The implementation of the „Hotspot Approach“ and the EU-Turkey Statement in Greece: A crisis contained, but not over: Schwerpunktwoche Herbsttagung Netzwerk Migrationsrecht 2017

In 2015, Greece found itself in the middle of the big corridor of escape created by displaced people who tried to reach Northern Europe. The “hotspot approach” was one of the measures introduced by the European Commission as a model of operational support by the EU agencies to Member States facing disproportionate migratory pressure, with the aim to help them to swiftly identify, register and fingerprint migrants, and support the implementation of relocation and returns, in the context of what was called the “refugee crisis”

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Προδιαθεσικοί Παράγοντες Βαλβιδοπαθειών

Εισαγωγή: Ο επιπολασμός της βαλβιδικής νόσου στις Η.Π.Α. είναι περίπου στο 2,5% του γενικού πληθυσμού. Για την εμφάνιση των βαλβιδοπαθειών, έχουν ενοχοποιηθεί διάφοροι παράγοντες κινδύνου ή προδιαθεσικοί παράγοντες. Σκοπός: Η εκτίμηση της συχνότητας των βαλβιδοπαθειών στον ελληνικό πληθυσμό, καθώς και των προδιαθεσικών παραγόντων που τις προκαλούν. Υλικό – Μέθοδος: Πραγματοποιήθηκε περιγραφική μελέτη συσχετίσεων με τη μέθοδο ερωτηματολογίου, όπου διεξήχθη τον Φεβρουάριος – Οκτώβριος 2018 σε δύο νοσοκομεία της Αττικής. Το δείγμα της μελέτης αποτέλεσαν 83 ενήλικες ασθενείς με διαγνωσμένη βαλβιδοπάθεια που νοσηλεύτηκαν στα υπό μελέτη νοσοκομεία, προκείμενου να υποβληθούν σε καρδιοχειρουργική επέμβαση. Για τη συλλογή των δεδομένων κατασκευάστηκε ερωτηματολόγιο, όπου στο πρώτο μέρος καταγράφονταν δημογραφικά δεδομένα των ασθενών και στο δεύτερο μέρος κλινικά δεδομένα. Τα στοιχεία αναλύθηκαν με το στατιστικό πρόγραμμα SPSS 24.0 και στατιστική σημαντικότητα p-value≤0,05. Αποτελέσματα: Το 14.5% ασθενών έπασχαν από ανεπάρκεια αορτικής βαλβίδας, το 27.7% από ανεπάρκεια μιτροειδούς, το 1.2% από ανεπάρκεια της τριγλώχινας, το 2.4% από ανεπάρκεια της πνευμονικής, το 43.3% από στένωση της αορτικής βαλβίδας, το 3.6% από στένωση της μιτροειδούς και το 7.2% από μικτή βαλβιδική νόσο. Το φύλο (p=0.044), η ηλικία (p≤0.001), η αρτηριακή υπέρταση (p=0.03), η υπερχοληστερολαιμία (p≤0.001), η στεφανιαία νόσος (p≤0.001) και η ύπαρξη συγγενούς καρδιοπάθειας (p≤0.001), διέφεραν στατιστικά σημαντικά μεταξύ των ασθενών με διαφορετική βαλβιδοπάθεια Συμπεράσματα: Η συχνότερη βαλβιδοπάθεια στην Ελλάδα είναι η στένωση της αορτικής βαλβίδας. Οι προδιαθεσικοί παράγοντες που διαφέρουν μεταξύ των ατόμων με διαφορετική βαλβιδοπάθεια είναι το φύλο, η ηλικία, η αρτηριακή υπέρταση, η υπερχοληστερολαιμία, η στεφανιαία νόσος και η ύπαρξη συγγενούς καρδιοπάθειας.Introduction: The prevalence of valvular heart disease in the USA is 2.5% of the general population. The incidence of valvular heart disease has been correlated with various risk factors or predisposing factors. Aim: The estimation of the frequency of the valvular heart disease in the Greek population, as well as the frequency of predisposing factors that causes them. Material - Method: This is a descriptive and correlational study, which conducted in February - October 2018 in two hospitals in Athens. The sample of the study consisted of 83 adult patients, who have diagnosed with valvular disease and hospitalized in the hospitals to undergo cardiac surgery. For data collection was constructed a questionnaire. In the first part of questionnaire, we recorded demographic data of patients and in the second part the clinical data. Data were analyzed with the statistical program SPSS 24.0 and the statistical significance was ≤0.05. Results: 14.5% of patients had aortic valve regurgitation, 27.7% mitral regurgitation, 1.2% tricuspid regurgitation, 2.4% pulmonary regurgitation, 43.3% aortic valve stenosis, 3.6% stenosis mitral valve and 7.2% of mixed valve disease. The gender (p=0.044), age (p≤0.001), hypertension (p = 0.03), hypercholesterolemia (p≤0.001), coronary heart disease (p≤0.001), and congenital heart disease (p≤0.001) were differed statistically between the patients with different valvular heart disease. Conclusions: The most common valvular disease in Greece is aortic valve stenosis. The predisposing factors, which differ among individuals with valve disease, were gender, age, arterial hypertension, hypercholesterolemia, coronary heart disease and congenital heart disease