Congenital lumbar herniae: a systematic review.

PURPOSE: Congenital lumbar hernia is defined as the protrusion of intraperitoneal or extraperitoneal viscera through a defect of the posterior abdominal wall, present at birth. The aim of our study was to perform a systematic review of this rare pathology, with emphasis on surgical decision-making. METHODS: The English literature (2000-2020) was reviewed, using PubMed, EMBASE and GoogleScholar databases, combining the terms "hernia", "lumbar", "flank", "Grynfeltt", "Petit" and "congenital". Overall, 35 studies were included, describing 85 patients. RESULTS: Mean age was 9.7 ± 20.7 months (range 1 day-10 years). 55.7% were males and 44.3% were females. All patients presented electively, with flank bulging as the main symptom. Superior lumbar triangle (Grynfeltt) herniae accounted for 41.8%, inferior lumbar triangle (Petit) herniae for 32.8%, whereas 25.4% were classified as diffuse. A left-sided hernia was observed in 47%, a right-sided in 42.4%, while 10.6% were bilateral. 71.8% of the patients had associated anatomical anomalies, mainly the lumbocostovertebral syndrome. Most patients (83.3%) were treated surgically, while 16.7% conservatively with surveillance. In 93.3%, the surgical approach was open, with laparoscopy employed in 6.7% of cases. The majority (71.7%) underwent primary suture repair of the hernia defect, whereas a mesh was required in 28.3%. Post-operative morbidity was 6.7% and recurrence rate was 3.3% at a mean follow-up of 26.4 months. CONCLUSION: Congenital lumbar hernia is a rare pathology in the paediatric population, with only 85 cases reported since 2000. Although the diagnosis is frequently straightforward, it should raise the suspicion for associated congenital anomalies and further investigation is required, with cross-sectional imaging. Surgical repair is usually performed during the first year, to allow for symmetrical torso development.

Synthesis and evaluation of coastal and marine biodiversity spatial information in the United Arab Emirates for ecosystem-based management.

The United Arab Emirates (UAE) host valuable coastal and marine biodiversity that is subjected to multiple pressures under extreme conditions. To mitigate impacts on marine ecosystems, the UAE protects almost 12% of its Exclusive Economic Zone. This study mapped and validated the distribution of key coastal and marine habitats, species and critical areas for their life cycle in the Gulf area of the UAE. We identified gaps in the current protection of these ecological features and assessed the quality of the data used. The overall dataset showed good data quality, but deficiencies in information for the coastline of the north-western emirates. The existing protected areas are inadequate to safeguard key ecological features such as mangroves and coastal lagoons. This study offers a solid basis to understand the spatial distribution and protection of marine biodiversity in the UAE. This information should be considered for implementing effective conservation planning and ecosystem-based management.

Photo-Fenton and Fenton-like processes for the treatment of the antineoplastic drug 5-fluorouracil under simulated solar radiation.

In the present study, photo-Fenton and Fenton-like processes were investigated for the degradation and mineralization of the antineoplastic drug 5-fluorouracil (5-FU). For the optimization of photo-Fenton treatment under simulated solar light (SSL) radiation, the effects of several operating parameters (i.e., 5-FU concentration, Fe3+, and oxidant concentration) on the treatment efficiency were studied. According to the results, SSL/[Fe(C2Ο4)3]3-/Η2Ο2 process was the most efficient, since faster degradation of 5-FU and higher mineralization percentages were achieved. All the applied processes followed quite similar transformation routes which include defluorination-hydroxylation as well as pyrimidine ring opening, as demonstrated by the transformation products identified by high resolution mass spectrometry analysis. The toxicity of the treated solutions was evaluated using the Microtox assay. In general, low toxicity was recorded for the initial solution and the solution at the end of the photocatalytic treatment, while an increase in the overall toxicity was observed only at the first stages of SSL/Fe3+/Η2Ο2 and SSL/Fe3+/S2O82- processes.

Photocatalytical removal of fluorouracil using TiO2-P25 and N/S doped TiO2 catalysts: A kinetic and mechanistic study.

In the present study, the photocatalytic activity of TiO2-based photocatalysts toward degradation and mineralization of the anti-cancer drug 5-fluorouracil (5-FU) in aqueous phase was investigated under simulated solar and visible irradiation. Commercial TiO2 (P25) and N/S-doped TiO2 catalysts synthesized by a simple sol-gel method were used as photocatalysts. TiO2 P-25 was found to be the most photoactive catalyst for the removal of 5-FU, under simulated solar irradiation. Among N/S-doped TiO2 catalysts, the one with molar Ti:N/S ratio equal to 0.5 was the most efficient under simulated solar irradiation. In contrast, under visible irradiation the catalyst with equimolar Ti:N/S ratio showed the highest performance for the removal of 5-FU. Scavenging experiments revealed that HO radicals and h+ were the major reactive species mediating photocatalytic degradation of 5-FU using TiO2 P-25 and N/S-doped TiO2 catalysts, under simulated solar irradiation. On the other hand, the essential contribution of 1O2 and O2- in the degradation of 5-FU under visible light was proved. The transformation products (TPs) of 5-FU, were identified by LC-MS-TOF suggesting that defluorination followed by hydroxylation and oxidation are the main transformation pathways, under all the studied photocatalytic systems.

Photocatalytic reduction of Cr(VI) by char/TiO2 composite photocatalyst: optimization and modeling using the response surface methodology (RSM).

The photocatalytic reduction of Cr(VI) using pyrolytic char/TiO2 (PC/TiO2) composite catalyst under simulated solar irradiation was studied. Response surface methodology (RSM) and experimental design were used for modeling the removal kinetics and for the optimization of operational parameters. RSM was developed by considering a central composite design with four input variable, i.e. catalyst concentration, initial concentration of Cr(VI), pH, and % (v/v) methanol concentration for assessing individual and interactive effects. A quadratic model was established as a functional relationship between four independent variables and the removal efficiency of Cr(VI). It was found that all selected variables have significant effect on Cr(VI) removal efficiency; however, the pH, the % concentration of methanol, and their interaction exhibited the major effects. Within the studied experimental ranges, the optimum conditions for maximum Cr(VI) removal efficiency (72.1 %) after 60 min of photocatalytic treatment were: catalyst concentration 55 mg L-1, Cr(VI) concentration 20 mg L-1, pH 4, and 5 % (v/v) methanol concentration. Under optimum conditions, Cr(VI) reductive removal followed pseudo-first-order kinetics, and nearly complete removal took place within 90 min. The results revealed the feasibility and the effectiveness of PC/TiO2 as photocatalyst in reduction reactions due to their ability of e--h+ pair separation increasing the transfer of the photogenerated e- to the catalyst's surface and thus the reduction of Cr(VI).

Photocatalytic degradation of pentachlorophenol by visible light Ν-F-TiO2 in the presence of oxalate ions: optimization, modeling, and scavenging studies.

The efficiency of heterogeneous photocatalysis using N-F-TiO2 as photocatalyst to degrade a priority pollutant, pentachlorophenol (PCP), in the presence of oxalates (OA) was investigated in detail. Response surface methodology was used to optimize the effect of three variables (catalyst concentration, OA/PCP ratio, and pH) on the photocatalytic degradation of pentachlorophenol. A quadratic model was established as a functional relationship between three independent variables and the degradation efficiency of PCP. The results of model fitting and statistical analysis demonstrated that the pH played a key role in the degradation of PCP. Within the studied experimental ranges, the optimum conditions for maximum PCP degradation efficiency (97.5 %) were: catalyst concentration 600 mg L(-1), OA/PCP ratio 2, and pH 10. The contribution of HO(·), O2 (·-), and e(-) produced during the photocatalytic treatment was investigated with the addition of scavengers. The photocatalytic degradation was essentially proceeded through an oxidative mechanism at both acid and alkaline pH values by HO(.) and O2 (·-) radicals attack. It was found that O2 (·-) were the major reactive species involved in PCP degradation in pH 4 and HO(·) in pH 10.

Photocatalytic degradation of pentachlorophenol by N-F-TiO2: identification of intermediates, mechanism involved, genotoxicity and ecotoxicity evaluation.

In the present study the photocatalytic degradation of a toxic priority pollutant, PCP, in the presence of N-F codoped TiO2 was explicitly investigated. The efficiency of the process to remove PCP was monitored for the first time through combined evaluation of several aspects: the kinetic study of the PCP degradation, identification of transformation products by a combination of mass spectrometric techniques (HR-LC-MS and GC-MS), assessment of total mineralization during the process, and evaluation of the genotoxicity and ecotoxicity of the initial and treated solutions applying the cytokinesis block micronucleus (CBMN) assay and Microtox assay, respectively. On the basis of identified products, a proposed degradation pathway is presented, involving mainly oxidative dechlorination reactions. Genotoxicity and ecotoxicity studies clearly demonstrated the efficiency of the photocatalytic process in the detoxification as well as in the elimination of genotoxicity and cytotoxicity of the irradiated solutions.

A review on advanced oxidation processes for the removal of taste and odor compounds from aqueous media.

In view of the global concern about the occurrence of taste and odor (T&O) compounds in waters for drinking water supply and the necessity for the development of more innovative and efficient technologies for water treatment and depuration, the focus of this study is to provide a state of the art overview on current knowledge for the application of advanced oxidation technologies for the treatment of T&O compounds in aquatic media. The most representative and newly emerging compounds belonging to the major groups of T&O compounds, such as geosmin, methylisoborneol, benzothiazoles, mercaptans and sulfides as well as aromatic and other miscellaneous T&O compounds, are included in the systematic overview. The current data has been compiled and extensively discussed in terms of the degree of degradation, reaction kinetics, effect of operational parameters and water quality, identity of intermediate and final products and possible transformation pathways.

Nutrient intake in relation to central and overall obesity status among elderly people living in the Mediterranean islands: the MEDIS study.

BACKGROUND AND AIM: The aim of the present work was to evaluate the relationship between energy-generating nutrients and the presence of central and overall obesity after correcting for socio-demographic, lifestyle and clinical characteristics, among healthy elders. METHODS AND RESULTS: During 2005-2007, 553 elderly men and 637 elderly women (mean age 74±7years) from eight Mediterranean islands in Greece and Cyprus, were enrolled. The retrieved information included demographic, bio-clinical and dietary characteristics. MedDietScore assessed adherence to the Mediterranean dietary pattern. The prevalence of obesity was 27% in males and 39% in females (p<0.001), while 73% of males and 87% of females had central obesity. The prevalence of diabetes, hypercholesterolemia and hypertension was higher in the obese than in the non-obese participants (p<0.01). After adjusting for various confounders, a 1% increase in carbohydrate consumption was associated with a 12% (95% CI 0.78-0.99) lower likelihood of having central obesity, while a 1% increase in carbohydrate and protein consumption was associated with a 14% (95% CI 0.78-0.95) and 16% (95% CI 0.72-0.97) lower likelihood of being obese, respectively. Vegetable protein was found to be associated with a 15% (95% CI 0.77-0.93) lower likelihood of being obese while, only low glycemic index carbohydrates seem to be associated with a 6% (95% CI 0.90-0.98) lower likelihood of having central obesity. CONCLUSIONS: The presented findings suggest that a diet high in carbohydrates and vegetable protein is associated with a lower likelihood of being obese and may help elderly people to preserve normal weight.

Long-term animal-protein consumption is associated with an increased prevalence of diabetes among the elderly: the Mediterranean Islands (MEDIS) study.

AIM: The role of animal-protein consumption on the prevalence of diabetes is not yet fully understood. For this reason, this study investigated the relationship between long-term animal-protein intake and diabetes in elderly individuals with no known cardiovascular disease. METHODS: During 2005-2007, 1190 men and women, aged 65-100 years, from Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Corfu and Zakynthos were enrolled into the study. Diabetes was defined as fasting blood glucose ≥ 125 mg/dL or the use of antidiabetic medication. All participants were asked about their dietary habits through a semiquantitative food-frequency questionnaire. Assessment of protein and energy intakes was performed using food-composition tables. RESULTS: After adjusting for age, gender, obesity, history of hypertension, hypercholesterolaemia and dietary habits, a 5% increase in protein intake from meat and meat products was associated with a 34% (OR=1.338, 95% CI: 1.02-1.76) greater likelihood of diabetes, while a 5% increase in total protein intake was associated with a 29% (OR=1.288, 95% CI: 1.00-1.69) greater likelihood of diabetes. No significant associations between diabetes and protein intakes from vegetables and cereals were observed. CONCLUSION: Animal-protein consumption was associated with a higher prevalence of diabetes among the elderly, whereas protein intakes, especially from plant sources, within the recommended range appear to confer considerable protection. This suggests that reducing or controlling the burden of diabetes through dietary means in the elderly should include monitoring their daily protein intake.

G.B. Morgagni: the father and founder of contemporary pathology.

Giovanni Morgagni (1682-1771) who lived in the 18th century was the greatest pathologist that ever existed. His fame extended beyond his country, Italy, and his name became universally known, being the Father of Contemporary Pathology. He set the basis for the creation of a new medical specialisation, pathology, which was unknown at the time. His brilliant mind made a big step in the formation of a new type of clinical thought in every day medicine. He managed to make the clinician, physician and surgeon think and act in a different scientific manner; to think in an anatomo-clinical way. In other words, by correlating the symptoms of a certain disease with the corresponding pathological alterations, he also discovered many new diseases and wrote many books which were unique for their wisdom.