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1.
Oral Health Prev Dent ; 18(1): 873-879, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33215479

RESUMO

PURPOSE: To assess the knowledge of postgraduate dental students about evidence-based methodology pertaining to the design, conduct, and critical appraisal of clinical trials. MATERIALS AND METHODS: Senior postgraduate students were surveyed from the dental schools of three universities in Athens (Greece), Boston (USA), and Zürich (Switzerland). The proportion of students correctly answering each of the 10 questions of the survey, as well as the cumulative scores, were analysed statistically with descriptive statistics and logistic/linear regression analysis at α = 5%. RESULTS: A total of 96 students with a mean age of 30.0 years attained an overall correct score of 45.6% ± 15.0%, with correct answers to each question ranging from 13.5% to 86.5%. The questions most frequently answered incorrectly pertained to characterising sensitivity/specificity (13.5%), the number needed to treat (14.0%), the credibility of trial synthesis in meta-analysis (23.7%), and publication bias (29.5%). The vast majority of postgraduate students could correctly identify the role of statistical power of a trial (63.8%), random allocation sequence in a randomised trial (76.0%), and blinding in a randomised trial (86.5%). Paediatric dentistry postgraduate students scored better than students from other departments (+15.1%; 95% CI: 3.0% to 27.1%; p = 0.02). CONCLUSIONS: Postgraduate students in orthodontics and other dental specialties possessed moderate knowledge on evidence-based methodology and clinical trials. Efforts should be made to integrate such subjects in university postgraduate curricula, so that future dental specialists can critically appraise such research papers.


Assuntos
Odontologia Baseada em Evidências , Estudantes de Odontologia , Adulto , Criança , Grécia , Humanos , Projetos de Pesquisa , Inquéritos e Questionários , Suíça
2.
Arch Virol ; 165(12): 3003-3006, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33025198

RESUMO

A significant number of new members of the genus Vitivirus have been identified recently, mainly due to the advent of high-throughput sequencing (HTS). Grapevine virus I (GVI), which was identified in New Zealand in 2018, is one of these viruses. RNAseq HTS analysis of a Greek grapevine (cv. Daphnia), revealed the presence of a GVI-like isolate (D2-1/19). Sequence analysis confirmed the classification of D2-1/19 as GVI. However, both sequence and phylogenetic data exhibited high levels of variability between D2-1/19 and the previously characterized GVI isolates. This study provides the full-length sequence of a divergent GVI isolate, adding knowledge to the limited information available about this recently identified virus.


Assuntos
Flexiviridae/genética , Genoma Viral , Filogenia , Vitis/virologia , Flexiviridae/isolamento & purificação , Grécia , Sequenciamento de Nucleotídeos em Larga Escala , Doenças das Plantas/virologia , Sequenciamento Completo do Genoma
3.
Arch Osteoporos ; 15(1): 163, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33067646

RESUMO

Use of the FRAX (Fracture Risk Assessment Tool) tool to assess fracture risk is the most common practice worldwide. Our findings suggest that in treatment-naïve women with osteopenia treatment would be cost-effective for approximately one-third of the study population and nearly half of the subjects over 75 years, according to the Greek-specific FRAX-based thresholds. INTRODUCTION: When evaluating a patient with low bone mineral density (BMD), fracture risk estimation is of paramount importance. Fracture risk assessment using the FRAX tool is the most common and most studied practice worldwide. PATIENTS-METHODS: The primary aim of the "ACROSS" study was to record the 10-year probability of major osteoporotic fractures and hip fractures, using the Greek version of the FRAX tool, in a rather representative population of 230 postmenopausal treatment-naïve women with osteopenia. Secondary aims of the study were to identify (1) the risk for fractures according to age and the years from menopause, (2) the proportion of patients qualifying for treatment according to the Greek cost-effective FRAX thresholds, and (3) the perception of both the patient and the treating physician regarding the estimated fracture risk. RESULTS: The mean 10-year risk was 10.7% ± 6.6 for major osteoporotic fractures and 3.4% ± 4.2 for hip fractures. For women up to 75 years of age, the 10-year risk for major osteoporotic and hip fractures was 8.8% and 2.1%, respectively, while for women over 75 years, the risk was 15.2% and 6.6%, respectively. Patients generally believed that they had low fracture risk independently of age, while the physicians considered that the risk increases with advancing age. CONCLUSIONS: According to the Greek-specific FRAX-based thresholds, the administration of osteoporosis treatment would be cost-effective for approximately one-third of the study population and nearly half of the subjects over 75 years. Patients are not fully aware of their fracture risk.


Assuntos
Doenças Ósseas Metabólicas/complicações , Fraturas Ósseas/etiologia , Fraturas por Osteoporose/etiologia , Pós-Menopausa , Medição de Risco/métodos , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Doenças Ósseas Metabólicas/epidemiologia , Feminino , Fraturas Ósseas/epidemiologia , Grécia/epidemiologia , Humanos , Pessoa de Meia-Idade , Osteoporose/complicações , Fraturas por Osteoporose/epidemiologia , Fatores de Risco
4.
Psychiatriki ; 31(3): 197-200, 2020.
Artigo em Inglês, Grego Moderno | MEDLINE | ID: mdl-33099460

RESUMO

From the beginning of 2020, the alarming news from Italy and the first known cases arrived in Greece, along with travelers from the Holy Land. Spain, France and all other countries followed. From the first week of March, restrictive measures began in Greece and then confinement in order to limit the spread of the pandemic and not drown the National Health System by serious cases. The policy of restrictive measures to stop the pandemic was the internationally accepted response1 and the generalized adherence proved effective, despite the shock and the various reactions from the unprecedented, generalized state of restriction, different scale from epidemics of other times.2-4 In other countries, the loose restrictive measures have cost thousands of deaths. The general restrictive measures, however, have serious consequences for people's mental equilibrium, economy and employment, and for this reason they can only be of limited duration.5 The gradual return to normal life rhythms began gradually from May. But the test of the holiday time and the gradual opening of the tourist season, that is, the open communication of moving populations with limited, random checks for the virus and only local restrictions of the gathering of citizens. We are experiencing now the gradual and severe increase in cases, with an uncertain spreading, with asymptomatic and younger in age likely playing a central role in the spread of the virus, while the fear of a potential large increase in serious cases remains. At the time of this writing, the only means of coping is to maintain and locally strengthen the protective measures, while we gradually realize that these measures came to stay for many more months.6,7 A major problem is that the initial small number of cases favored the underestimation of risk by part of the population, and the serious consequences on people's jobs and lives, along with the deregulation of employment and social security relations legislated in recent months, have provided substantial material to conspiracy theories. We carefully monitor the research on the epidemiological behavior of covid-19 and the clinical data, the discussion on the drugs that make the symptoms milder, the effect of the virus on the CNS and the expected vaccine or vaccines. Our role from the beginning concerned the enormous psychological burden of a global health crisis, with serious consequences on people's working and social lives and equally avoiding the deregulation of the management of our patients and of the units that provide it. At the time of confinement, the telephone contact, familiar to all generations, offered valuable information and support, the lines 10306 and 1110, as well as many local or voluntary help-lines. Telepsychiatry was used more widely - being also an initiative of the Hellenic Psychiatric Association - and seems to have entered impetuously in our work, as well as in education. Its central or complementary role and its safe use are issues that are widely discussed at the moment.8 Protection measures against the virus seriously affect the normal functioning of health and mental health services. The solution should be sought in the urgent operational upgrade, the very necessary reinforcement of the staff and its effective protection from the virus and stress from exposure to danger, which has emerged as important factors for the normal operation of the mental health units.9 The use of telepsychiatry has solved a number of operational problems, but in many cases, it remains complementary, as it cannot replace physical presence in more specific care operations. The need not only to normalize, but to improve the follow up of our patients, the need to strengthen the units that provide basic, community mental health services, is shown by the increase in cases of involuntary hospitalization in the psychiatric hospitals of Athens and Thessaloniki during the last two months. A health crisis that affects almost the entire planet and the working and social life of most is a major social and political problem that concerns all of us,10 while mental health professionals are called to offer their scientific tools for people to face a multifaceted threat and in particular to claim and ensure the continuation of the treatment of our patients and the normal operation of our units.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Grécia/epidemiologia , Humanos , Saúde Mental , Pandemias , Saúde da População , Quarentena
6.
Clin Exp Rheumatol ; 38 Suppl 126(4): 189-194, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095153

RESUMO

OBJECTIVES: Thymic stromal lymphopoietin (TSLP) has been implicated in primary Sjögren's syndrome (pSS) and related B-cell lymphoproliferation and lymphoma (NHL) by studies on salivary pathologic tissues and serum. The purpose of this work was to validate serum TSLP as biomarker of pSS and related lymphoproliferation by the study of two additional independent cohorts. METHODS: Serum TSLP was measured by ELISA in the original published Cohort-1 from Udine, Italy, including 91 patients. Two additional cohorts were then studied for validation: Cohort-2, including 4 sub-cohorts comprising 125 patients from the Universities of Roma, L'Aquila, Pisa and Perugia, belonging to the Italian SS Study Group (GRISS), and Cohort-3, including 59 patients from the University of Athens, Greece. Overall, 159 control subjects were enrolled. Active pSS-NHL, as well as pre-lymphomatous conditions, i.e. persistent salivary gland swelling and mixed cryoglobulinaemia, were investigated in detail. In addition, serum samples from pSS-NHL in complete remission were analysed (n=27). RESULTS: TSLP serum levels were confirmed to be significantly higher in pSS compared to controls in both Cohort-2 and Cohort-3, in particular in patients with lymphoproliferation. Serum TSLP was much higher in pSS pre-lymphomatous conditions. Finally, active NHL showed the highest TSLP serum levels, while in NHL in remission TSLP resulted undetectable or significantly lower than in benign pSS. CONCLUSIONS: By the study of independent cohorts, it was again demonstrated that serum TSLP levels are increased in pSS, above all in more advanced B-cell lymphoproliferation and NHL. Serum TSLP can therefore represent a novel biomarker for pSS-related lymphoproliferation.


Assuntos
Síndrome de Sjogren , Biomarcadores , Citocinas , Grécia , Humanos , Itália , Síndrome de Sjogren/diagnóstico
7.
Zootaxa ; 4772(3): zootaxa.4772.3.5, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-33055604

RESUMO

Despite Greece being a global hotspot of subterranean biodiversity, its hypogean fauna is largely neglected from both an ecological and conservational point of view. An overview of the Niphargidae occurring in Greece is presented as an annotated list of all available published records. These records have resulted in an updated species list reflecting taxonomic corrections and species distribution range in the Greek peninsula. A total of 23 species, attributed to 3 genera, is up to date known from Greece with a high rate of endemicity found particularly in Crete. The endemic species of Greece amount to 21 (91% of total species richness), with the remaining species distributing also in the Republic of North Macedonia. Currently, none of them is listed in the national, European or global IUCN Red Lists of Threatened Species. Considering the increasing habitat degradation due to anthropic pressure, groundwater harvesting and climate change we could lose rare and endemic species without even acknowledging their existence.


Assuntos
Anfípodes , Animais , Biodiversidade , Ecossistema , Espécies em Perigo de Extinção , Grécia
8.
Zootaxa ; 4830(1): zootaxa.4830.1.4, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-33056253

RESUMO

An ongoing investigation on the Greek hoverfly fauna using adult morphology has revealed new species within three genera. In this study, the knowledge of the Mediterranean hoverfly fauna has been enhanced by describing the following species: Cheilosia candida Vujic et Radenkovic sp. n. (Pindos Mountains), Paragus thracusi Radenkovic, Likov et Vujic sp. n. (Rhodope Mountains) and Psilota aegeae Vujic, Ståhls et Smit sp. n. (Lesvos island). Diagnosis of new species, as well as identification keys to the Mediterranean species of the subgenus Convocheila Barkalov of Cheilosia Meigen and the European species of the genus Psilota Meigen have been provided. Additionally, mtDNA COI barcodes for the members of the Psilota atra group (except Psilota nana Smit et Vujic) have been given. In addition, the taxonomic status of Psilota anthracina Meigen has been discussed.


Assuntos
Dípteros , Animais , Grécia , Mitocôndrias
9.
PLoS One ; 15(10): e0240393, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119605

RESUMO

The first case of COVID-19 was confirmed in Israel on February 21, 2020. Within approximately 30 days, the total number of confirmed cases climbed up to 1, 000, accompanied by a doubling period of less than 3 days. About one week later, after this number exceeded 4, 000 cases, and following some extreme lockdown measures taken by the Israeli government, the daily infection rate started a sharp decrease from the peak value of 1, 131 down to slightly more than 100 new confirmed cases on April 30. Motivated by this encouraging data, similar to the trends observed in many other countries, along with the growing economic pressures, the Israeli government has quickly lifted most of its emergency regulations. Throughout May, the daily number of new cases stayed at a very low level of 20-40 until at the end of May it started a steady increase, exceeding 1, 000 by the end of June and 2, 000 on July 22. As suggested by some experts and popular media, this disturbing trend may be even a part of a "second wave". This article attempts to analyze the data available on Israel at the end of July 2020, compared to three European countries (Greece, Italy, and Sweden), in order to understand the local dynamics of COVID-19, assess the effect of the implemented intervention measures, and discuss some plausible scenarios for the foreseeable future.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Número Básico de Reprodução , Betacoronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Previsões , Grécia , Humanos , Israel/epidemiologia , Itália , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Densidade Demográfica , Suécia
10.
J Environ Manage ; 276: 111322, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-32891035

RESUMO

Economic growth is a prerequisite for development while energy is the engine for growth process. In the era of globalization, production cost heavily dependent on energy intensity and efficiency with keeping environmental conditions intact. Therefore, the structuring of a significant environmental index is pre-requisition of the world with energy intensity, energy efficiency. For this objective, this study employs 18-years data set between 2000 and 2018 of Organization for Economic Co-operation and Development (OECD) to form a universal aspect of economics, environmental index, and energy efficiency (EEE). The data envelopment analysis (DEA) and arithmetic mean aggregation in the formation of mathematical aggregation mechanisms are applied for empirical analysis. According to the results, Iceland maintained an overall high rank regarding energy efficiency, energy intensity, and environment followed by Greece, New Zeeland, and Norway. In this investigation, Ireland followed by the UK and the USA are the lowest performer regarding energy and environment. Thus, the study concludes that energy (efficiency & intensity) and environment hold complex relations and needs a special set of policies to address them collectively and it is expected that this study can be used as valuable information for the policymaking process.


Assuntos
Desenvolvimento Econômico , Grécia , Islândia , Irlanda , Noruega
11.
BMC Med Inform Decis Mak ; 20(1): 216, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912224

RESUMO

BACKGROUND: Telehealth (TH) was introduced as a promising tool to support integrated care for the management of chronic obstructive pulmonary disease (COPD). It aims at improving self-management and providing remote support for continuous disease management. However, it is often not clear how TH-supported services fit into existing pathways for COPD management. The objective of this study is to uncover where TH can successfully contribute to providing care for COPD patients exemplified in a Greek care pathway. The secondary objective is to identify what conditions need to be considered for successful implementation of TH services. METHODS: Building on a single case study, we used a two-phase approach to identify areas in a Greek COPD care pathway where care services that are recommended in clinical guidelines are currently not implemented (challenges) and areas that are not explicitly recommended in the guidelines but that would benefit from TH services (opportunities). In phase I, we used the care delivery value chain framework to identify the divergence between the clinical guidelines and the actual practice captured by a survey with COPD healthcare professionals. In phase II, we conducted in-depth interviews with the same healthcare professionals based on the discovered divergences. The responses were analyzed with respect to identified opportunities for TH and care pathway challenges. RESULTS: Our results reveal insights in two areas. First, several areas with challenges were identified: patient education, self-management, medication adherence, physical activity, and comorbidity management. TH opportunities were perceived as offering better bi-directional communication and a tool for reassuring patients. Second, considering the identified challenges and opportunities together with other case context details a set of conditions was extracted that should be fulfilled to implement TH successfully. CONCLUSIONS: The results of this case study provide detailed insights into a care pathway for COPD in Greece. Addressing the identified challenges and opportunities in this pathway is crucial for adopting and implementing service innovations. Therefore, this study contributes to a better understanding of requirements for the successful implementation of integrated TH services in the field of COPD management. Consequently, it may encourage healthcare professionals to implement TH-supported services as part of routine COPD management.


Assuntos
Prestação Integrada de Cuidados de Saúde/métodos , Pessoal de Saúde/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , Telemedicina/organização & administração , Grécia , Humanos , Entrevistas como Assunto , Equipe de Assistência ao Paciente , Pesquisa Qualitativa , Autogestão
12.
PLoS One ; 15(9): e0239187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941533

RESUMO

OBJECTIVES: Sexual violence can have a destructive impact on the lives of people. It is more common in unstable conditions such as during displacement or migration of people. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers. This study describes the patterns of sexual violence reported by migrants and asylum seekers and the clinical care provided to them. METHODS: This is a descriptive study, using routine program data. The study population consisted of migrants and asylum seekers treated for conditions related to sexual violence at the Médecins Sans Frontières clinic on Lesvos Island (September 2017-January 2018). RESULTS: There were 215 survivors of sexual violence who presented for care, of whom 60 (28%) were male. The majority of incidents reported (94%) were cases of rape; 174 (81%) of survivors were from Africa and 185 (86%) of the incidents occurred over a month before presentation. Half the incidents (118) occurred in transit, mainly in Turkey, and 76 (35%) in the country of origin; 10 cases (5%) occurred on Lesvos. The perpetrator was known to the survivor in 23% of the cases. The need for mental health care exceeded the capacity of available mental care services. CONCLUSION: Even though the majority of cases delayed seeking medical care after the incident, it is crucial that access to mental health services is guaranteed for those in need. Such access and security measures for people in transit need to be put in place along migration routes, including in countries nominally considered safe, and secure routes need to be developed.


Assuntos
Refugiados/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Grécia , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Campos de Refugiados/estatística & dados numéricos , Refugiados/psicologia , Sociedades Médicas/estatística & dados numéricos , Migrantes/psicologia
13.
Eur Psychiatry ; 63(1): e88, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32921324

RESUMO

BACKGROUND: Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. METHODS: After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. RESULTS: A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. CONCLUSIONS: Regional disparities in resources and services for seniors' mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.


Assuntos
Atitude do Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde , Transtornos Mentais/terapia , Serviços de Saúde Mental , Bulgária , Grécia , Pesquisas sobre Serviços de Saúde , Humanos , República da Macedônia do Norte , Telemedicina/métodos
15.
Psychiatr Danub ; 32(Suppl 1): 164-166, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890383

RESUMO

BACKGROUND: It seems important to understand how was the life of young people during the Antiquity, in the Greek cities and in Rome. Furthermore, it can be useful to find if there is a stage that marks the transition to adulthood. Finally, as the Romans are considerate to be great codifiers of laws, it seems important to study the Roman law to understand the legal conception of adolescence at this period. SUBJECTS AND METHODS: A literature review has been done about studies published between 1962 and 2015. Those publications were found in some historical databases (as Persée, Cairns, J-Stor, OpenEdition) and in academic libraries. RESULTS: In the Greek cities, the adolescent, at 18 years old, has to do a military service called the ephebia. At the end of this formation, the young man, aged of 20 years old, comes back to his city. However, he has to continue his (intellectual) training until about his 30 years old. Generally, at this age, a man marries a young girl and becomes a respected adult. In the Roman law, there is no conception of legal age for the majority: the young people stay under the authority of the pater familias (father of the family) until the death of the father. If the father is dead: the boy becomes a pupil and has a specific juridical status until his 25 years. Two important stages exist for the young Romans: wearing the toga virilis (toga of manhood) and the wedding. CONCLUSIONS: There is an evolution in the perception of the adolescence during the Antiquity: for the Greeks, the adolescence ends at 20 years old with an important stage, the ephebia. In the Roman law, there is no legal age because everyone lives under the authority of the pater familias.


Assuntos
História Antiga , Psicologia do Adolescente , Adolescente , Adulto , Feminino , Grécia , Humanos , Masculino , Casamento , Adulto Jovem
16.
Environ Monit Assess ; 192(10): 627, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32901375

RESUMO

Numerous health studies have linked the exposure to particulate matter with adverse health effects, while there is an increasing scientific interest in the particle metrics of surface area (SA) and lung-deposited SA (LDSA) concentration. In the present study, two integrated SA estimation methods, both based on widely used instrumentation, were applied at an urban traffic environment in Athens for a 6-month period. The first estimation method used the size distribution by number to estimate SA (average SA1 669.3 ± 229.0 µm2 cm-3), while the second method used a simple inversion scheme that incorporates number and mass concentrations (average SA2 1627.9 ± 562.8 µm2 cm-3). In pairwise comparisons, SA2 levels were found two times greater than the corresponding SA1, but exhibited a strong correlation (r = 0.73). SA1 and SA2 concentrations correlated well with the traffic-related pollutants NOx (r = 0.64 and 0.78) and equivalent black carbon (r = 0.53 and 0.51). The diurnal variation of SA1 concentrations by size range indicated traffic as a major controlling factor. Estimated LDSA (53.9 µm2 cm-3 on average) concentrations were also clearly affected by anthropogenic emissions with more pronounced associations in the 0.01-0.4 µm range (r = 0.66 with NOx and r = 0.65 with equivalent black carbon). Validating estimated LDSA through simultaneous measurements with a reference instrument revealed that the estimation method underestimates LDSA by a factor between 2 and 3, exhibiting, however, a high correlation (r = 0.79). Overall, the performance of estimation methods appear satisfactory and indicate that a trustworthy assessment of the temporal variability of SA and LDSA concentration metrics can be provided in real time, on the basis of relatively lower-cost instrumentation, especially in view of recent advances in particle sensing technologies.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Grécia , Material Particulado/análise , Emissões de Veículos/análise
17.
Stud Health Technol Inform ; 274: 31-41, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32990663

RESUMO

This chapter aims at providing the student with a general overview of the Health Organization Development and Design basic concepts. More precisely, this chapter outlines the origins and the future of Health services planning and development and the structure of health organizations. The typology of different international healthcare systems implemented in United Kingdom, United States of America, Greece, Serbia and Germany is also presented.


Assuntos
Assistência à Saúde , Alemanha , Grécia , Humanos , Sérvia , Reino Unido , Estados Unidos
18.
Am J Case Rep ; 21: e926915, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32963216

RESUMO

BACKGROUND Recent studies demonstrated evidence of coagulation dysfunction in hospitalized patients with severe coronavirus disease 2019 (COVID-19) due to excessive inflammation, hypoxia, platelet activation, endothelial dysfunction, and stasis. Effective anticoagulation therapy may play a dominant role in the management of severe COVID-19 cases. CASE REPORT A 73-year-old man with a 6-day history of fever up to 38.5°C, dyspnea, cough, and fatigue was diagnosed with COVID-19. He had a past medical history significant for hypertension and coronary artery bypass grafting. Two days after hospital admission, the patient developed acute respiratory failure, requiring intubation, mechanical ventilation, and transfer to the intensive care unit (ICU). He received treatment including antibiotics, hydroxychloroquine, tocilizumab, vasopressors, prone positioning, and anticoagulation with enoxaparin at a prophylactic dose. After a 15-day ICU stay, the patient was hemodynamically stable but still hypoxemic; a transthoracic echocardiogram at that time, followed by a transesophageal echocardiogram for better evaluation, revealed the presence of a right atrium thrombus without signs of acute right ventricular dilatation and impaired systolic function. Since the patient was hemodynamically stable, we decided to treat him with conventional anticoagulation under close monitoring for signs of hemodynamic deterioration; thus, the prophylactic dose of enoxaparin was replaced by therapeutic dosing, which was a key component of the patient's successful outcome. Over the next few days he showed significant clinical improvement. The follow-up transesophageal echocardiogram 3 weeks after effective therapeutic anticoagulation revealed no signs of right heart thrombus. CONCLUSIONS The presented COVID-19 case, one of the first reported cases with evidence of right heart thrombus by transesophageal echocardiography, highlights the central role of diagnostic imaging strategies and the importance of adequate anticoagulation therapy in the management of severe COVID-19 cases in the ICU.


Assuntos
Infecções por Coronavirus/complicações , Ecocardiografia Transesofagiana/métodos , Átrios do Coração/diagnóstico por imagem , Cardiopatias/terapia , Pneumonia Viral/complicações , Síndrome Respiratória Aguda Grave/complicações , Trombose/terapia , Idoso , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Tosse/diagnóstico , Tosse/etiologia , Cuidados Críticos/métodos , Progressão da Doença , Serviço Hospitalar de Emergência , Febre/diagnóstico , Febre/etiologia , Seguimentos , Grécia , Átrios do Coração/patologia , Cardiopatias/diagnóstico por imagem , Cardiopatias/etiologia , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Índice de Gravidade de Doença , Trombose/diagnóstico por imagem , Trombose/etiologia , Resultado do Tratamento
19.
Environ Monit Assess ; 192(10): 652, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32964332

RESUMO

Location selection for offshore wind farms is a major challenge for renewable energy policy, marine spatial planning, and environmental conservation. This selection constitutes a multi-criteria decision-making problem, through which parameters like wind velocity, water depth, shorelines, fishing areas, shipping routes, environmental protection areas, transportation, and military zones should be jointly investigated. The aim of the present study was thus to develop an integrated methodology for assessing the siting of bottom-fixed offshore wind farms in two different countries (with different legal, political, and socio/economic characteristics). Our methodology combined multi-criteria decision-making methods and geographical information systems and was implemented in Cyclades (Greece) and in the sea area of Izmir region (Turkey). Experts used fuzzy sets and linguistic terms to achieve more consistent and independent rankings and results. In the Turkish region, the results showed that 519 km2 (10.23%) of the study area is suitable for offshore wind farms, while in the Greek region, only 289 km2 (3.22%) of the study area was found to be suitable. This spatial suitability analysis may contribute to provide some useful recommendations for the spatial marine planning at the regional scale, as well as for the preliminary assessment of new offshore wind farms in both countries.


Assuntos
Fontes Geradoras de Energia , Sistemas de Informação Geográfica , Monitoramento Ambiental , Grécia , Centrais Elétricas , Turquia , Vento
20.
In Vivo ; 34(5): 3039-3045, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32871850

RESUMO

BACKGROUND: Antibody testing is necessary to identify immune individuals in the post-initial wave of the COVID-19 pandemic. PATIENTS AND METHODS: We prospectively evaluated the performance of a quantitative point-of-care test (POCT) for SARS-CoV-2 antibodies. The patient group (PG) comprised of hospitalized confirmed COVID-19 cases. Asymptomatic healthcare volunteers with negative rRT-PCR were included in the control group (CG). Measurement of IgM and IgG was obtained by dry fluorescence immunoassay. RESULTS: Twenty-six PG (65.9±15.4 years old, male 57.7%) and 18 CG (45.6±10.1 years old, male 33.3%) were included. By manufacturer's cut-off (≥0.04 mIU/ml), sensitivity and specificity were 73.08% and 88.89% for IgM and 88.46% and 33.33% for IgG, respectively. Estimated areas under the ROC curve were 0.907 and 0.848 for IgM and IgG, respectively. Results were improved using a cut-off of IgM ≥0.05 mIU/ml and IgG ≥0.10 mIU/ml. CONCLUSION: Using stringent cut-off values, SARS-CoV-2 antibody POCT detects immune people and can be used during socioeconomic normalization of communities.


Assuntos
Anticorpos Antivirais/isolamento & purificação , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pandemias , Pneumonia Viral/diagnóstico , Idoso , Anticorpos Antivirais/sangue , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Grécia/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade
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