AIM:Oxidized low-density lipoprotein (oxLDL) is a pivotal factor of the atheromatous process. Statins reduce atheromatosis and cardiovascular risk. The aim of the present study was to investigate the effect of statin therapy on circulating oxLDL and the possible impact of such effect on stenosis due to carotid artery atheromatosis.METHODS:A total of 100 patients (76 males, median age 68 years) with carotid atheromatosis were enrolled. Those with stenosis >70% (n=50) were pre-treated with carotid angioplasty, whereas those with <70% were treated conservatively. Both groups were given low-dose atrorvastatin, tittered to maintain LDL cholesterol <100 mg/dL. Anthropometrics, complete lipid profile, and oxLDL were obtained in 1, 3, 6 and 12 months. Stenosis was evaluated by ultrasonography at baseline and 12 months.RESULTS:Lipid profile significantly improved at 12 months and oxLDL fell from 62.26+/-22.03 mg/dL at baseline to 44.49+/-21.75 mg/dL at 12 months (P<0.001). In the invasively pretreated group no restenosis was noticed; in the conservatively treated group a significant reduction of stenosis was demonstrated (47.6+/-13.2% vs 37.7+/-15.7%, P<0.001). The decrease of oxLDL correlated with the reduction of stenosis (r=0.17, P=0.018). In multivariate analysis, oxLDL was an independent risk factor for re-stenosis (hazard ratio=4.319, P<0.001).CONCLUSION:A marked reduction of oxLDL was shown in patients with carotid atheromatosis treated with low-dose atorvastatin. Moreover, oxLDL could be a measure of the degree of stenosis in such patients.

La retinopatía del prematuro (ROP) es una de las principales causas de ceguera infantil potencialmente evitable. Los avances en los cuidados neonatales consiguen la supervivencia de niños de bajo peso extremo asociado con una mayor incidencia de la enfermedad. El objetivo de este estudio es evaluar la fiabilidad en el diagnóstico de la ROP a través de retinografías obtenidas con la cámara de campo amplio RetCam 3 y estudiar la variabilidad en el diagnóstico de ROP en función del evaluador.El examen con oftalmoscopio indirecto fue realizado por un oftalmólogo pediátrico experto en ROP. Las imágenes retinianas fueron obtenidas por el mismo oftalmólogo y un técnico especializado en la captura de imágenes digitales. Un total de 30 sets de imágenes fueron analizados por 3 grupos enmascarados: grupo A (8 oftalmólogos), grupo B (5 expertos en visión) y grupo C (2 oftalmólogos expertos en ROP).Acorde con el diagnóstico mediante oftalmoscopia indirecta, la sensibilidad (26-93), el índice Kappa (0,24-0,80) y el porcentaje de aciertos fueron estadísticamente significativos en el grupo C para el diagnóstico de ROP tipo 1. En el diagnóstico de ROP tipo 1 + tipo 2 el índice Kappa (0,17-0,33) y el porcentaje de aciertos (58-90) fueron estadísticamente significativos, obteniendo valores superiores en el grupo C.El diagnóstico realizado por oftalmólogos expertos en ROP con el retinógrafo móvil RetCam 3 ha demostrado ser un método fiable.The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam 3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator.The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam 3 wide-angle camera. A total of 30 image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists).According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type 1. In the diagnosis of ROP Type 1 + Type 2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C.The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam 3 has proved to be a reliable method.

The production and use of polymeric materials worldwide has reached levels of 150 million tonnes per year, and the majority of plastic materials are discarded in waste landfills where are burned generating toxic emissions. In the present study we conducted laboratory experiments for batch combustion/burning of commercial polymeric materials, simulating conditions of open fire combustion, with the purpose to analyze their emissions for chemical characteristics of toxicological importance. We used common types of plastic materials: poly(vinyl chloride) (PVC), low and high density poly(ethylene) (LDPE, HDPE), poly(styrene) (PS), poly(propylene) (PP) and poly(ethylene terephthalate) (PET). Samples of particulate smoke (soot) collected on filters and residue solid ash produced by controlled burning conditions at 600-750 degrees C are used for analysis. Emissions of particulate matter, persistent free radicals embedded in the carbonaceous polymeric matrix, heavy metals, other elements and PAHs were determined in both types of samples. Results showed that all plastics burned easily generating charred residue solid ash and black airborne particulate smoke. Persistent carbon- and oxygen-centered radicals, known for their toxic effects in inhalable airborne particles, were detected in both particulate smoke emissions and residue solid ash. Concentrations of heavy metals and other elements (determined by Inductively Coupled Plasma Emission Spectrometry, ICP, method) were measured in the airborne soot and residue ash. Toxic heavy metals, such as Pb, Zn, Cr, Ni, and Cd were relatively at were found at low concentrations. High concentrations were found for some lithophilic elements, such as Na, Ca, Mg, Si and Al in particulate soot and residue solid ash. Measurements of PAHs showed that low molecular weight PAHs were at higher concentrations in the airborne particulate soot than in the residue solid ash for all types of plastic. Higher-ringed PAHs were detected at higher concentrations in the residue solid ash of PVC as compared to those from the other types of plastic. The open-air burning of plastic material and their toxic emissions is of growing concern in areas of municipal solid waste where open-fires occur intentionally or accidentally. Another problem is building fires in which victims may suffer severe smoke inhalation from burning plastic materials in homes and in working places.

Medical waste from hospitals and other healthcare institutions has become an imperative environmental and public safety problem. Medical waste in Greece has become one of the most urgent environmental problems, because there are 14,000 tons produced annually, of which only a small proportion is incinerated. In the prefecture of Attica there is only one modern municipal medical waste incinerator (started 2004) burning selected infectious hospital waste (5-6 tons day(-1)). Fly and bottom residues (ashes) are collected and stored temporarily in barrels. High values of metal leachability prohibit the landfilling of these ashes, as imposed by EU directives. In the present study we determined quantitatively the heavy metals and other elements in the fly and bottom ashes of the medical waste incinerator, by inductively coupled plasma emission spectrometry (ICP) and by energy dispersive X-ray analysis (EDAX). Heavy metals, which are very toxic, such as Pb, Cd, Ni, Cr, Cu and Zn were found in high concentrations in both fly and bottom ashes. Metal leachability of fly and bottom ashes by water and kerosene was measured by ICP and the results showed that toxic metals in both ashes, such as Pb, Cr, Cd, Cu and Zn, have high leaching values. These values indicate that metals can become soluble and mobile if ash is deposited in landfills, thus restricting their burial according to EU regulations. Analysis of polychlorinated biphenyls and polycyclic aromatic hydrocarbons in fly and bottom ashes showed that their concentrations were very low. This is the first known study in Greece and the results showed that incineration of medical waste can be very effective in minimizing the most hazardous and infectious health-care waste. The presence of toxic metals with high leachability values remains an important draw back of incineration of medical waste and various methods of treating these residues to diminish leaching are been considered at present to overcome this serious technical problem.