Combination Therapies for Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is considered a highly prevalent disease associated with various co-morbidities that lead to socioeconomic burden. Despite large-scale investigation, no pharmacological treatment has been approved specifically for NAFLD to date. Lifestyle modifications and diet are regarded as highly beneficial for the management of NAFLD, albeit with poor compliance, thus rendering pharmacological treatment highly important. Based on the current failure to discover a “magic bullet” to treat all patients with NAFLD and considering the multifaceted pathophysiology of the disease, combination therapies may be considered to be a rational alternative approach. In this regard, several drug categories have been considered, including, but not limited to, lipid-lowering, anti-hypertensive, glucose-lowering, anti-obesity, anti-oxidant, anti-inflammatory and anti-fibrotic medications. The aim of this review is, in addition to summarizing some of the multiple factors contributing to the pathophysiology of NAFLD, to focus on the efficacy of pharmacological combinations on the management of NAFLD. This may provide evidence for a more personalized treatment of patients with NAFLD in the future

Integrated Ecological Assessment of Heavily Polluted Sedimentary Basin within the Broader Industrialized Area of Thriassion Plain (Western Attica, Greece)

The Thriassion Plain, the Saronikos Gulf and Eleusis Bay, Western Attica in Greece, receive pressures from the enormous industrial activity, as well as the Athens metropolitan area and the Piraeus port. Therefore, it is considered as brownfield in the Eastern Mediterranean Sea. The multi-component industrial activity has impacted the soil, the groundwater of Thriassion Plain and the coastal marine sediments of the adjacent Eleusis Bay, part of Saronikos Gulf as well as a brackish lagoon, Koumoundourou Lake. The industrial activity is expressed by high contents of metals, and oil products. This study presents the pollution record of selected published papers that indicate the temporal evolution of legislated polluting compounds, supporting researchers to provide solutions and policy makers to focus on the whole spectrum of potential policy alternatives

Integrated Ecological Assessment of Heavily Polluted Sedimentary Basin within the Broader Industrialized Area of Thriassion Plain (Western Attica, Greece)

The Thriassion Plain, the Saronikos Gulf and Eleusis Bay, Western Attica in Greece, receive pressures from the enormous industrial activity, as well as the Athens metropolitan area and the Piraeus port. Therefore, it is considered as brownfield in the Eastern Mediterranean Sea. The multi-component industrial activity has impacted the soil, the groundwater of Thriassion Plain and the coastal marine sediments of the adjacent Eleusis Bay, part of Saronikos Gulf as well as a brackish lagoon, Koumoundourou Lake. The industrial activity is expressed by high contents of metals, and oil products. This study presents the pollution record of selected published papers that indicate the temporal evolution of legislated polluting compounds, supporting researchers to provide solutions and policy makers to focus on the whole spectrum of potential policy alternatives

Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization Childhood Obesity Surveillance Initiative 2010

Abstract Background In children, abdominal obesity is a better predictor of the presence of cardiovascular risk factors than body mass index (BMI)-defined obesity. We aimed to evaluate the prevalence of abdominal obesity in the Greek pediatric population and to assess the impact of residence on the prevalence of both BMI-defined and abdominal obesity. Methods In the context of the Childhood Obesity Surveillance Initiative of the World Health Organization (WHO) Regional Office for Europe, a national representative sample of 7.0–7.9 and 9.0–9.9-year-old children was evaluated (n = 2,531 and 2,700, respectively). Overweight and obesity according to BMI were estimated using both the WHO and International Obesity Task Force cut-off points. Abdominal obesity was defined as waist circumference/height ratio >0.5. Results The prevalence of abdominal obesity did not differ between 7-year-old boys and girls (25.2 and 25.3%, respectively; p = NS). Among 9-year-old children, abdominal obesity was more prevalent in boys than in girls (33.2 and 28.2%, respectively; p = 0.005). Among normal weight and overweight children, the prevalence of abdominal obesity was 1.6–6.8 and 21.8–49.1%, respectively. The prevalence of abdominal and BMI-defined obesity did not differ between children living in the mainland, in Crete and in other islands except in 7-year-old girls, where the prevalence of BMI-defined obesity was highest in those living in Crete, intermediate in those living in other islands and lowest in those living in the mainland. In 9-year-old boys and in 7- and 9-year-old girls, the prevalence of abdominal obesity was highest in children living in Athens and lowest in children living in Thessaloniki, whereas children living in other cities and in villages showed intermediate rates. The prevalence of abdominal obesity in 7-year-old boys and the prevalence of BMI-defined obesity did not differ between children living in cities and villages. Conclusions The prevalence of pediatric abdominal obesity in Greece is among the highest worldwide. Boys and children living in the capital are at higher risk for becoming obese. Given that abdominal obesity is more prevalent than BMI-defined obesity and appears to be more sensitive in identifying cardiovascular risk, measurement of waist circumference might have to be incorporated in the screening for childhood obesity