residential wood burning (RWB) emissions. Very high winter-mean OC concentrations (26.0 μg m−3) were observed, associated with an OC/EC ratio of 9.9, and mean BC wb and PM 2.5 levels of 4.5 μg m−3 and 57.5 μg m−3, respectively. Simultaneously, record-high levoglucosan (Lev) concentrations (mean: 6.0 μg m−3; max: 15.9 μg m−3) were measured, revealing a severely biomass burning (BB)-laden environment. The water-soluble OC component (WSOC) accounted for 56 ± 9% of OC in winter, exhibiting high correlations (R2 = 0.93–0.97) with BB tracers (nss-K+, BC wb , Lev), nitrate and light absorption, potentially indicating the formation of water-soluble brown carbon (BrC) from fast oxidation processes. The examination of diagnostic ratios involving BB tracers indicated the prevalence of hardwood burning, while the mean Lev/OC ratio (22%) was remarkably higher than literature values. Applying a mono-tracer method based on levoglucosan, we estimated very high BB contributions to OC (∼92%), EC (∼64%) and WSOC (∼87%) during winter. On the contrary, low levels were registered during summer for all carbonaceous components, with winter/summer ratios of 4–5 for PM 2.5 and BC, 10 for OC, 30 for BC wb and ∼1100 for levoglucosan. The absence of local BB sources in summer, combined with the photochemical processing and aging of regional organic aerosols, resulted in higher WSOC/OC fractions (64 ± 13%). The results indicate highly soluble fine carbonaceous aerosol fraction year-round, which when considered alongside the extreme concentration levels in winter can have important implications for short- and long-term health effects. [Display omitted] • PM 2.5 chemical characterization in a semi-mountainous city of Southeast Europe. • Severe PM 2.5 , OC and levoglusocan levels are found due to wood burning in winter. • Biomass burning contributes 92%, 87%, 64% to OC, WSOC, EC, respectively in winter. • High levoglucosan-to-OC ratio (22%) is found for local hardwood burning emissions. • Fresh wood burning aerosols were highly water-soluble with implication for toxicity. [ABSTRACT FROM AUTHOR]