Διαχείριση Υδατικών Πόρων Άνυδρων Νησιών. Το Υδροσύστημα Μυκόνου.

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Επιστήμη και Τεχνολογία Υδατικών Πόρων

Cost-effectiveness of intravitreal therapy with both anti-VEGF and Dexamethasone implant in patients with Diabetic Macular Edema

Purpose: The aim of this study was to evaluate the cost-effectiveness of intravitreal therapy (IVT) with both anti-VEGF and Dexamethasone implant in patients with Diabetic Macular Edema (DME) during two years’ follow-up. Methods: A retrospective review of 191 patients (382 eyes) with type I and II diabetes and DME was performed. Pre-IVT and final best correct visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), number and type of IVT,number of examinations, and fluorescein angiography were assessed. Based on surgery procedure other than IVT, patients were divided into 5 groups. To avoid bias, we analysed only patients who had undergone cataract surgery before (group 1) or during enrolment (group 2). Results: 41 eyes from Group 1 and 48 eyes from group 2 were evaluated. Median BCVA ranged between 20/80 and 20/63 Snellen (P = 0.008) in Group 1 and from 20/63 to 20/40 Snellen (P = 0.0035) in Group 2, while improvement up to 1 Snellen line was observed in 58.5 and 68.75% of eyes in Group 1 and 2, respectively.In terms of median CMT, a statistically reduction (P = 0.0007) was found in Group 2 (-85 μm), whereas no statistical differences were found in Group 1. The two groups showed no statistically significant difference in median IOP. The estimated cost per eye was €7803 in Group 1 and €8988 Group 2, whereas the mean cost per patient was €15190 and €16580 in Group 1 and 2, respectively. Analysis between groups did not show any statistical difference in the considered parameters. Conclusions: In this study, despite the high treatment cost, vision improvement in DME patients undergoing IVT was disappointing. Our results emphasise the need for a better understanding of the cost-effectiveness of DME treatmen

Functional gastrointestinal disorders in children and adolescent

Background: Functional gastrointestinal disorders (FGIDs) are a common, diverse group of disorders of unknown etiology, resulting in significant sociοeconomic burden. In this study, we aimed to assess the prevalence of FGIDs in children aged 6–18 years and examine their association with various demographic and socioeconomic parameters. Methods: This was a school-based, cross-sectional study approved by the relevant government authorities. Informed consent was obtained by the legal representatives of all children who participated. Diagnoses of FGIDs were based on the Greek official translation of the ROME-III questionnaire. Demographic and socioeconomic information were also collected.Results: A total of 1588 children (51.8% females, mean age: 12.9±2.8 years) were included. The overall prevalence of any-FGID was 23.1% (95% CI: 21.1–25.2). The most common FGIDs were functional constipation, n=231 (13.9%), abdominal migraine, n=84 (5.6%), aerophagia, n=58 (3.5%), and irritable bowel syndrome, n=48 (3.0%). Multiple logistic regression analysis on the probability of any-FGID identified physical exercise, TV-exposure, victimization, gender, parental educational level, number of children at home and number of adults at home as significant covariates for any-FGID in the final model. Conclusions: FGIDs affect approximately 1 in 4 school-aged children in Greece. The following characteristics are associated with a higher probability of any-FGID: female gender, living in a non-nuclear household, victimization, lower parental education level, infrequent physical activity, and high television exposure.Εισαγωγή και σκοπός: Οι λειτουργικές γαστρεντερικές διαταραχές (ΛΓΕΔ) είναι μια ποικίλη ομάδα διαταραχών άγνωστης αιτιολογίας με σημαντικό κοινωνικοοικονομικό κόστος. Σκοπός της μελέτης ήταν η αξιολόγηση της επιπολασμού των ΛΓΕΔ σε παιδιά ηλικίας 6-18 ετών και η συσχέτισή τους με διάφορες δημογραφικές και κοινωνικοοικονομικές παραμέτρους.Υλικό και μέθοδοι: Η συγχρονική αυτή μελέτη πραγματοποιήθηκε σε σχολεία πανελλαδικά με τη χρήση της ελληνικής επίσημης μετάφρασης του ερωτηματολογίου γαστρεντερικών συμπτωμάτων βασισμένο στα κριτήρια της Ρώμης ΙΙΙ. Επίσης, συγκεντρώθηκαν δημογραφικές και κοινωνικοοικονομικές πληροφορίες.Αποτελέσματα: Στη μελέτη συμπεριελήφθησαν συνολικά 1588 παιδιά (51,8% θηλυκά, μέση ηλικία: 12,9 ± 2,8 έτη). Ο συνολικός επιπολασμός για οποιουδήποτε ΛΓΕΔ ήταν 23,1% (95% CI: 21,1-25,2). Οι συχνότερες ΛΓΕΔ ήταν η λειτουργική δυσκοιλιότητα, n = 231 (13,9%), η κοιλιακή ημικρανία, n = 84 (5,6%), η αεροφαγία, n = 58 (3,5%) και το σύνδρομο ευερεθίστου εντέρου, n = 48 (3,0%). Πολλαπλές αναλύσεις λογιστικής παλινδρόμησης σχετικά με την πιθανότητα για οποιουδήποτε ΛΓΕΔ αναγνώρισε τη φυσική άσκηση, την έκθεση στην τηλεόραση, την κακοποίηση, το φύλο, το επίπεδο εκπαίδευσης των γονέων, τον αριθμό των παιδιών στο σπίτι και τον αριθμό των ενηλίκων στο σπίτι ως σημαντικές παραμέτρους για οποιοδήποτε ΛΓΕΔ στο τελικό μοντέλο.Συμπέρασμα: Περίπου 1 στα 4 παιδιά σχολικής ηλικίας στην Ελλάδα αναφέρουν ότι πληρούν τα κριτήρια της Ρώμης για κάποια ΛΓΕΔ. Τα ακόλουθα χαρακτηριστικά συνδέονται με την υψηλότερη πιθανότητα εμφάνισης ΛΓΕΔ σε ένα παιδί: τα θήλεα, που ζουν σε μη τυπική οικογενειακή δομή, που έχουν χαμηλό γονικό μορφωτικό επίπεδο, είναι θύματα κακοποίησης και κάνουν καθιστική ζωή

Functional gastrointestinal disorders in Greek Children based on ROME III criteria: identifying the child at risk

Background: Functional gastrointestinal disorders (FGIDs) are a common, diverse group of disorders of unknown etiology, resulting in significant socieconomic burden. In this study, we aimed to assess the prevalence of FGIDs in children aged 6–18 years and examine their association with various demographic and socioeconomic parameters. Methods: This was a school-based, cross-sectional study approved by the relevant government authorities. Informed consent was obtained by the legal representatives of all children who participated. Diagnoses of FGIDs were based on the Greek official translation of the ROME-III questionnaire. Demographic and socioeconomic information were also collected. Key Results: A total of 1588 children (51.8% females, mean age: 12.9±2.8 years) were included. The overall prevalence of any-FGID was 23.1% (95% CI: 21.1–25.2). The most common FGIDs were functional constipation, n=231 (13.9%), abdominal migraine, n=84 (5.6%), aerophagia, n=58 (3.5%), and irritable bowel syndrome, n=48 (3.0%). Multiple logistic regression analysis on the probability of any-FGID identified physical exercise, TV-exposure, victimization, gender, parental educational level, number of children at home and number of adults at home as significant covariates for any-FGID in the final model. Conclusions and Inferences: FGIDs affect approximately 1 in 4 school-aged children in Greece. The following characteristics are associated with a higher probability of any-FGID: female gender, living in a non-nuclear household, victimization, lower parental education level, infrequent physical activity, and high television exposure. © 2016 John Wiley & Sons Lt

Topical betamethasone sodium phosphate, tetracycline hydrochloride and nonsteroidal anti-inflammatory drugs in the treatment of diabetic macular edema: a case report

Purpose: To report a case of clinically significant diabetic macula edema (DME) cured only with topical Betamethasone Sodium Phosphate, Tetracycline Hydrochloride and nonsteroidal anti-inflammatory drugs. Methods: A 44-year-old type I diabetic woman was referred to our Unit after a partial tarsorrhaphy procedure for exposure keratopathy in her left eye. OCT examination of her right eye revealed a clinically significant DME with important visual loss (Central Macular Thickness [CMT] 716 μm, Best Correct Visual Acuity [BCVA] 20/100 Snellen). The patient refused the suggested intravitreal therapy (Ranibizumab injections with PRN protocol). Topical treatment with Betamethasone Sodium Phosphate, Naphazoline Nitrate, Tetracycline Hydrochloride (Alfaflor®, Alfa Intest, Italy) and Diclofenac (Voltaren Oftabak®, Thea, France) eye-drops 4 times/day was started. Results: In the following 10 months, right CMT decreased to 335 μm and right BCVA increased to 20/25 Snellen. However, OCT scans still showed some intraretinal cysts. Topical Diclofenac was then replaced with Bromfenac (Yellox®, Bausch & Lomb, Italy) eye-drops 2 times/day. After 4 months’ treatment, right BCVA was 20/20 Snellen and OCT scans showed a normal CMT. This treatment was continued and there was no recurrence of DME in the next 11 months of follow-up. No adverse events were noted. Conclusions: Topical Betamethasone Sodium Phosphate and Tetracycline Hydrochloride, together with nonsteroidal anti-inflammatory eye-drops, might be an effective alternative for the treatment of newly diagnosed DME in patients not suitable for intravitreal therapy. Future case-control studies are necessary to confirm these results

Bullying victimization: Associated contextual factors in a Greek sample of children and adolescents

School bullying is increasingly recognized as an important factor affecting both individual's wellbeing and social functioning. Several studies provide evidence for the potential role of contextual factors that relate to bullying victimization such as the socioeconomic status of the parents/ family, the quality of family and home environment, the school climate, structure and ethos, and also various community characteristics. The objectives of this school-based, cross-sectional study were to report the prevalence of the perception of being bullied in a sample of Greek children and adolescents from 6 to 17 years of age and to investigate the relations among the subjective impression of bullying victimization and several sociodemographic and socioeconomic factors. We hypothesized that influences external to individual children and adolescents play a decisive role to their perception of being victimized. Bullying victimization was measured through a simple "yes/no" question, which confirmed or rejected respectively the fact that the child or adolescent has been at some time victimized in the school environment. Also, demographic and socioeconomic data about the families of children and adolescents were collected. A total of 1,588 children (51.8% females, mean age ± SD: 12.9±2.8 years) were assessed. The overall prevalence of victimization was 10.4%. Multiple logistic regression analysis on the probability of being victimized identified that living at a main urban center (Odds Ratio[OR]: 2.63, CI: 1.78-3.87, p<0.001), presence of a person with a chronic illness at home (OR: 1.90, CI: 1.12-3.20, p=0.016), poor family economic status (OR: 1.83, CI: 1.05-3.20, p=0.032),and increased number of adults at home (OR: 2.00, CI: 1.00-3.77, p=0,041) had a positive correlation with the prevalence of reported bullying victimization. Moreover, higher parental educational level related to lower probability of victimization (OR: 0.88, CI: 0.78-0.99, p=0.05). These findings demonstrate that several demographic and socioeconomic factors play a potential role in bullying victimization among schoolchildren. Our results also highlight the need to consider the influence of contextual factors in the design of targeting efforts countering and/or preventing bullying victimization

Dietary habits and abdominal pain-related functional gastrointestinal disorders: A school-based, cross-sectional analysis in Greek children and adolescents

Background/Aims: The abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) affect a significant proportion of the pediatric population and consist 1 of the most frequent causes for seeking medical advice. In this study, we aimed to assess the relation of dietary habits with the likelihood of AP-FGIDs. Methods: This was a school-based, cross-sectional study approved by the Greek Government authorities, after obtaining informed consent by the legal representatives of the children. Diagnoses of AP-FGIDs were based on the Greek official translation of the Rome III questionnaire. Demographic, socioeconomic and dietary data were collected through self-reporting or parent-reporting questionnaires. Associations between the probability of AP-FGIDs and dietary practices were assessed after adjusting for known confounders through a multiple logistic regression analysis. Results: A total of 1365 children (147 AP-FGIDs and 1218 controls, 52.4% females, mean age: 12.8 ± 2.8 years) were included. Multiple regression analysis identified the following statistically significant confounders: victimization, the presence of a person with a severe health problem at home, female sex, engaging in limited physical exercise, and living in a single adult family. Subsequently, logistic regression, adjusted for the abovementioned confounders, showed that reduced fish and increased junk food consumption were related to a higher likelihood of AP-FGIDs. Conclusions: Children with AP-FGIDs report excessive junk-food and reduced fish intake compared to controls. Further studies are needed in order to clarify the nature of this observation. © 2019 The Korean Society of Neurogastroenterology and Motilit

Dietary habits in Greek children with functional constipation based on Rome III criteria: A school-based, cross-sectional multivariate analysis

Background Functional constipation (FC) is the most common gastrointestinal disorder of childhood and has a multifactorial etiology. We aimed to assess dietary habits in Greek children with FC compared to the general population (control group, CG). Methods This was a subgroup analysis of a school-based, cross-sectional study carried out in children 6-18 years of age, between January and June 2014, using the Rome III criteria for the diagnosis of FC. Dietary parameters, as well as socioeconomic and demographic data and their association with the likelihood of FC, were analyzed through multivariate logistic regression analysis and expressed as odds ratios (OR). Results A total of 1439 children (1218 CG, 221 FC) were included in the analysis. The final model showed that consumption of was the only dietary parameter significantly related to FC; higher frequency of consumption was inversely related to the likelihood of FC (OR: 0.98, 95% CI: 0.96, 0.99, P=0.048). Significant socioeconomic confounders with a positive association with FC were: Parental educational level, victimization, physical activity and number of adults at home. Conclusions Increased frequency of fiber consumption is significantly associated with higher odds of FC irrespective of socioeconomic background and lifestyle parameters. Interventional studies are required to validate these cross-sectional observations. © 2021 Hellenic Society of Gastroenterology