Background Intraoperative bradycardia is a hardly studied complication of modified radical neck dissection (MRND). Methods Using convenient sampling, we retrospectively studied a cohort (n = 159) of ...patients who underwent MRND at Papanikolaou General Hospital, Thessaloniki, Greece between 2019 and 2020 to investigate whether MRND laterality (bilateral vs. unilateral) affects the occurrence of intraoperative bradycardia (a pulse rate lower than 50 bpm). Results Roughly two-thirds of the patients underwent unilateral MRND, and the rest underwent bilateral MRND. Bradycardia was observed in 25.8% of the cohort. We used logistic regression and investigated several potential confounding factors. Unilateral MRND was associated with a lower risk of intraoperative bradycardia compared to bilateral MRND in the simple regression model (relative risk (RR): 0.555, 95% confidence interval (CI): 0.331-0.932, p = 0.027). MRND laterality was not significantly associated with intraoperative bradycardia (p = 0.082) in the multiple regression model, whereas an American Society of Anesthesiologists physical status (ASA-PS) score of 3 vs. 4 (adjusted odds ratio (aOR) = 0.125, 95% CI: 0.0340-0.457, p = 0.002), the presence of atrial fibrillation (aOR = 11.4, 95% CI: 4.10-31.8, p < 0.001) and induction of anesthesia with dexmedetomidine (aOR = 4.57, 95% CI: 1.34-15.6, p = 0.015) were significantly associated with intraoperative bradycardia. Conclusions MRND laterality was close to statistical significance. Bigger sample sizes may provide more definitive information since the effect of MRND laterality on intraoperative bradycardia remains unclear. Our findings can inform clinical practice so that clinicians know when to expect bradycardia and are better prepared to manage it.
We studied neuroinflammation in individuals with late-life, depression, as arisk factor for dementia, using 11CPK11195 positron emissiontomography (PET). Five older participants with major depression ...and 13controls underwent PET and multimodal 3T magnetic resonance imaging (MRI),with blood taken to measure C-reactive protein (CRP). We found significantlyhigher CRP levels in those with late-life depression and raised11CPK11195 binding compared with controls in brain regionsassociated with depression, including subgenual anterior cingulate cortex,and significant hippocampal subfield atrophy in cornu ammonis 1 andsubiculum. Our findings suggest neuroinflammation requires furtherinvestigation in late-life depression, both as a possible aetiologicalfactor and a potential therapeutic target.
Cardiac rehabilitation (CR) constitutes a valuable therapeutic approach for patients with a broad spectrum of cardiovascular diseases facilitating the development and maintenance of a desirable level ...of physical, social, and psychological functioning following the onset of cardiovascular disease. Nowadays, cardiac rehabilitation programs emphasize the use of a multidisciplinary approach. The current review aims at presenting the state-of-the-art knowledge on the indications of patients entering cardiac rehabilitation programs, including their core components, duration, and effectiveness. Following a careful review of the international literature, we conclude that there are significant differences between the most commonly cited international CR guidelines as well as additional limitations and gaps in knowledge. Despite the benefits associated with CR and despite their widespread acceptance, CR referrals and program attendance remains low, while many questions have not been so far addressed through scientific research. Overall, the findings of our study suggest a critical need for the development of robust and evidence-based standardized CR interventions to increase their use and effectiveness throughout the world.
Epidemiology is the practical tool to provide information on which policy makers should base planning of services. Epidemiological data for thalassemia is based on inaccurate and often conflicting ...measurements. This study attempts to demonstrate with examples the sources of inaccuracy and confusion. The Thalassemia International Foundation (TIF) suggests that congenital disorders, for which increasing complications and premature death are avoidable through appropriate treatment and follow-up, should be given priority based on accurate data and patient registries. Moreover, only accurate information about this issue, especially for developing countries, will move national health resources in the right direction.
Electronic cigarette use has increased over the past decade. Its potential role in smoking cessation, in addiction and as a 'gateway' to tobacco smoking is subject to intense research. This ...cross-sectional study, carried out in 2013, aims to present the habits of students aged 13-15 in Greece with regard to e-cigarettes and investigate potential risk factors and the relationship between e-cigarettes, tobacco smoking and other nicotine products. It is the first such study to be carried out in Greece. The survey was based on the standardized methodology of the Global Youth Tobacco Survey. All potential associations were investigated using multiple logistic regression. In total 2.8% of the 4096 participating students were current e-cigarette users and 12.3% of them were ever users. E-cigarette use was associated with male gender, being older, current use of combustible tobacco products and e-cigarette use in the family. Ever e-cigarette use, being older, female gender and higher pocket money were associated with an increased susceptibility to tobacco smoking. E-cigarette prevalence in Greece in 2013 was similar to that of other, developed countries. The smoking and vaping habits of adolescents must be monitored in order to assess trends over time and whether any policy alterations are necessary.
Introduction & Purpose: Statin treatment is an integral part of cardiovascular prevention. Recent studies have highlighted their potential diabetogenic action, mostly in a dose-dependent mode. ...Pitavastatin has studies showing that this statin may not follow the above rule. The present retrospective study highlights the metabolic effects of initiating pitavastatin vs. rosuvastatin therapy in diabetic and nondiabetic statin-naive patients.
Materials & Methods: A total of 74 hyperlipidemic patients included: 41 with DM, mean age 62.4 years (23 on Pitavastatin + 18 on Rosuvastatin)33 non-DM, mean age 62.2 years (15 on Pitavastatin + 18 on Rosuvastatin)Biochemical data were extracted from the medical records of the participants after consent.
Results: For the group of patients with DM, we found that those on Pitavastatin showed statistically significant difference in increasing HDL and decreasing total cholesterol, LDL, triglycerides and γGT. Those on Rosuvastatin showed decrease in total cholesterol, LDL, triglycerides without HDL increase. For the group of patients without DM, we found that mean fasting blood glucose was 97.2mg/dl before Rosuvastatin initiation and 104.1mg/dL after 1 year. A statistically significant difference was recorded also in reducing total cholesterol and LDL and increasing γGT. Accordingly, blood glucose was 102 before Pitavastatin initiation and 95.6mg/dL after 1 year. A statistically significant difference was recorded in HDL increase and total cholesterol, LDL, triglycerides, γGT and ALT decrease.
Conclusion: In accordance to prospective studies, this retrospective short term “real world” study highlights the rosuvastatin-induced carbohydrate metabolism disorder and the favorable effects of pitavastatin in glucose metabolism and biochemical liver markers, as well as the beneficial effect on lipid profile, regardless the presence of DM.
Disclosure
D. Lygnos: None. A. Papazafiropoulou: None. S. Soteriades: None. N. D. Loxas: None. M. Xenou: None. I. Zoupas: None. E. Fousteris: None.
BackgroundOutbreaks of norovirus gastroenteritis aboard cruise ships may affect a large number of people, debilitate vulnerable travellers, disrupt vacations and cause economic losses to the cruise ...ship industry.AimWe aimed to identify risk factors for norovirus outbreaks on cruise ships and assess the effectiveness of prevention and control measures.MethodsWe conducted a systematic literature review searching PubMed and Scopus databases as well as grey literature for articles and reports describing norovirus outbreaks on cruise ships between 1990 and 2020. We also performed a meta-analysis of norovirus prevalence in passengers and crew members.ResultsData from 45 outbreaks on 26 cruise ships from 1990 to 2020 were identified in 13 articles and five reports, with a weighted average of prevalence (attack rate) for passengers of 7% (95% confidence interval (CI): 5.00-9.00) and for crew of 2% (95% CI: 0.00-3.00). Person-to-person was the most frequent mode of transmission in 35 of the 45 outbreaks (in 14 the only mode and in 21 as part of multiple transmission routes). Having an ill cabin mate (OR = 38.70; 95% CI: 13.51-110.86) was the most common risk factor. Six outbreak investigations reported poor hygiene, while four reported satisfactory hygiene in the cruise setting. Behavioural risk factors among travellers were investigated in three of the 13 studies.ConclusionsThe findings indicate a need for behavioural interventions to improve personal hygiene, symptom reporting and compliance with isolation measures, and for reconsidering current isolation policies where symptomatic and healthy individuals are isolated in the same cabin.
Nicotine dependence is one of the main reasons for the continuation of smoking among adolescents. Loss of autonomy (LOA) is a measure of dependence. This study is the first to investigate LOA and its ...determinants among Greek adolescents. In 2013, 13-to-15-year-old middle-school students were selected by multi-stage clustered sampling. LOA was evaluated with the Hooked-on-Nicotine Checklist (HONC). Multiple univariate analysis was used to assess the association between adolescent demographics, smoking habits, and loss of autonomy. Three-hundred thirty-nine current smokers responded to the questionnaire (response rate: 82.3%). Of these respondents, 51.2% were male and 88.8% reported at least one LOA symptom. The mean HONC score was 4.13/10 (95% CI: 3.82-4.45). Higher scores were negatively associated with lower smoking frequency (cumulative odds ratio (cOR): 0.240, 95% CI: 0.144-0.400) and positively associated with lower age at first cigarette (cOR: 2.29, 95% CI: 1.38-3.82). Female gender was significantly associated with the prevalence but not the degree of LOA. Overall, the prevalence and the degree of nicotine dependence among adolescent smokers in Greece is similar to other countries. Frequent smoking and initiation of smoking at a younger age are linked to nicotine dependence, although it was not possible to make causal inferences. The relationship between nicotine dependence and gender remains unclear.
We studied neuroinflammation in individuals with late-life, depression, as a
risk factor for dementia, using 11CPK11195 positron emission
tomography (PET). Five older participants with major ...depression and 13
controls underwent PET and multimodal 3T magnetic resonance imaging (MRI),
with blood taken to measure C-reactive protein (CRP). We found significantly
higher CRP levels in those with late-life depression and raised
11CPK11195 binding compared with controls in brain regions
associated with depression, including subgenual anterior cingulate cortex,
and significant hippocampal subfield atrophy in cornu ammonis 1 and
subiculum. Our findings suggest neuroinflammation requires further
investigation in late-life depression, both as a possible aetiological
factor and a potential therapeutic target.
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