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Metabolic syndrome is an increasingly prevalent constellation of disease processes among the global population. Hypertension and obesity are among the contributing etiologies, and obesity increases the likelihood of hypertensive heart disease by creating a proinflammatory state, as well as increasing sympathetic tone and formation of reactive oxygen species. Hypertensive heart disease is characterized by myocardial fibrosis, which portends higher risk of developing reduced ejection fraction, diastolic dysfunction, ischemia, and arrhythmias, making early diagnosis and treatment essential to the prevention of cardiac events., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To examine prefrontal and amygdala activation during emotional processing in youth with or at varying risk for developing mania to identify candidate central prodromal risk biomarkers., Method: Four groups of medication-free adolescents (10-20 years old) participated: adolescents with first-episode bipolar I disorder (BP-I; n = 32), adolescents with a parent with bipolar disorder and a depressive disorder (at-risk depressed [ARD]; n = 32), healthy adolescents with a parent with bipolar disorder (at-risk healthy [ARH]; n = 32), and healthy adolescents with no personal or family history of psychiatric illness (healthy comparison [HC]; n = 32). Participants underwent functional magnetic resonance imaging while performing a continuous performance task with emotional and neutral distracters. Region-of-interest analyses were performed for the bilateral amygdala and for subregions of the ventrolateral prefrontal cortex and anterior cingulate cortex., Results: Overall, no group differences in bilateral amygdala and ventrolateral prefrontal cortex (Brodmann area [BA] 45/47) activation during emotional or neutral stimuli were observed. The BP-I group exhibited lower right pregenual anterior cingulate cortex activation compared with the HC group, and activation in the left BA 44 was greater in the ARH and ARD groups compared with the HC group. BP-I and ARD groups exhibited blunted activation in the right BA 10 compared with the ARH group., Conclusion: During emotional processing, amygdala and ventrolateral prefrontal cortex (BA 45/47) activation does not differ in youth with or at increasing risk for BP-I. However, blunted pregenual anterior cingulate cortex activation in first-episode mania could represent an illness biomarker, and greater prefrontal BA 10 and BA 44 activations in at-risk youth could represent a biomarker of risk or resilience warranting additional investigation in prospective longitudinal studies., (Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

A number of bacterial, viral and other diseases can be contracted by man through exposure to sewage-polluted bathing-water or beach sand. The increasing use of the sea for recreation has led to major concern regarding health hazards to both local and tourist populations. Epidemiological studies attempting to correlate microbiological water quality with health effects have produced different results, leading to a wide variation in recreational water quality criteria and standards applied, and to considerable controversy regarding their implementation. The Mediterranean provides a good example of a problem region where health risks are accentuated as a result of high utilization of bathing areas coupled with long exposure periods. Coastal pollution by sewage is still a major concern and control measures vary considerably. A number of microbiological/epidemiological studies have been carried out since 1953 in an attempt to define the levels of risk following exposure to different concentrations of bacteria in bathing waters. Most of these have been prospective studies whose design involved subject recruitment on the beach itself, classification of swimmers on the basis of immersion of the head in the water, and follow-up interviews after 7-10 days, together with a system for validation of gastrointestinal symptomatology. Practically all studies showed higher morbidity among bathers as compared to non-bathers, but correlation between specific symptoms and bacterial indicator concentrations varied considerably. On the basis of the 1972-1978 Cabelli Environmental Protection Agency (EPA) study in the United States of America, later developed by EPA into a recommended health-effects criterion for marine recreational waters, one would expect 25-40 gastrointestinal cases per 1,000 persons exposed to seawater containing 100 enterococci per 100 ml. Extrapolation of these figures to annual bathing populations indicates the potential magnitude of the problem. Much more work is needed however before a satisfactory dose-response relationship is obtained, principally because of confounding factors inherent in all studies carried out so far, which still require a solution.