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The presence of pesticide residues in groundwater, many years after their phase out in European Union verifies that the persistence in aquifer is much higher than in other environmental compartments. Currently used and banned pesticides were monitored in Northern Greece aquifers and a human health risk assessment was conducted. The target compounds were the herbicides metolachlor (MET), terbuthylazine (TER), atrazine (ATR) and its metabolites deisopropylatrazine (DIA), deethylatrazine (DEA) and hydroxyatrazine (HA). Eleven sampling sites were selected to have representatives of different types of wells. Pesticides were extracted by solid-phase extraction and analyzed by liquid chromatography. MET was detected in 100% of water samples followed by ATR (96.4%), DEA and HA (88.6%), DIA (78.2%) and TER (67.5%). ATR, DIA, DEA, HA, MET and TER mean concentrations detected were 0.18, 0.29, 0.14, 0.09, 0.16 and 0.15 μg/L, respectively. Obtained results were compared with historical data from previous monitoring studies and temporal trends were assessed. Preferential flow was the major factor facilitating pesticide leaching within the month of herbicide application. Moreover, apparent age of groundwater and the reduced pesticide dissipation rates on aquifers resulted of long-term detection of legacy pesticides. Although atrazine had been banned more than 18 years ago, it was detected frequently and their concentrations in some cases were over the maximum permissible limit. Furthermore, human health risk assessment of pesticides was calculated for two different age groups though drinking water consumption. In all examined wells, the sum of the HQ values were lower than the unity. As a result, the analyzed drinking water wells are considered safe according to the acute risk assessment process. However, the presence of atrazine residues causes concerns related with chronic toxicity, since ATR R values were greater than the parametric one of 1 × 10−6 advised by USEPA, for both age groups.

The presence of pesticide residues in groundwater, many years after their phase out in European Union verifies that the persistence in aquifer is much higher than in other environmental compartments. Factors such as limited degradation, and adsorption in phreatic horizon have resulted in frequent detection of pesticide residues and their metabolites in the saturated zone. Currently used and banned pesticides were monitored in Northern Greece aquifers and risk to human health was assessed. The target compounds were the herbicides metolachlor, terbuthylazine, atrazine and its metabolites Deisopropylatrazine (DIA), Deethylatrazine (DEA) and Hydroxyatrazine (HA). The area’s aquifer has been extensively studied over the past 20 years. Eleven sampling sites were selected in order to have representatives of different type of wells. Namely, five drinking water, two irrigation wells and four experimental boreholes located close to Greek/Turkish/Bulgarian borders were monitored and fifty-four samples were analyzed. Pesticides were extracted by solid-phase extraction and analyzed by liquid chromatography. Metolachlor was detected in 100% of water samples followed by ATR (96.4%), DEA and HA (88.6%), DIA (78.2%) and TER (67.5%). Atrazine, DIA, DEA, HA, MET and TER mean concentrations detected were 0.18, 0.29, 0.14, 0.09, 0.16 and 0.15 μg/L, respectively. Obtained results were compared with historical data from our previous monitoring studies (1999-2003 and 2010-2012) and temporal trends were assessed. Preferential flow was the major factor facilitating pesticide leaching within the month of herbicide application. Moreover, apparent age of groundwater and the reduced pesticide dissipation rates on aquifers resulted of long-term detection of legacy pesticides. Although atrazine had been banned more than 15 years ago, it was detected frequently during our monitoring campaign and their concentrations in some cases were over the maximum permissible limit. Furthermore, human health risk assessment of pesticides was calculated for two different age groups though drinking water consumption. The presence of atrazine residues causes concerns related with chronic toxicity.

Suicidal behavior occurs at much higher rates in correctional facilities than in the community, yet little is known about factors that distinguish inmates at risk for attempting versus dying by suicide. Individuals in the current study included 925 inmates housed in 2 large U.S. jails and 8 state correctional systems who attempted (79.5%) or died by (20.5%) suicide for whom archival data were available. Mental health professionals completed a tracking sheet after suicide-related incidents, documenting inmate psychological, diagnostic, and treatment related risk factors. Differences between inmates who attempt versus those who die by suicide indicate that when mental health staff are aware of inmates' current and historical risk factors, deaths by suicide are less likely to occur. (PsycINFO Database Record

Constructed wetlands (CWs) and biopurification systems (BPS) present two low-cost approaches for the removal of pesticides from waters of agricultural origin. Both strategies were tested in the treatment of the herbicide terbuthylazine, a triazine of worldwide use. Three horizontal subsurface flow (HSF) CW systems were operated continuously for one year; the planted CWs (containing either Phragmites australis or Typha latifolia) were able to remove up to 73.7% and 58.4% of the pesticide, respectively, and exhibited a markedly superior performance compared to the unplanted CW. However, by the end of the treatment period, some symptoms of phytotoxicity were observed in the plants of the CWs, which are related to high terbuthylazine concentrations in plant material. A coconut fiber-containing biomixture was used in BPS which was able to rapidly remove terbuthylazine, with an estimated half-life of 8.1 d, the fastest so far reported in these systems. However, the biomixture failed to detoxify the matrix, according to ecotoxicological tests of seed germination. The current data suggests that coupled/hybrid configurations comprising CWs and BPS in series could provide increased effectiveness and a low-cost technology to remove terbuthylazine from highly contaminated water.

Intracorneal ring segment (ICRS) implantation represents a modern, minimally invasive, surgical option for visual improvement in patients with keratoconus. ICRS modify the corneal geometry in a manner that enhances its refractive properties and thereby, they improve visual acuity. It is well-documented that implantation of ICRS decreases the keratometric readings, spherical equivalent and cylinder, reduces high-order aberrations and improves uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BCDVA) in patients with keratoconus. Success rate after ICRS implantation is high, depending on appropriate patient selection and adherence to suitable implantation nomograms, and most important, the overall complication rate is very low. This review is summarizing current indications/contra-indications for ICRS implantation, implantation techniques, clinical outcomes and potential complications, shedding light on myths and realities related to this innovative surgical option.

Background The impact of Body Mass Index (BMI) on efficacy of TNF blocking therapy in Rheumatoid Arthritis (RA) patients and therefore on control of the disease is an important question. Objectives The aim of this study is to determine the influence of BMI on the efficacy of TNF blocking therapy in terms of disease activity in patients with RA. Methods A retrospective, observational study of 168 consecutive RA patients who received subcutaneously (SC) TNF blocking treatment (adalimumab, etanercept, golimumab and certolizumab pegol). Their follow-up data, for at least 26 weeks, and their baseline BMIs were available. The WHO definition for normal weight, overweight and obesity was applied, whereas clinical response was compared by BMI subgroups. Results The average BMI was 26.83±4.34 kg/m 2 and the baseline Disease Activity Score in 28 joints (DAS28 [ESR]) was high at 5.72±0.84. Mean age was 63.47±12.58 years and 135 (80.36%) were female. The median disease duration was 13.01±8.57 years. Overall, patients with normal weight responded better to treatment regimen, followed by overweight and obese subgroups. After a follow-up period of 26 weeks, the obese group had significantly higher DAS28 (ESR) and Health Assessment Questionnaire (HAQ) than either normal or overweight subgroups (3.26±0.84 vs 2.72±0.78 vs 2.81±0.82, p vs 0.076±0.01 vs 0.178±0.01, p p :0.002 and normal HAQ (≤0.5) p : 0.003. Conclusions Patients with RA and higher BMIs demonstrated a diminished clinical response after 26 weeks of SC-administered TNF-blocking treatment compared with their counterparts with lower BMIs. References [1] Klaasen R1, et al. Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum2011Feb;63(2):359–64. [2] Puig L1. Obesity and psoriasis: body weight and body mass index influence the response to biological treatment. J Eur Acad Dermatol Venereol2011Sep;25(9):1007–11. [3] Daien CI1, et al. Predictive factors of response to biological disease modifying antirheumatic drugs: towards personalized medicine. Mediators Inflamm2014;2014:386148. [4] Schulman E1, et al. Overweight and Obesity Reduce the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results from the Canadian Early Arthritis Cohort Study. Arthritis Care Res (Hoboken)2017Nov 30. Disclosure of Interest None declared

Summary Common burdock (Arctium minus) is a common biennial weed of non-arable land in typical rural settings of Orestiada, Greece. The aim of this study was to describe the basic morphological traits of this species throughout the main phenological stages of its life cycle and to obtain some insight into its growth and productivity in Orestiada. Based on our observations, the plants occurred most commonly in moist and fertile soils, usually as isolated individuals or in small patches near the parent plants. The species is characterized by its large basal ‘elephant-ear’ leaves during the vegetative stage, appearing in alternate arrangement, with irregularly wavy and non-toothed edges, as well as with long hollow stalks forming a noticeable furrow on the top. By monitoring individual plants, it was found that fl owering (in the second year of growth) mostly occurred from late June up to early August. The fl owers were purple, occurring in bristly heads at the top of the stem. The bristly heads formed a fruit, containing small black seeds. The average number of capitula per plant, from randomly selected populations in Orestiada, was found to be 69.7 and 57.7 respectively, whereas the mean seed number per capitulum reached 30.3 and 33.3 seeds, respectively

Hereditary angioedema is a rare genetic disorder resulting from an inherited deficiency or dysfunction of the C1-esterase inhibitor of the classic complement pathway. It is characterised by recurrent episodes of angioedema, without urticaria or pruritus, most often affecting the skin or the mucosal tissues of the upper respiratory and gastrointestinal tracts. We describe the peri-operative care of a woman with hereditary angioedema undergoing laparoscopic cholecystectomy with emphasis on the role of anaesthetists as peri-operative physicians.

Arrhythmogenic right ventricular dysplasia, also called right ventricular cardiomyopathy, is a genetically determined heart muscle disease, characterised by life-threatening ventricular arrhythmias in apparently healthy young people. The primary myocardial pathology is that the myocardium of the right ventricular free wall is replaced by fibrous or fibrofatty tissue, with scattered residual myocardial cells. Right ventricular function is abnormal and in severe cases is associated with global right ventricular dilation and overt biventricular heart failure. Although still relatively rare, arrhythmogenic right ventricular cardiomyopathy is a well recognised cause of sudden unexpected peri-operative death. In this review, we describe the basic characteristics of this disease, emphasising the diagnosis and we offer some suggestions for the anaesthetic management of these patients in the peri-operative period.

An approach combining monitoring and ecotoxicological data has been undertaken to assess pesticide loading in the drainage canals of two transboundary rivers of northeastern Greece near the Greek/Bulgarian/Turkish borders as well as the subsequent risk to non-target aquatic organisms. Aquatic risk assessment was based on the Risk Quotient (RQ=MEC/PNEC) regarding three trophic levels, algae, aquatic invertebrates and fish. Alachlor, atrazine, carbaryl, carbofuran, cypermethrin, DEA, DIA, diazinon, dimethoate, endosulfan, metolachlor, monilate, prometryn and trifluralin were the compounds detected at the highest concentrations on a regular basis. Extreme concentrations were observed just after high rainfall events during the month of pesticide application. Aquatic risk assessment revealed non-acceptable risk for 10 compounds when median concentrations were used as ΜEC values. However, should extreme concentrations be taken into account, 15 compounds were considered as likely to pose a threat to aquatic organisms. Conformity to EC environmental quality standards is also discussed.

The present paper is an interesting and rare complication of implantation of a permanent pacemaker lead. The rarity of the case is based upon that ventricular perforation is usually present during implantation, whereas in our case, it was presented late--1 month after implantation. Furthermore, in our case, the pacemaker lead had migrated through the left hemidiaphragm into the peritoneal cavity.