Climate Change Dependence in Ex Situ Conservation of Wild Medicinal Plants in Crete, Greece

Over 80% of the global population addresses their primary healthcare needs using traditional medicine based on medicinal plants. Consequently, there’s a rising demand for these plants for both household and industrial use at local, regional, national, and international levels. However, wild harvesting has negatively impacted natural ecosystems. Cultivating medicinal species has been proposed as a conservation strategy to alleviate this pressure. Yet, in this age of global climate change concerns, smallholder farmers’ views on the benefits of such cultivation clash with the uncertainties of climate change impacts, amplifying their anxieties. In this context, the climate change dependence of ex situ cultivation of ten wild medicinal taxa with significant ethnopharmacological interest in Crete, Greece, were studied, projecting their potential habitat suitability under various future climate scenarios. The results demonstrated species-specific effects. Based on the potential cultivation area gains and losses, these effects can be categorized into three groups. We also outlined the spatial patterns of these gains and losses, offering valuable insights for regional management strategies benefiting individual practitioners

The termination of the franchise agreement

WITH THIS DISSERTATION THE WRITER ,THROUGH A COMPARATIVE LEGEAL SEARCH IN VARIOUS JURISDICTIONS , IN ADDITION TO GREEK LAW AND GREEK JURISPRUDENCE ,CRITICALLY ANALYZED NA DISCUSSED THE REASONS FOR THE TERMINATION OF THE FRANCHISE AGREEMENT AS WELL AS THE CONSEQUENCES FROM SUCH TERMINATION , ESTABLISING , INTER ALIA, THE RIGHT OF THE FRANCHISEE FOR RECEIVING CLIENT'S COMPENSATIONΑΝΑΛΥΕΤΑΙ Η ΕΝΝΟΙΑ ΤΗΣ ΔΙΚΑΙΟΧΡΗΣΗΣ , ΠΑΡΑΘΕΤΟΝΤΑΣ ΝΟΜΙΚΟΥΣ ΚΑΙ ΟΙΚΟΝΟΜΙΚΟΥΣ ΟΡΙΣΜΟΥΣ ΑΠΟ ΤΟ ΕΛΛΗΝΙΚΟ ΚΑΙ ΑΛΛΟΔΑΠΟ ΔΙΚΑΙΟ ΜΕ ΠΑΡΑΠΟΜΠΕΣ ΣΕ ΕΛΛΗΝΙΚΗ ΚΑΙ ΔΙΕΘΝΗ ΝΟΜΟΛΟΓΙΑ . ΑΝΑΛΥΟΝΤΑΙ ΟΙ ΔΙΑΚΡΙΣΕΙΣ ΤΗΣ ΣΥΜΒΑΣΗΣ ΔΙΚΑΙΟΧΡΗΣΗΣ ΚΑΙ Η ΣΥΓΚΡΙΣΗ ΤΗΣ ΣΥΜΒΑΣΗΣ ΔΙΚΑΙΟΧΡΗΣΗΣ ΜΕ ΠΑΡΕΜΦΕΡΕΙΣ ΔΙΑΡΚΕΙΣ ΣΥΜΒΑΣΕΙΣ . ΑΝΑΛΥΟΝΤΑΙ ΟΙ ΛΟΓΟΙ ΛΥΣΕΩΣ ΤΗΣ ΣΥΜΒΑΣΕΩΣ ΔΙΚΑΙΟΧΡΗΣΗΣ ΚΑΙ ΟΙ ΣΥΝΕΠΕΙΕΣ ΑΠΟ ΤΗΝ ΕΝ ΛΟΓΩ ΛΥΣΗ ΜΕ ΕΙΔΙΚΗ ΑΝΑΦΟΡΑ ΣΤΗΝ ΑΠΟΖΗΜΙΩΣΗ ΠΕΛΑΤΕΙΑΣ ΚΑΙ ΣΤΙΣ ΑΝΑΠΟΣΒΕΣΤΕΣ ΕΠΕΝΔΥΣΕΙΣ ΠΟΥ ΔΙΚΑΙΟΥΤΑΙ Ο ΔΙΚΑΙΟΔΟΧΟΣ ΚΑΤΑ ΤΗΝ ΛΥΣΗ ΤΗΣ ΣΥΜΒΑΣΗΣ ΔΙΚΑΙΟΧΡΗΣΗΣ

Ενδαγγειακή αντιμετώπιση στένωσης υπονεφρικού τμήματος αορτής. Συστηματική ανασκόπηση

Σκοπός: Η είσοδος της ενδαγγειακής χειρουργικής και η συνεχής βελτίωση τόσο των υλικών αλλά και των τεχνικών έδωσε τη δυνατότητα της αντιμετώπισης της αορτικής αποφρακτικής νόσου ακόμη μάλιστα και σύνθετων βλαβών. Συστηματικές ανασκοπήσεις της αορτικής αγγειοπλαστικής λείπουν από τη βιβλιογραφία Η εργασία αυτή στόχο της έχει μετά από ενδελεχή ανασκόπηση της σχετικής βιβλιογραφίας να αναδείξει την εφαρμοσιμότητα, ασφάλεια και αποτελεσματικότητα της μεθόδου ώστε να είναι δυνατή η εξαγωγή χρήσιμων συμπερασμάτων για την καταλληλότερη διαχείριση αυτών των ασθενών. Υλικό – Μέθοδος: Μελετήθηκαν 20 εργασίες που αφορούν την ενδαγγειακή αντιμετώπιση της υπονεφρικής αθηρωματικής νόσου την τελευταία 15ετία με αριθμό ασθενών >10. Ο συνολικός αριθμός των ασθενών που αντιμετωπίσθηκαν ήταν 643. Σε 15 μελέτες διευκρινίζεται το είδος των ενδοναρθήκων της αγγειοπλαστικής και σε αυτές διαπιστώνεται ότι υπερέχουν αριθμητικά τα balloon mounted stents έναντι των self expandable stents (262/142). Αποτελέσματα: Καταγράφηκαν 35 επιπλοκές με κατανομή σε 20 μείζονες και 15 ελάσσονες, δηλ ποσοστό 5,7%. Επίσης μετεπεμβατικά αντιμετωπίσθηκαν 29 νέες βλάβες εντός των stents από τις οποίες οι 23 αντιμετωπίσθηκαν με νέα αγγειοπλαστική. Το ποσσοτό τεχνικής επιτυχίας της αγγειοπλαστικής ήταν 94 % Ενώ το ποσοστό της πρωτογενούς βατότητας στην τριετία ήταν 85,5% κατά μέσον όρο. Συμπεράσματα: Η αγγειοπλαστική της αποφρακτικής νόσου της υπονεφρικής αορτής αποτελεί μία τεχνική που με την εξέλιξη των τεχνικών και υλικών μπορεί να αντιμετωπίσει ακόμη και σύνθετες βλάβες του αορτολαγόνιου άξονα. Η νοσηρότητα είναι χαμηλή ενή η πρωτογενής βατότητα είναι υψηλή. Τυχαιοποιημένες μελέτες θα βοηθήσουν στην εξαγωγή ασφαλέστερων συμπερασμάτων.Objectives: Utilization of endovascular techniques broaden the available therapies for severe aortic stenosis. In the literature there is no systematic review available regarding transluminal aortic angioplasty. Aim of this study is to perform a systematic review and summarize data about outcomes of this technique (feasibility, safety, patency). Material and methods: A systematic literature review was conducted to identify eligible studies published between January 2005 and December 2019. The following databases were used as seach engines: PubMed and Scopus. Eligible studies included two major criteria: (i) patients with aortic occlusive disease (ii) studies including at least 10 patients. Results: Overall, a total of 643 patients were included in 20 studies. In most cases, balloon expandable stents were preferred over self-expandable stents (262 vs 142). Regarding complications, there were 30 complications reported (20 major and 15 minor) which represent an incidence of 5.7%. Also, there were 29 in-stent restenosis noted, 23 of which were treated with a repeated angioplasty. Technical success was estimated to be 94% and three-year primary patency was 85.5%. Conclusion: Transluminal angioplasty of aorta is a feasible procedure even for complex aortoiliac lesions. Low morbidity and high short and mid-term primary patency represent the major advantages of this method. Further studies and randomized controlled trials are essential to prove this suggestio

Asymptomatic pulmonary embolism in patients with symptomatic deep vein thrombosis of the extremities: Three year results of a prospective study

Objective: Symptomatic pulmonary embolism (PE) has been associated with high morbidity and mortality. However, data on the clinical impact of AsPE on patients with known deep vein thrombosis (DVT) are limited in literature. Methods: Patients treated in our institution for symptomatic DVT without any symptoms or signs of PE were prospectively included in this study. The diagnosis of DVT was verified using colored Duplex ultrasonography based on international guidelines. All patients underwent a thorax-computed angiography in order to detect cases with AsPE. Basic characteris- tics of all patients and major outcomes were compared between patients with DVT and no PE and patients with DVT plus AsPE. Mean follow-up was 3 +/- 0.32 years. Results: AsPE was detected overall in 39 patients (32%). The majority (37%) of patients reported long-lasting bed rest/im- mobility, 15% had a neoplasia, although 32% of patients did not have any typical DVT risk factor. There was no difference regarding age, gender, location of thrombosis or typical risk factors. Basic serum parameters did not differ between the two groups, either. However, more patients with PE showed d-dimer values of <5mg/l compared to patients with DVT only (p=0.017). Deaths from all causes and total days of initial hospitalization did not differ between the two groups. However, AsPE was found to be a risk factor both for new symptomatic PE (RR = 5.675, CI 95% [1.592 and ndash; 20.233], p = 0.0074) as well as readmission to hospital (RR = 2.736, CI 95% [1.523 and ndash; 4.915], p = 0.0008). Conclusions: AsPE occurs frequently in patients with symptomatic DVT, although neither typical risk factors nor the lo- cation of DVT seem to be associated with its presence. Therefore, early recognition of AsPE as well as close long-term monitoring is necessary to reduce possible recurrence and readmission. [Arch Clin Exp Surg 2016; 5(3.000): 138-143

Research progress in the application of inferior vena cava filter on acute venous thrombosis

Anticoagulant therapy using heparins or per os vitamin K antagonists has been the treatment of choice in patients with venous thromboembolic disease for decades. However, the introduction of inferior vena cava (IVC) filters recently has provided new therapeutic choices appropriate for specific groups of patients with venous thromboembolic disease. This review aims to present all current evidence on the indications and precautions for the proper IVC filters utilization. There is still a great challenge in identifying the proper populations that would benefit from an IVC filter implantation or extraction. New randomized trials are needed to produce safe and clear guidelines of proper use

Effects of acute and chronic cadmium administration on the vascular reactivity of rat aorta

The effect of acute and chronic cadmium (Cd) administration on the vascular function of the rat aorta was studied. The rats were randomly divided into four main groups (A: saline controls under chronic administration, B: Cd-treated rats under chronic administration, C: saline controls under acute administration, D: Cd-treated rats under acute administration). After their sacrifice, the aortic rings were divided into rings with endothelium (E+) and without (E-), and suspended in an isolated organ bath with Krebs - Henseleit buffer. Maximal tension (T max, in g) was measured in response to potassium chloride (KCl) and phenylephrine (PE) in all aortic rings. Relaxation response to acetylcholine (ACh) administration was expressed as percent of maximal tension induced by PE. Chronic administration: A statistically significant increase of the contraction was observed between groups B (i.m. Cd 0.5 mg/kg for 120 days) and A (i.m. 0.9% NaCl for 120 days) in response to KCl (20-60 mM) and the T max as well (in both the E+ and the E- subgroups). No statistically significant difference was observed in response to PE and ACh exposure. Acute administration: A statistically significant increase was observed between group D(E+) (i.m. Cd 2 mg/kg, 8 h before sacrifice) and group C(E+) (i.m. 0.9% NaCl, 8 h before sacrifice) in response to 10-30 mM of KCl, and a significant decrease between D(E-) and C(E-) in response to 10(-7)-10(-6) M of PE, though T (max) was increased between D(E-) and C(E-) with PE exposure. The contractile response levels of the E+ aortic rings to PE and ACh showed no statistically significant difference

Fenestrated Endovascular Repair for Pararenal or Juxtarenal Abdominal Aortic Aneurysms: a Systematic Review

Background: This review aims to collect all available data on early and late outcomes in patients undergoing fenestrated endovascular aortic aneurysm repair (F-EVAR) for pararenal or juxtarenal abdominal aortic aneurysms (AAAs). Methods: The Pubmed, Embase, Scopus and Cochrane Library databases were systematically searched to identify eligible studies. Studies reporting at least early mortality after F-EVAR in patients with pararenal or juxtarenal AAA were included. Thirty-day outcomes were defined as early, and outcomes reported after 30 days postoperatively were defined as late. Basic characteristics of all studies and demographics of patients were reported. Results: Overall, 30 studies (17 retrospective and 13 prospective) including 23,385 patients in total were included. Out of 23,385 patients, a total of 2,271 patients were treated with F-EVAR for pararenal/juxtarenal AAA. Overall, 4,216 target vessels were to be treated (data from 24 studies). Pooled early mortality reached 2.55% (ranging from 0% to 6.74%), with a pooled technical success of 96.8% (ranging from 82.8% to 100%). Regarding late outcomes, pooled allcause mortality reached 17% (ranging from 0% to 50%), 1-year primary patency was 94.6% (ranging from 91.8% to 97.1%) and reintervention rate was 10.4% (ranging from 0% to 57.4%). Mean/median follow-up ranged from 3 to 60 months. Conclusions: Early outcomes indicate that F-EVAR is a safe and efficient treatment for patients with pararenal/juxtarenal AAAs. Although long-term outcomes are acceptable, late-intervention rate remains high

The value of chemoprophylaxis against Enterococcus species in elective cholecystectomy - A randomized study of cefuroxime vs ampicillin-sulbactam

Hypothesis: Cephalosporins are widely used and considered to be effective as prophylaxis in biliary surgery. Nevertheless, they lack activity against enterococci. We conducted a study to compare the efficacy of ampicillin-sulbactam vs cefuroxime in preventing surgical site infections following elective cholecystectomy. Design: A prospective randomized controlled trial Setting: A major tertiary care hospital. Patients: Four hundred eighteen randomized patients (of 549 total), who from July 2002 to August 2004 underwent elective open or laparoscopic cholecystectomy with prospective assessment for development of surgical site infections for 1 month postoperatively. Intervention: A single intravenous dose of 1.5 g of cefuroxime (group A, n=207) or 3 g of ampicillin-sulbactam (group B, n=211) was administered during induction of anesthesia. Bile and gallbladder mucosal cultures were taken intraoperatively from all patients. Main Outcome Measure: Number of postoperative surgical site infections. Results: A postoperative surgical site infection was noted in 19 (4.5%) of 418 patients, 18 from group A and 1 from group B (P&lt;.001). In the group that received cefuroxime, 15 (83.3%) of 18 surgical site infections were due to Enterococcus species. Intraoperative bactibilia as well as intraoperative gallbladder rupture were associated with surgical site infections (P&lt;.001). Conclusions: A single dose of ampicillin-sulbactam favored better compared with cefuroxime for prevention of postoperative surgical site infections due to Enterococcus species after elective cholecystectomy. Ampicillin-sulbactam may be a better agent for antimicrobial prophylaxis in high-risk patients undergoing elective cholecystectomy, especially in a setting where the incidence of enterococcal infections is higher