Search

Background/Aim. Under the current financial crisis in Greece, an effort has been made by the Greek health authorities to encourage generic prescribing, in order to lower medicinal cost. The purpose of this work was to study antipsychotics use, and to calculate utilization of generics in antipsychotics sales in a sample from the medicines market of Thessaloniki, the second largest city in Greece. Methods. A sample of antipsychotics registered sales was collected using the new Electronic Health Records that have been applied in pharmacies during the last years in Greece. The sample corresponded to a small amount of sales from the market of Thessaloniki during the period July 2014–June 2015, including only community and no hospital sales. All brand names (prototype and generics) of antipsychotics and their relative ratios in the sales were estimated, and the percentage of generics in the sale of each medicine was calculated. The amount of medicines was estimated in Defined Daily Doses (DDDs) of the reference/prototype drug and its generics. Results. Olanzapine, quetiapine, haloperidol and risperidone sales corresponded to 77% of total antipsychotics sales with percentages of sales 25%, 19%, 19% and 14% respectively. The percentage of sales of other antipsychotics was 7% for amisulpride, 6% for aripiprazole, 4% for ziprasidone and 3% for clozapine. Generic use corresponded to 41% of total sales of antipsychotic drugs (10.884 DDDs out of 26.433 DDDs). Concerning second generation antipsychotics, generic use was high for amisulpride, olanzapine, risperidone and quetiapine. Conclusion. In the study sample, second generation antipsychotics corresponded to 78% of sales in the community of Thessaloniki. Haloperidol utilization was also notable. Considering Greek practices, the percentage of generics in antipsychotics sales was very high even for some of the newest antipsychotics.

Background/Aim. Sometimes resistance of Pseudomonas aeruginosa (Ps. aeruginosa) is developed during antibiotic treatment, in spite of the initial susceptibility in vitro. The aim of this study was to use an in vitro model for the study of the development of resistant strains of Ps. aeruginosa after a short exposure to ceftazidime, and to study the hydrolysing capacity of β-lactamases produced by the resistant strains. Methods. Among 563 clinical strains of Ps. aeruginosa, 37 multisensitive strains were collected for the study. After being identified, strains with simultaneous sensitivity to 5 expanded spectrum cephalosporins were chosen. For each strain, the minimal inhibitory concentration (MIC) of the 5 expanded spectrum cephalosporins was determined, and the production of extended spectrum β-lactamases (ESBL) was excluded by the double-disc synergy diffusion test. Strains non producing ESBL were cultivated in concentrations of ceftazidime equal to MIC×2 and MIC×4. After 24 hours of culture, the development of resistant strains was estimated and the cephalosporinase activity of the produced β-lactamases was determined by their ability to hydrolyse cefazolin. Hydrolysis of cefazolin was studied by measuring the change of its absorbance on 272 nm using a Shimadzu 160A spectrophotometer. The hydrolyzing capacity of the enzymes was expressed as the percentage of the antibiotic, which was hydrolysed in 10 sec. Results. A total of 60% and 50% of strains developed resistant strains after exposure to ceftazidime in concentration MIC×2 and MIC×4, respectively. The hydrolyzing capacity of the original strains was 15-36% while the hydrolyzing capacity of the resistant strains was 10-73%. Totally 64% of the resistant strains expressed higher hydrolyzing capacity than the original strains. Conclusion. Regardless of the susceptibility test results, Ps. aeruginosa presented a high tendency to develop resistant strains after a short exposure to ceftazidime in vitro. In most cases the resistant strains expressed higher cephalosporinase activity than the original strains, suggesting derepression of chromosomal β-lactamases. Our model offers a simple, inexpensive and rapid method for detecting resistance of Ps. aeruginosa developed due to derepression of β-lactamases, and for discriminating resistant strains with derepressed β-lactamases from strains that developed other mechanisms of resistance.

The European Open Platform for Prescribing Education (EurOP2E) seeks to improve and harmonize European clinical pharmacology and therapeutics (CPT) education by facilitating international collaboration and sharing problem-based, online, open educational resources. The COVID-19 pandemic forced teachers to switch to virtual modalities, highlighting the need for high-quality online teaching materials. The goal of this study was to establish the online problem-based teaching resources needed to sustain prescribing education during the pandemic and thereafter. A nominal group technique study was conducted with prescribing teachers from 15 European countries. Results were analyzed through thematic analysis. In four meetings, 20 teachers from 15 countries proposed and ranked 35 teaching materials. According to the participants, the most necessary problem-based-online teaching materials related to three overarching themes. Related to learning outcomes for CPT, participants proposed creating prescription scenarios, including materials focusing on background knowledge and resources on personalized medicine and topical/ethical issues such as the prescription's impact on planetary health. Second, related to teaching, they proposed online case discussions, gamification and decision support systems. Finally, in relation to faculty development, they recommend teacher courses, a repository of reusable exam questions and harmonized formularies. Future work will aim to collaboratively produce such materials.

Antimicrobial resistance is a global health threat resulting in increased morbidity and mortality. This retrospective study aimed to estimate antimicrobial susceptibility and multidrug resistance prevalence of clinical isolates in a regional hospital in Northern Greece during the last 6 years by analyzing the annual reports of the Laboratory of Microbiology. A total of 12,274 strains of certain bacteria were isolated from both hospitalized and ambulatory patients from biological products, mainly urine (range 63–78% during the study period). E. coli was the most frequent pathogen found (37.4%). A significant increase in the number of the main pathogens causing hospital-acquired infections (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium) was found in the time period of 2021–2023 compared to 2018–2020 (p < 0.0001). In total, 1767 multidrug-resistant bacterial strains were isolated, most of them belonging to Acinetobacter baumannii (36.4%) and Klebsiella pneumoniae (39.6%), and were located in the intensive care unit (ICU) (59.8%). Extensively drug resistance (XDR) and pan drug resistance (PDR) were significantly higher in 2021–2023 than in 2018–2020 (XDR: 641/1087 in 2021–2023 vs. 374/680 in 2018–2020 and PDR: 134/1087 in 2021–2023 vs. 25/680 in 2018–2020, p < 0.0001), resulting in an urgent need to establish certain strategies in order to eliminate this threatening condition.

Early failure of silicone voice prostheses resulting from fungal colonization and biofilm formation poses a major concern in modern ear nose throat surgery. Therefore, developing new infection prevention techniques to prolong those implants’ survivorship is crucial. We designed an in vitro laboratory study to include nanomaterial-enhanced polymer coating with a plasma spraying technique against Candida albicans growth to address this issue. The anti-biofilm effects of high- and low-dose Al2O3 nanowire and TiO2 nanoparticle coatings were studied either alone or in conjunction with each other using checkerboard testing. It was demonstrated that both nanomaterials were capable of preventing fungal biofilm formation regardless of the anti-fungal agent concentration (median absorbance for high-dose Al2O3-enhanced polymer coating was 0.176 [IQR = 0.207] versus control absorbance of 0.805 [IQR = 0.381], p = 0.003 [98% biofilm reduction]; median absorbance for high-dose TiO2-enhanced polymer coating was 0.186 [IQR = 0.024] versus control absorbance of 0.766 [IQR = 0.458], p < 0.001 [93% biofilm reduction]). Furthermore, synergy was revealed when the Bliss model was applied. According to the findings of this work, it seems that simultaneous consideration of Al2O3 and TiO2 could further increase the existing antibiofilm potential of these nanomaterials and decrease the likelihood of localized toxicity.

The aim of this work was to study age, sex, and BMI (Body Mass Index)-related differences in the development of anti-SARS-CoV-2-Spike IgG antibodies, after vaccination with the BNT162b2 COVID-19 vaccine, in health care workers of a General Hospital in a city in Northern Greece. Blood sampling was drawn two to four weeks following the second dose of the vaccine, and six months after the first blood sample collection. Measurement of serum IgG antibodies against the spike domain of SARS-CoV-2 was performed using the SARS-CoV-2 IgG II Quant assay. All participants had sufficient serum IgG titers in the first measurement. Women developed higher IgG titers than men. The IgG titers were inversely related to age in both sexes; there was also a small, insignificant tendency to be inversely related to BMI. Six months after the first measurement, the IgG titers decreased dramatically to values less than 5% of the initial. This decrease was observed in both men and women and was inversely related to age. Multivariate regression analysis showed that age and sex explained with statistical significance 9% of the variance in SARS-CoV-2 IgG titers in our study population; the role of BMI was limited and insignificant.

Purpose: There is a widely held belief that sustainable development (SD) policies are essential for universities to successfully engage in matters related to sustainability, and are an indicator of the extent to which they are active in this field. This paper aims to examine the evidence which currently exists to support this assumption. It surveys a sample of universities in Brazil, Germany, Greece, Portugal, South Africa and the UK and the USA to ascertain the extent to which universities that are active in the field of sustainable development have formal policies on sustainable development, and whether such policies are a pre-condition for successful sustainability efforts. Design/methodology/approach: The study involved 35 universities in seven countries (five universities respectively). A mixed-methods approach has been used, ranging from document analysis, website analysis, questionnaires and interviewing. Findings: Although only 60 per cent of the sampled universities had a policy that specifically addressed SD, this cannot be regarded as an indicator that the remaining 40 per cent are not engaged with substantial actions that address SD. Indeed, all of the universities in the sample, regardless of the existence of a SD formal policy, demonstrated engagement with environmental sustainability policies or procedures in some form or another. This research has been limited by the availability and ability to procure information from the sampled universities. Despite this, it is one of the largest research efforts of this kind ever performed. Research limitations/implications: This research has been limited by the availability and ability to procure information from the sampled universities. Practical implications: The findings provide some valuable insights into the connections between SD policies on the one hand and the practice of sustainable development in higher education institutions on the other. Social implications: Universities with SD policies can contribute to models of economic growth consistent with sustainable development. Originality/value: The study is the one of the largest research efforts of this kind ever performed.

This cross-sectional study aimed to evaluate the association between hepatic steatosis and fibrosis indices and adherence to the Mediterranean diet (MD), physical activity (PA), and quality of life (QoL) in individuals unaware of the status of their liver. Participants were asked to complete three questionnaires validated in Greek, namely: (1) the Chronic Liver Disease Questionnaire (CLDQ) for QoL assessment; (2) the semi-quantitative Food Frequency Questionnaire (FFQ), from which the MedDietScore was calculated; and (3) the International Physical Activity Questionnaire (IPAQ) for PA evaluation. Hepatic steatosis was evaluated using the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Hepatic fibrosis was evaluated using the NAFLD Fibrosis Score (NFS), Fibrosis-4 (FIB-4), and AST-to-platelet ratio index (APRI). This study recruited 200 participants (90% men) aged 36 ± 6 years. Hepatic steatosis indices were not associated with MedDietScore and QoL. In terms of PA, univariable analysis showed that higher values of hepatic steatosis indices were associated with less intense activity. This association remained significant only for HSI during multivariable analysis (moderate activity vs. low activity: beta: −2.0, 95% confidence interval (CI): −3.5, −0.37, p = 0.016; and high activity vs. low activity: beta: −3.3, 95% CI: −5.03, −1.60, p < 0.001), after controlling for age, waist circumference, and the presence of metabolic syndrome. When using hepatic fibrosis indices, none of the participants had high probability of advanced hepatic fibrosis or cirrhosis (F3–F4). Consequently, we were unable to extensively evaluate the association between hepatic fibrosis indices and lifestyle characteristics or QoL. We showed that HSI, but not other steatosis indices, remained robustly associated with PA after adjusting for potential confounders in a population unaware of the presence of fatty liver. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM). There is currently no approved treatment for NAFLD. The main aim was the evaluation of the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RA) vs. dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment on noninvasive indices of hepatic steatosis and fibrosis in patients with T2DM. In this retrospective study, three noninvasive indices of hepatic steatosis [HSI, NAFLD ridge score, and triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio] and five of fibrosis (APRI, FIB-4, NAFLD fibrosis score, BAAT and BARD) were calculated before and after (6–18 months) the addition of a DPP-4i (n = 152) or a GLP-1 RA (n = 37) in patients with T2DM. Regarding steatosis indices, NAFLD ridge score was significantly decreased in the GLP-1 RA group (baseline: 0.90 ± 0.34, follow-up: 0.67 ± 0.24; p = 0.001), but not in the DPP-4i group (p = 0.25); the difference for group∗time interaction was significant (p = 0.02). HSI showed a trend between groups, being significantly different at baseline and follow-up (p < 0.001) with no significant difference in group∗time interaction. Indices of fibrosis were not essentially changed within or between groups. NAFLD ridge score was significantly decreased after the addition of GLP-1 RA in patients with T2DM. This study warrants further prospective clinical trials. • NAFLD ridge score was decreased only within the GLP-1 RA group. • GLP-1 RA or DPP-4 inhibitors had a similarly null effect on fibrosis indices. • Hepatic steatosis index showed a trend towards decrease in GLP-1 RA group. [ABSTRACT FROM AUTHOR]

Abstract: Background: Digit ratios, such as the second to fourth digit ratio (2D:4D), are biometric markers that are influenced by estrogen and testosterone concentrations in utero and are determined genetically by HOX genes (homeodomain-containing homeotic genes). Sex steroids also play a crucial role in the occurrence of myocardial infarction (MI), which is considered to be gender dependent and related to testosterone. Additionally, first-trimester exposure to excess levels of estrogens and progesterone has been linked to cardiovascular anomalies. Objective: The aim of this work was to study digit ratios in a Greek population and assess their clinical importance as markers of predisposition to MI. Methods: Two samples were used: a group of Greek men and women hospitalized with MI, and a control group of healthy Greek men and women of the same age. Finger lengths were measured twice for both hands using electronic calipers. In the results, digits were designated as 2D (second digit), 3D (third digit), 4D (fourth digit), and 5D (fifth digit). Results: A total of 50 Greek men and 50 Greek women with MI were recruited (mean [SD] age, 69.3 [11.2] years for men; 69.7 [11.0] years for women). The control group consisted of 40 healthy Greek men and 40 healthy Greek women (mean age, 68.0 [11.8] years for men; 66.8 [10.7] years for women). In the control group, 2D:4D, 2D:3D, and 2D:5D ratios were significantly higher in women than in men (2D:4D: right hand, P < 0.001; left hand, P = 0.002; 2D:3D: right hand, P < 0.001; left hand, P = 0.003; 2D:5D: right hand, P < 0.001; left hand, P < 0.05). The mean values of 2D:4D ratios appeared to increase in the following order: healthy men < men with MI < healthy women < women with MI, although this difference was not statistically significant. In men with MI, 2D:4D and 3D:4D ratios were significantly higher than the respective ratios in healthy men (2D:4D: right hand, P = 0.001; left hand, P < 0.05; 3D:4D: right hand, P < 0.05; left hand, P = 0.001), but no significant differences were observed in the ratios between women with MI and healthy women. Conclusions: Digit ratios that include ring-finger length (ie, 4D) may be useful biomarkers for predisposition to MI in Greek men, but not in Greek women. Sexual dimorphism of digit ratios was present in both groups and was independent of the individuals'' health status. [Copyright &y& Elsevier]

Objectives: Patients suffering from invasive mycoses often receive concomitant antifungal therapy and antibacterial agents. Ciprofloxacin, a carboxyfluoroquinolone, was previously observed to demonstrate the pharmacodynamic interactions with antifungal agents by altering their growth inhibitory activity against Candida albicans and Aspergillus fumigatus. However, little is known about the interaction between other extended-spectrum fluoroquinolones, such as levofloxacin and moxifloxacin, and antifungal agents against C. albicans and A. fumigatus.Methods: Using a microdilution chequerboard technique, we employed isobolographic analysis adapted to incorporate a non-active agent in order to analyse the potential in vitro interaction between ciprofloxacin, levofloxacin or moxifloxacin and the following representative antifungal agents: amphotericin B, fluconazole or voriconazole and caspofungin.Results: Synergistic interactions [interaction indices (Iis) 0.69-0.83, P < 0.05] were observed between amphotericin B (0.07-0.31 mg/L) and either ciprofloxacin (0.19-7.65 mg/L) or levofloxacin (0.41-32.88 mg/L) against C. albicans and A. fumigatus. Synergy (Iis 0.56-0.87, P < 0.05) also was found between voriconazole (0.09-0.14 mg/L) and ciprofloxacin (0.22-11.41 mg/L) as well as between caspofungin (8.94-22.07 mg/L) and levofloxacin (0.14-5.17 mg/L) against A. fumigatus. Some antagonistic (Iis 1.16-1.29, P < 0.05) interactions were observed between fluoroquinolones and fluconazole against C. albicans. In general, ciprofloxacin enhanced the activity of antifungal agents more than moxifloxacin and levofloxacin against both C. albicans and A. fumigatus.Conclusions: The knowledge of the pharmacodynamic interactions between fluoroquinolones and antifungal agents may guide selection and potentially improve the outcome of immunosuppressed patients with concurrent bacterial and fungal infections. [ABSTRACT FROM AUTHOR]

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The transfer and presentment of the traditional dance of a country on stage, is an aesthetical and at the same time a political action, that brings a special meaning when dance is presented to a foreign audience. This happens because stage presentation of the traditional dance can be considered as a picture of the country that enacts on stage its civilizational ideals and principles. The aim of this assignment is the research of topics that are associated with the stage presentation of the Greek dance by the Greek dancing groups and its encounter as an artistic kind. The research is based on the analysis of 80 traditional dancing "performances" that took place from April 2003 to April 2004 with the participation of 320 dancing groups from all around Greece. Additionally, we retrospected on the global and Greek bibliography related to the certain topic. For the analysis of the data given quantitative and qualitative analysis were used. By the analysis was resulted that the "performances" of the dancing groups the recent years present the same aesthetics and artistic attitude and they don't correspond to the theatrical demands and the artistic criteria. From their performances several specialties are absent such as director, choreographer, costumer and the whole responsibility is upon the dancing teachers. This probably happens due to the economic condition of the dancing groups and their inadequate corpsmen with the suitable scientific, managerial and technical staff and the educational inadequacy of dancing teachers. [ABSTRACT FROM AUTHOR]