Distribution of dissolved 137Cs, 131I and 238Pu at Eastern Mediterranean Sea in case of hypothetical accident at the Akkuyu Nuclear Power Plant

A coupled hydrodynamic/lagrangian particle drift model was applied to obtain the distribution of key radionuclides that are dispersed at the surface water (upper 100 m) of Eastern Mediterranean Sea, in case of an accident of Nuclear Power Plant at Akkuyu. The model was applied to simulate the dispersion of key artificial radionuclide concentration, in case of a hypothetical accident to assess issues related to sea health and potential hazards. The released radionuclide was found to have a favorable westward direction, following the prevailing currents. The variability of the predicted pattern is interpreted according to the near surface circulation patterns in the study area. The dispersion of key radionuclides (137Cs, 238Pu and 131I) was studied in a spatial and temporal manner at the neighboring coasts of the location of the NPP. Furthermore, the fate of the plume was predicted for each month after the accident date close to the areas of Akkuyu, namely Cyprus, Rhodes Island, North Cretan coast, Cyclades and Syrian Coast. The annual study revealed that the radioactive plume is present with high concentration (maximum values of 1200 Bq m-3 for the long lived isotopes and 600 Bq m-3 for 131I) in the location of the plant for short period of time (1-2 months), while the other areas are affected during the whole year with low level of activity concentration (20-50 Bqm-3). The ERICA Assessment Tool was also used to evaluate dose rates to common marine biota at the studied areas.

Long-term follow-up of endoscopic therapy of anal canal condylomata acuminata with podophyllotoxin

BACKGROUND

Condylomata acuminata of the anal canal, a common sexually transmitted disease, are difficult-to-treat lesions with a high recurrence rate after initial successful treatment.

OBJECTIVE

Our aim was to evaluate by anoscopy the efficacy of podophyllotoxin 0.5% solution topically applied for the treatment of anal warts.

METHODS

We prospectively studied consecutive patients with condylomata acuminata of the anal canal that spared the rectum. They were treated with 0.5% podophyllotoxin solution topically applied on the warts, by anoscopy. Podophyllotoxin solution was administered on days 1, 2 and 3 every week (a treatment cycle) for a maximum of 4 weeks. Patients whose warts were not completely eradicated were classified as failures. Follow-up anoscopy was performed monthly for the first 6 months and every 6 months thereafter. Those who relapsed during the follow-up period were retreated.

RESULTS

Twenty-two immunocompetent patients entered the study. The primary clearance rate was 22.7, 54.5, 68.1 and 86.3% after 1, 2, 3 and 4 treatment cycles, respectively. During the follow-up period (46, 12-60 months), seven patients (36.8%) relapsed. Four of them were successfully retreated. Thus, a complete cure was achieved in 16 out of 22 patients (72.7%). Adverse side-effects were mild. They included proctalgia in six (27.2%), bleeding in four (17.2%), and both proctalgia and bleeding in two (9%) patients.

CONCLUSIONS

Endoscopic topical application of 0.5% podophyllotoxin solution is an effective and well-tolerated method for the treatment of condylomata acuminata of the anal canal.

Field data analysis and application of a complex water column biogeochemical model in different areas of a semi-enclosed basin: towards the development of an ecosystem management tool

The Pagasitikos gulf ecosystem is studied through the analysis of experimental field data acquired during several monitoring projects and the application of a complex biogeochemical model. The gulf was separated into three different parts (internal, top central-external, bottom central-external) according to the patterns exhibited by the key ecosystem indicators. Unlike other semi-enclosed gulfs Pagasitikos can be characterised as meso-oligotrophic undergoing periods of P or N limitation. Although the signal of nutrient inputs is not very clear in the field data, their importance is assessed through simulation. Increased phosphate concentrations either due to mixing or due to anthropogenic activities can result in phytoplanktonic blooms with significant contribution by diatoms. The effect of hydrodynamic patterns on primary production has been demonstrated through ecosystem modeling indicating that due to long stratification periods, all nutrients released through the benthic regeneration are trapped in the deeper layers, developing a microbial food web. However when the thermocline erodes nutrients find their way up in the upper layers of the euphotic zone and the system turns into more classical type with primary producers growing significantly faster.

A prospective randomized controlled trial of intravenous ciprofloxacin as an adjunct to corticosteroids in acute, severe ulcerative colitis

BACKGROUND

The role of antibiotics in the treatment of ulcerative colitis is controversial. This study aims at assessing the therapeutic role of ciprofloxacin as an adjunct to corticosteroids in acute severe ulcerative colitis.

METHODS

In this prospective, randomized, double-blind, placebo-controlled trial, 55 consecutive patients fulfilling the criteria of Truelove and Witts for severe ulcerative colitis were randomized on admission to the hospital to receive intravenously ciprofloxacin (400 mg b.i.d.) (n = 29) or placebo (n = 27). All patients received parenteral nutrition, intravenous hydrocortisone (100 mg q.i.d.) and hydrocortisone enemas (100 mg b.i.d.). Patients were assessed after 10 days of continuous treatment, or at any time a severe complication occurred.

RESULTS

At study entry, there were no significant differences between treatment groups in any patient or disease-related parameter. Twenty-three of 29 patients (79.3%) treated with ciprofloxacin and 20 of 26 patients (77%) treated with placebo showed substantial improvement and were given oral steroids (P > 0.1). Six patients in each group did not improve (n = 10) or developed complications (n = 2). Nine of these 12 patients underwent emergency colectomy; three patients consented to receive intravenous cyclosporin but did not achieve remission of colitis and they underwent elective colectomy. There were no perioperative or late deaths.

CONCLUSIONS

A short course of intravenous ciprofloxacin does not seem to augment the effect of corticosteroids for patients with acute, severe ulcerative colitis.

A prospective randomized controlled trial of intravenous ciprofloxacin as an adjunct to corticosteroids in acute, severe ulcerative colitis

BACKGROUND

The role of antibiotics in the treatment of ulcerative colitis is controversial. This study aims at assessing the therapeutic role of ciprofloxacin as an adjunct to corticosteroids in acute severe ulcerative colitis.

METHODS

In this prospective, randomized, double-blind, placebo-controlled trial, 55 consecutive patients fulfilling the criteria of Truelove and Witts for severe ulcerative colitis were randomized on admission to the hospital to receive intravenously ciprofloxacin (400 mg b.i.d.) (n = 29) or placebo (n = 27). All patients received parenteral nutrition, intravenous hydrocortisone (100 mg q.i.d.) and hydrocortisone enemas (100 mg b.i.d.). Patients were assessed after 10 days of continuous treatment, or at any time a severe complication occurred.

RESULTS

At study entry, there were no significant differences between treatment groups in any patient or disease-related parameter. Twenty-three of 29 patients (79.3%) treated with ciprofloxacin and 20 of 26 patients (77%) treated with placebo showed substantial improvement and were given oral steroids (P > 0.1). Six patients in each group did not improve (n = 10) or developed complications (n = 2). Nine of these 12 patients underwent emergency colectomy; three patients consented to receive intravenous cyclosporin but did not achieve remission of colitis and they underwent elective colectomy. There were no perioperative or late deaths.

CONCLUSIONS

A short course of intravenous ciprofloxacin does not seem to augment the effect of corticosteroids for patients with acute, severe ulcerative colitis.

A prospective randomized controlled trial of oral ciprofloxacin in acute ulcerative colitis

OBJECTIVES

The aim of this prospective, randomized, controlled trial was to evaluate the role of ciprofloxacin as an adjunct to corticosteroids in acute ulcerative colitis.

METHODS

Seventy consecutive patients with mild (n = 37) or moderately active (n = 33) ulcerative colitis were randomized to receive oral ciprofloxacin (250 mg b.i.d., n = 34) or placebo (n = 36) for 14 days. In addition, they were given oral prednisolone (initial dose 20 or 40 mg for mild and moderately active ulcerative colitis, respectively) and rectal betamethasone enemas (2 g at night) for 7-9 weeks. All patients were receiving olsalazine (0.5 g twice daily). At study entry, the groups were similar with respect to age, sex, extent, duration, and severity of disease, and previous treatments. Patients were assessed clinically, endoscopically, and histologically before, at the end of the trial (day 14), and on completion of steroid treatment, or at any time worsening of symptoms or a complication of ulcerative colitis occurred.

RESULTS

At the end of the study, 24 patients (70.5%) in the ciprofloxacin group and 26 patients (72%) in the placebo group achieved remission (p > 0.1, Yates chi 2). Ten patients in each group necessitated higher doses of oral (n = 12) or intravenous (n = 8) steroids. Of the latter patients, two underwent emergency colectomy without perioperative deaths. Clostridium difficile toxin A was not detected in nonresponders to ciprofloxacin treatment.

CONCLUSIONS

A short course of oral ciprofloxacin treatment does not seem to increase the proportion of patients with active ulcerative colitis going into remission.

The role of colonoscopy in the differential diagnosis of acute, severe hemorrhagic colitis

BACKGROUND AND STUDY AIMS

This study assesses the diagnostic value of colonoscopy performed at an early stage of a first attack of acute, severe hemorrhagic colitis.

PATIENTS AND METHODS

One hundred fourteen consecutive patients were prospectively studied. The colonoscopic diagnosis was compared with the final diagnosis of the colitis, which was based on clinical, microbiological, endoscopic, and histological criteria during the acute illness, but also on the results of a thirty-month follow-up of the patients aiming to confirm whether the colitis was relapsing or nonrelapsing in nature.

RESULTS

The colonoscopic diagnosis was ulcerative colitis (UC) in 40, Crohn's disease in four, and infective colitis (IC) in 70 patients. The endoscopic diagnosis was finally confirmed in all 40 UC patients and in 68 of 70 (97.1%) IC patients. Two patients with an initial endoscopic and histological diagnosis of IC presented with typical attacks of UC 28 and 30 months later, respectively. Prominent endoscopic appearances in IC were mucosal edema, erythematous areas, hemorrhagic spots, bleeding, microaphthoid ulcers, and luminal exudate. Although rectal sparing was occasionally seen, endoscopic lesions were continuous and severe in the distal colon, but were patchily and unevenly distributed in other parts of the colon in IC. In UC, prominent colonoscopic findings were bleeding, mucosal friability, granularity, and ulceration; lesions were continuously distributed in the involved area.

CONCLUSIONS

Colonoscopy is a useful procedure in the differential diagnosis of severe bloody diarrhea of unknown cause.

[Treatment of traumatic postoperative total hyphaemas (author's transl)]

For more than ten years, we have successfully been using fibrinolysin for the treatment of total traumatic hyphaemas. Recently that enzyme was applied in 2 cases of total hyphaema with secondary glaucoma after cataract extraction and the results were excellent.