Introduction: Vitamin D plays a vital role as an essential nutrient for human health, but a significant number of people worldwide have a deficiency in this vitamin. Chronic Vitamin D deficiency has been linked to several adverse health outcomes, including musculoskeletal disorders, cardiovascular disease (CVD), cancer, and autoimmune disorders. Methodology: We conducted a comprehensive literature search using academic databases, including PubMed, MEDLINE, Scopus, and Google Scholar. The search terms included “Vitamin D deficiency,” “chronic disease,” “musculoskeletal disorders,” “cardiovascular disease,” “cancer,” and “autoimmune disorders.” We focused on articles that examined the link between chronic Vitamin D deficiency and various health outcomes. Results: Studies suggest that Vitamin D deficiency may contribute to several chronic diseases, including osteoporosis, osteoarthritis, hypertension, and CVD. Evidence indicates that inadequate levels of Vitamin D can increase the risk of certain types of cancer, such as colorectal and breast cancer. Studies have also found that people with autoimmune disorders, such as type 1 diabetes, multiple sclerosis, and rheumatoid arthritis, have lower levels of Vitamin D compared to healthy individuals. Conclusions: The findings of this literature review highlight the importance of identifying and treating chronic Vitamin D deficiency to prevent or manage associated health conditions. Strategies to prevent Vitamin D deficiency include increased sun exposure, dietary changes, and Vitamin D supplementation. Regular screening for Vitamin D deficiency may also be necessary, particularly in high-risk populations. Clinicians should consider Vitamin D status when evaluating patients with chronic diseases and take appropriate steps to address any deficiencies.

Background: Isotretinoin is the drug of choice for severe acne. We sought to examine the potential link between isotretinoin and insulin resistance. Methods: We conducted a systematic review and meta-analysis in accordance with the PRISMA statement. A comprehensive search of the PubMed/MEDLINE, SCOPUS, and Cochrane databases was performed until 12 January 2022 utilizing the PICO (Patient, Intervention, Comparison, Outcome) tool. Fifteen English-language studies focusing on isotretinoin-treated acne patients were included. Serum levels of insulin, glucose, and adiponectin were evaluated before and after treatment, and insulin sensitivity was assessed using the HOMA–IR. A meta-analysis was conducted using RevMan 5.4.1 software, and a quality assessment was undertaken using the ROBINS-I tool. Results: The meta-analysis unveiled a statistically significant rise in the post-treatment levels of adiponectin, an anti-inflammatory agent, which inhibits liver glucose production while enhancing insulin sensitivity (SMD = 0.86; 95% confidence interval (95% CI) = 0.48–1.25, p-value < 0.0001; I2 = 58%). Our subgroup analysis based on study type yielded consistent findings. However, no statistically significant outcomes were observed for insulin, glucose levels, and the HOMA-IR. Conclusions: There is not a clear association between isotretinoin and insulin resistance, but it appears to enhance the serum levels of adiponectin, which participates in glucose metabolism.

Diabetes is a global public health concern with increasing prevalence worldwide. Chromium (Cr), a trace element found in soil, water, and food, has been proposed to have a possible positive effect in glucose metabolism and diabetes mellitus prevention. However, the relationship between trivalent chromium [Cr(III)] exposure, mainly through the consumption of diet supplements, and type 2 diabetes mellitus (T2DM) remains controversial. An extensive systematic review of the current literature on randomized controlled studies (RCTs) was conducted from 1 January 2000, to January 2024 using the databases PubMed, Scopus, ScienceDirect, and Cochrane, with specific keywords and inclusion as well as exclusion criteria. After close screening of the research studies retrieved from the mentioned websites was conducted, the most related studies were included in the final systematic review. The studies were evaluated for the degree of relevance, quality, and risk bias, using appropriate quality assessment tools. Several of the included RCT studies reported possible benefits of Cr(III) supplementation, mainly in the form of chromium picolinate (CrPic), chromium yeast (CY), chromium chloride (CrCl3), and chromium nicotinate (CrN). The dosage of chromium was between 50 and 1000 μg/day and it was consumed from 2 to 6 months. Glycemic control markers, including FPG, insulin, HbA1C, and HOMA-IR levels, significantly decrease following chromium supplementation, mainly in studies with a longer intervention period. Supplementing with chromium (Cr) indicated that could significantly improve lipid profile by raising high-density lipoprotein and lowering triglyceride and total cholesterol while having little effect on low-density lipoprotein. However, most research findings include significant limitations, such as inconsistent dosage and type of chromium, formulation of supplements, and study duration. Further well-designed and high-quality research is needed to fully understand the role of chromium dietary supplementation and the potential risks related to its mechanisms of action, type, and dose, in the prevention and treatment of type 2 diabetes mellitus.

Zweck Tinnitus kann auch durch Medikamente wie Salicylat hervorgerufen werden. Ziel der Studie war es herauszufinden, ob unterschiedliche Konzentrationen von Salicylat Tinnitus unterschiedlicher Intensität verursachen können.

Background IL-19 and IL-24 induce proinflammatory cytokine production through the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway. The primary objective of this study was to investigate any changes in IL-19 and IL-24 expression between inflammatory bowel disease (IBD) patients and healthy controls, as well as before and after the initiation of biologics. The secondary objective was to investigate any relation between their expression and disease phenotype and activity. Methods IL-19 and IL-24 expression was measured in intestinal tissue samples from 121 patients with moderate to severe IBD versus healthy controls using immunohistochemistry. Their expression was then measured 12 months after treatment on the patient group treated with biologics. The disease activity was measured before and after treatment using the Harvey Bradshaw Index (HBI) for Crohn's disease (CD) patients and the Mayo Score (MS) for ulcerative colitis (UC) patients. Data were analyzed using SPSS (IBM Inc., Armonk, New York). Results IL-19 expression was raised in the IBD group versus healthy controls. In the CD group, the IL-19 expression was related with the disease activity score post-biologic treatment. IL-24 was also highly expressed in patients with active UC and CD and was increased post-treatment. Its expression in UC was statistically related with the MS. Conclusions IL-24 and IL-19 are key factors in IBD-related intestinal inflammation and this is one of the few human studies to suggest that. An immunosuppressive role of IL-24 was demonstrated in the UC group. A future use as biomarkers of disease activity and response to treatment might be feasible.

INTRODUCTION:Maternal infections such as chorioamnionitis could impact fetal lung development by altering cell proliferation and apoptosis. Chorioamnionitis favors the multiple pleiotropic cytokines production such as LIF (leukemia inhibitory factor) and an inflammation-related protein p53. The cytokine production can lead to lung tissue damage and lung disease development. AIM:The aim of the study is to evaluate the expression and the interaction of pro-anti-inflammatory proteins LIF and p53 on fetal lungs of all developmental stages after chorioamnionitis exposure. METHODS:Lung tissue was obtained from stillborn fetuses through elective abortion or miscarriage and was examined. This immuno-histochemical study aimed to evaluate the expression of pro-anti-inflammatory proteins LIF, and p53 on fetal lung tissues exposed to chorioamnionitis during three different stages of fetal lung development. Moreover, the interaction between LIF and p53 on inflammatory lung tissue was evaluated. RESULTS:The comparison analysis of p53 rates in the three different stages showed that the p53 rate was significantly higher in the saccular stage compared to pseudogladular stage and canalicular stage, respectively (p-value: 0.05). The comparison analysis of LIF rates in the three different stages showed that the LIF rate was significantly higher in pseudogladular stage compared to the canalicular stage and saccular stage, respectively. No significant association between p53 and LIF was detected during the study duration period (p-value: 0.082). CONCLUSION:The relationship between the two cytokines p53 and LIF interferes with the inflammation process. The result of their relation affects differently each stage of lung development as the cells maintain a different potential for differentiation and survival. Consequently, the extent of inflammation has a different importance at each stage.

Purpose: Pancreatic cancer (PC) is a fatal malignancy with an aggressive course derived from the cells of pancreatic tissue. Gestational diabetes mellitus (GDM) is a state of spontaneous hyperglycemia occurring during gestation and has been suggested as a risk factor PC. Women with a history of GDM revealed a risk rate of 7.1% for the development of PC. The current systematic review aims to investigate the correlation between GDM and the degree to the prevalence of PC. Methodology: For this systematic review, the PICO model was prepared to construct and outline the exact questions of the study, a PRISMA flow diagram was prepared and quality assessment was conducted using the Newcastle Ottawa Scale (NOS) for Cohort Studies, the NIH Quality Assessment Tool-Criteria for Case Reports and the Cochrane quality assessment tool for Systematic Reviews and Meta-analysis studies. Result: A total of eight articles were retrieved from the main databases, and a table was created to summarize the information found. Even though the data found were limited, the quality assessment performed revealed that the articles were of high validity. Conclusions: It can be concluded that GDM has an association with the development of PC and can be considered as a risk factor.

Lung cancer is a leading cause of cancer-related deaths globally, includes small cell lung cancer (SCLC), characterized by its aggressive nature and advanced disease at diagnosis. However, the identification of reliable biomarkers for SCLC has proven challenging, as no consistent predictive biomarker has been established. Nonetheless, certain tumor-associated antigens, including programmed death-ligand 1 (PDL1) and Delta-Like Ligand 3 (DLL3), show promise for targeted antibody-based immunotherapy. To ensure optimal patient selection, it remains crucial to comprehend the relationship between PDL1 and DLL3 expression and clinicopathological characteristics in SCLC. In this study, we investigated the expression patterns of PDL1 and DLL3 biomarkers in endobronchial samples from 44 SCLC patients, examining their association with clinical characteristics and survival. High PDL1 expression (>1%) was observed in 14% of patients, while the majority the SCLC patients (73%) exhibited high DLL3 expression (>75%). Notably, we found a positive correlation between high PDL1 expression (>1%) and overall survival. However, we did not observe any significant differences in the biomarkers expression concerning age, sex, disease status, smoking status, or distant metastases. Further subgroup analysis revealed that a high co-expression of both PDL1 (>1%) and DLL3 (100%) antigens was associated with improved overall survival. This suggests that SCLC expressing PDL1 and DLL3 antigens may exhibit increased sensitivity to therapy, indicating their potential as therapeutic targets. Thus, our findings provide novel insights into the simultaneous evaluation of PDL1 and DLL3 biomarkers in SCLC patients. These insights have significant clinical implications for therapeutic strategies, survival prediction, and development of combination immunotherapies.

Purpose: Postpartum psychosis (PPP) is a serious mental health illness affecting women post-parturition. Around 1 in 1000 women are affected by postpartum psychosis, and the symptoms usually appear within 2 weeks after birth. Postpartum mental disorders are classified into 3 main categories starting from the least to most severe types, including baby blues, postpartum depression, and postpartum psychosis. Materials and Methods: In this systematic review, genetic and epigenetic factors associated with postpartum psychosis are discussed. A PRISMA flow diagram was followed, and the following databases were used as main sources: PubMed, ScienceDirect, and Scopus. Additional information was retrieved from external sources and organizations. The time period for the articles extracted was 5 years. Results: Initially, a total of 2379 articled were found. After the stated criteria were applied, 58 articles were identified along with 20 articles from additional sources, which were then narrowed down to a final total of 29 articles. Conclusions: It can be concluded that there is an association between PPP and genetic and epigenetic risk factors. However, based on the data retrieved and examined, the association was found to be greater for genetic factors. Additionally, the presence of bipolar disorder and disruption of the circadian cycle played a crucial role in the development of PPP.

Purpose Tinnitus can also be induced by medications, such as salicylate. Purpose of the study was is to determine whether different concentrations of salicylate can cause tinnitus of different intensity.

Introduction: According to the Institute of Environmental Sciences, endocrine-disrupting chemicals (EDCs) are “natural or human-made chemicals that may mimic, block, or interfere with the body’s hormones, associated with a wide array of health issues”, mainly in the endocrine system. Recent studies have discussed the potential contribution of EDCs as risk factors leading to diabetes mellitus type 1 (T1DM), through various cellular and molecular pathways. Purpose: The purpose of this study was to investigate the correlation between the EDCs and the development of T1DM. Methodology: Thus, a 5-year systematic review was conducted to bring light to this research question. Using the meta-analysis and systematic review guideline protocol, a PRISMA flow diagram was constructed and, using the keywords (diabetes mellitus type 1) AND (endocrine-disrupting chemicals) in the databases PubMed, Scopus and ScienceDirect, the relevant data was collected and extracted into tables. Quality assessment tools were employed to evaluate the quality of the content of each article retrieved. Results: Based on the data collected and extracted from both human and animal studies, an association was found between T1DM and certain EDCs, such as bisphenol A (BPA), bisphenol S (BPS), persistent organic pollutants (POPs), phthalates and dioxins. Moreover, based on the quality assessments performed, using the Newcastle–Ottawa Scale and ARRIVE quality assessment tool, the articles were considered of high quality and thus eligible to justify the correlation of the EDCs and the development of T1DM. Conclusion: Based on the above study, the correlation can be justified; however, additional studies can be made focusing mainly on humans to understand further the pathophysiologic mechanism involved in this association.

OBJECTIVES:Clinical studies of repetitive transcranial magnetic stimulation (rTMS) do not provide consistent efficacy results, possibly due to variability in methodological parameters. Our aim is to systematically review preclinical rTMS protocols in murine models of epilepsy, offering insights from might facilitate the optimization of clinical trials. METHODS:We searched MEDLINE, SCOPUS and Web of Science from inception until December 2023, including English-written and peer-reviewed studies with clinical or electroencephalographic (EEG) outcomes. RESULTS:Among 480 search results, in the 23 eligible studies both mice and rats were used. Epilepsy induction methods included injections of pentylenetetrazole, kainic acid, picrotoxin and lithium-pilocarpine, electrical kindling (amygdala/ventral hippocampus), electroconvulsive shock and genetic models of absence and temporal lobe epilepsy. For motor threshold (MT) definition electromyography with motor evoked potentials and single-pulse TMS were used. Stimulation intensity ranged between 40 % and 200 % of MT or 0.125-2.5 T. High-frequency rTMS (≥5 Hz) demonstrated either no effect on seizure suppression or a rather facilitatory effect, promoting ictogenesis, with the exception of 20-Hz-rTMS coupling with lorazepam for status epilepticus cessation. Low-frequency rTMS (<5 Hz), primarily at 0.5 and 1 Hz, exerted an inhibitory effect on both clinical and EEG parameters on various epilepsy models in most studies and also significantly ameliorated performance in behavioral tests. CONCLUSIONS:rTMS holds potential for effective neuromodulation, that is critically dependent on stimulation frequency and epilepsy type. Translational knowledge gained from preclinical protocols may inform and optimize rTMS application for epilepsy management in future clinical trials.

The positive effect of platelet-rich plasma (PRP) on tendon metabolism has been extensively investigated and proven in vitro. Additionally, in vivo animal studies have correlated the application of PRP with the enhancement of tenocyte anabolic activity in the setting of tendon degeneration. However, less is known about its in vivo effect on human tendon biology. The purpose of the current prospective randomized comparative study was to evaluate the effect of PRP on torn human supraspinatus tendon. Twenty consecutive eligible patients with painful and magnetic resonance imaging (MRI)-confirmed degenerative supraspinatus tendon tears were randomized in a one-to-one ratio into two groups. The patients in the experimental group (n = 10) underwent an ultrasound-guided autologous PRP injection in the subacromial space 6 weeks before the scheduled operation. In the control group (n = 10), no injection was made prior to surgery. Supraspinatus tendon specimens were harvested from the lateral end of the torn tendon during shoulder arthroscopy and were evaluated under optical and electron microscopy. In the control group, a mixed cell population of oval and rounded tenocytes within disorganized collagen and sites of accumulated inflammatory cells was detected. In contrast, the experimental group yielded abundant oval-shaped cells with multiple cytoplasmic processes within mainly parallel collagen fibers and less marked inflammation, simulating the intact tendon structure. These findings indicate that PRP can induce microscopic changes in the ruptured tendon by stimulating the healing process and can facilitate a more effective recovery.

Squamous cell carcinoma of the head and neck (HNSCC) is the sixth most prevalent malignant entity with a significant fatality rate. The International Agency for Research on Cancer reported in 2018 that there are approximately 350,000 newly diagnosed instances of oral cancer per year, amounting to a cumulative incidence of 4.0 per 100,000 people. The aim of this review was to investigate the biomarkers associated with immunotherapy in head and neck cancer, and in particular oral cancer, as well as their respective immunotherapeutic agents. An extensive review of the literature was carried through. Relevant articles were searched in Medline Pubmed, Web of Science and Google scholar. The inclusion criterion was that the article should be written in English, whereas the exclusion criterion was the opposite. The current standard of care (SOC) for disease that recurs locally and/or metastatic disease was, until recently, platinum-based chemotherapy plus cetuximab. A potential treatment option is the monoclonal antibody cetuximab, which extends median progression-free survival (PFS) as it targets the epidermal growth factor (EGFR). Last decade, research has shown that there are two mechanisms of tumor's microenvironment (the immune escape and the T-cell exhaustion) which are related to total survival from cancer. Consequently, scientists focused on immunotherapy, a new therapeutic approach that activates a patient's immune system to fight tumor cells. Immune checkpoint inhibitors (ICIs) are a category of immunotherapies that are extremely effective at reactivating the immune system's defence against cancer. Oral cancer immunotherapy could target two significant immune checkpoints, cytotoxic T-lymphocyteassociated protein 4 (CTLA-4) and programmed death-1 (PD-1).

Background: Three years after the outbreak of the COVID-19 pandemic, psychological distress among college students remains increased. This study assesses stress, anxiety, and depression levels among students of the Aristotle University of Thessaloniki by the end of the third year of the pandemic (November 2022), revealing demographic characteristics and probable stressors. Methods: A questionnaire was distributed in November 2022 via the academic students' e-mails. The evaluation was performed with the DASS21 survey tool. The correlation analysis and the effect size calculation were performed with the t-test. Results: The majority of participants were undergraduates, on their first or second academic year, female students (67%), age of 18 to 21, unmarried or single (91%), and vaccinated against COVID-19 infection (83.4%). Severely increased levels of stress, anxiety, and depression (21.3%, 23.3%, and 25.1%, respectively) were measured. The normal and mild levels of stress, anxiety, and depression were 64.0%, 66.5%, and 57.2%, respectively. Female and younger students were at a higher risk of extremely severe stress, anxiety and depression prevalence (ORs up to 2.07, p-Values < 0.00001). Participants who were receiving psychological or psychiatric treatment exhibited severe stress, anxiety, and depression levels (ORs above 2.9, p-Values < 0.00001). Conclusions: Despite the undeniable withdrawal of the COVID-19 pandemic, the community of the Aristotle University of Thessaloniki presents high stress, anxiety, and depression levels, similar to those reported during the first year of the pandemic (November 2020). Stressors and risk factors were according to the reported literature and previous studies on Greek students. Academic psychological support offices should consider the students' "profile" in order to evaluate properly the potential risk for emotional and psychological distress. Evidence suggest that new technology (virtual reality, tele-psychiatry or tele-support apps and sessions) should also be implemented in universities.

OBJECTIVE To study the consequences of COVID-19 on the inhabitants of Lemnos and to examine the effect of the demographic, professional and medical profiles, as well as the effect of their habits during the pandemic. METHOD Quantitative, primary, synchronous and correlational research was conducted between and within the groups. The survey involved 115 residents of Lemnos. The relevant questionnaires, Fear of COVID-19 (a=0.901) and WHOQOL-BREF (a >= 0.841), were used. The statistical tests of independent samples t-test, ANOVA, Kruskal-Wallis, Chi-square, and Spearman were used with a significance level of 5%. RESULTS The economic impact on income was related to occupational status (p<0.001) and COVID-19 disease (p=0.002), while the economic impact on tourism was related to educational level (p=0.019) and the use of social media (p=0.045). Fear of COVID-19 was influenced by gender (p=0.004), the number of vaccines (p<0.001), outings for non-professional reasons (p=0.005) and exercise (p=0.002). Physical health was affected by gender (p=0.012), non-professional reasons (p=0.017), and physical activity (p<0.001). Mental health was affected by gender (p=0.003), age (p=0.043), monthly family income (p=0.031) and physical activity (p=0.030). Social relationships were affected by monthly family income (p=0.007), COVID-19 illness (p=0.036), non-professional outings (p=0.001) and physical activity (p<0.001). CONCLUSIONS The inhabitants of Lemnos felt a high degree of fear for their loved ones. However, the pandemic did not affect their levels of physical or mental health and social relationships. Social media raised the awareness of residents about the economic impact of the pandemic on the island.

Purpose: We investigated the efficacy of Mepolizumab treatment by assessing airway remodeling outcomes and patient characteristics associated with treatment response. Methods: MESILICO is a multicenter study. Patients with late-onset severe eosinophilic asthma and fixed obstruction were eligible to be administered Mepolizumab. Forty-seven patients were recruited. Bronchial biopsies were obtained before treatment initiation and after 12 months of treatment. Airway remodeling was assessed via changes from baseline in endobronchial biopsy basement membrane thickness, airway smooth muscles mass, epithelial integrity and tissue eosinophil number. Clinical parameters such as spirometry values (FEV1, FVC, PEF) were also evaluated. This trial is registered with ClinicalTrials.gov, number NCT04612556. Results: Preliminary results from sixteen patients are presented. Treatment with mepolizumab resulted in a significant reduction from baseline to 12 months of treatment in basement membrane thickness (p=0.007), airway smooth muscle area (p=0.011), extent of epithelial damage (p=0.009), and tissue eosinophil numbers (p=0.030). Significant improvements were also found in respiratory parameters (FEV1-p=0.036, FVC-p=0.008). Patients with more than 10% FEV1 improvement were found with less damaged epithelium after 12 months of treatment (p<0.001). Also, increased PEF values were positively correlated with high percentages of damage epithelial reduction (p=0.001, r=0.787). Conclusions: In our study, 12 months of mepolizumab treatment improves airway remodeling which is consistent with disease modification by mepolizumab. Funding: GSK214163.

OBJECTIVE To evaluate the impact of the pandemic on the employees of the Aristotle University of Thessaloniki, Greece, in terms of stress, anxiety and depression. METHOD The survey was conducted in the form of a question-naire, through the Depression, Anxiety, Stress Scale (DASS21), in two-time intervals; the first was conducted on 2020 and the second on 2021. The first launch included 86 administrative and 126 academic employees. The second launch included 106 administrative and 138 academic employees. Associations of DASS21 scores with participants' characteristics were investigated with Pearson's Chi-squared (x2) test, the odds-ratio and the multiple correspondence analysis. RESULTS In both years, stress, anxiety and depression levels were normal to mild or moderate. No significant differences were observed between the two years in both groups (p-value >0.05). Female academics presented higher anxiety, stress and depression in comparison to men. Female administrative staff was less depressed compared to male administrative respondents. Both younger academic and younger administrative participants expressed increased anxiety in comparison to older respondents (>46 years old). Increased stress, anxiety and depression levels were observed in those who had received psychiatric treatment in the past. CONCLUSIONS Despite the low levels of stress, anxiety and depression during the first two years of the pandemic, administrative and academic staff of the Aristotle University of Thessaloniki presented intriguing differences, depending on each respondent's personal characteristics and history.

Abstract Background and Aim: Unexplained recurrent pregnancy loss has been a a challenging research task to experts since there is no explicit pathophysiological mechanism and therefore, the treatment remains elusive. Immunological imbalance and morphological abnormalities are under investigation. This study aims to evaluate the implication of MMP-2, MMP-9, EGFR, and IL-8 in recurrent pregnancy loss cases. Materials & Methods: The study was carried out through comparison among two groups; the unexplained miscarriage group which consisted of 22 women, and the control group consisted of 18 women, who had electively terminated their pregnancies. Both groups were in the first trimester of gestation. The specimens included the trophoblast, decidua basalis, and decidua parietalis. The study was conducted via immunohistochemical methods. Antibodies were used against MMP-2, MMP-9, EGFR, and IL-8. The results were presented at a contingency table and were statistically analyzed with the Chi-Square Test (X2). Results: There were remarkable disparities in some cases in the comparison of the two groups. MMP-9 was detected significantly high in recurrent pregnancy loss (RPL) cases, both on trophoblastic and decidual specimens (p-value < .00001), MMP-2 displayed no difference among the two groups (mild to moderate detection on trophoblast and almost negative on decidual tissues). EGFR was highly detected in trophoblastic tissue (p-value = .014). IL-8 detection was particularly different in both trophoblast and decidua parietalis of the two groups (p-value < .01). Conclusion: The study revealed both morphological and immunological dysregulations that might participate in the RPL pathogenesis.