Epidemiological characteristics, management and early outcomes of acute coronary syndromes in Greece: The PHAETHON study.

INTRODUCTION: In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative cohort of ACS patients and examine current management practices and patient prognosis. METHODS: The PHAETHON study was conducted from May 2012 to February 2014. We enrolled 800 consecutive ACS patients from 37 hospitals with a proportional representation of all types of hospitals and geographical areas. Patients were followed for a median period of 189 days. Outcome was assessed with a composite endpoint of death, myocardial infarction, stroke, urgent revascularization and urgent hospitalization for cardiovascular causes. RESULTS: The mean age of patients was 62.7 years (78% males). The majority of patients (n=411, 51%) presented with ST-elevation myocardial infarction (STEMI), whereas 389 patients presented with NSTEMI (n=303, 38%) or UA (n=86, 11%). Overall, 58.8% of the patients had hypertension, 26.5% were diabetic, 52.5% had dyslipidemia, 71.1% had a smoking history (current or past), 25.8% had a family history of coronary artery disease (CAD) and 24.1% had a prior history of CAD. In STEMI patients, 44.5% of patients were treated with thrombolysis, 38.9% underwent a coronary angiogram (34.1% were treated with primary percutaneous coronary intervention) and 16.5% did not receive urgent treatment. The pain-to-door time was 169 minutes. During hospitalization, 301 (38%) patients presented one or more complications, and 13 died (1.6%). During follow-up, 99 (12.6%) patients experienced the composite endpoint, and 21 died (2.7%). CONCLUSIONS: The PHAETHON study provided valuable insights into the epidemiology, management and outcome of ACS patients in Greece. Management of ACS resembles the management observed in other European countries. However, several issues still to be addressed by public authorities for the timely and proper management of ACS.

Performance and antioxidant status of broiler chickens supplemented with dried mushrooms (Agaricus bisporus) in their diet.

In this study, we evaluated the growth performance and antioxidant status of broiler chicken supplemented with the edible mushroom Agaricus bisporus. Ninety 1-d-old female broiler chickens randomly allotted to 3 dietary treatments were given either a nutritionally balanced basal diet or the basal diet supplemented with 10 or 20 g of dried mushroom/kg of feed for 6 wk on an ad libitum basis. Body weight, feed intake, and feed conversion ratio values were monitored weekly. To evaluate the antioxidant status of broiler chicken, refrigerated liver, breast, and thigh tissues were assayed for levels of glutathione, reduced glutathione, glutathione reductase, glutathione peroxidase, and glutathione S-transferase, as well as malondialdehyde at 6 wk of age. Results showed that dietary mushroom supplementation at both inclusion levels was accepted well by the broiler chicken and improved feed efficiency compared with the control diet. Dietary mushroom inclusion at 20 g/kg improved both growth performance and feed efficiency compared with control diet at 42 d of age. Dietary mushroom at both inclusion levels reduced malondialdehyde production in liver, breast, and thigh tissues and elevated glutathione peroxidase, reduced glutathione, glutathione reductase, and glutathione S-transferase compared with the control treatment, the effects being dose-dependent. These results suggest that A. bisporus mushroom exerts both a growth-promoting and tissue antioxidant-protective activity when supplemented in broiler chicken diets.

Blunt trauma in intoxicated patients: is computed tomography of the abdomen always necessary?

BACKGROUND: Physical examination to detect abdominal injuries has been considered unreliable in alcohol-intoxicated trauma patients. Computed tomography (CT) plays the primary role in these abdominal evaluations. METHODS: We reviewed medical records of all blunt trauma patients admitted to our trauma service from January 1, 1992, to March 31, 1998. Study patients had a blood alcohol level > or =80 mg/dL, Glasgow Coma Scale (GCS) score of 15, and unremarkable abdominal examination. RESULTS: Of 324 patients studied, 317 (98%) had CT scans negative for abdominal injury. Abdominal injuries were identified in 7 patients (2%), with only 2 (0.6%) requiring abdominal exploration. A significant association was found between major chest injury and abdominal injury. CONCLUSION: The incidence of abdominal injury in intoxicated, hemodynamically stable, blunt trauma patients with a normal abdominal examination and normal mentation is low. Physical examination and attention to clinical risk factors allow accurate abdominal evaluation without CT.