Globalny kryzys finansowy, konsekwencje zdrowotne i wskazania dla pracowników ochrony zdrowia: przegląd literatury

Aim. Identifying the effects of the global financial crisis on health, public health system(s) and healthcare workers is the main purpose of this paper.Material and methods. A review of the literature was undertaken. The following keywords were adopted: economic crisis, financial crisis, health implications, public health, unemployment, labour substitution, mental health, healthcare (nursing), and education as a Mesh word or text words in the title and in the abstract, via MedLine/ Cinahl and Scopus database. A ten-year timeframe (2001-2011) was set in order to include the most recent studies. Articles reporting the relationship between financial crisis, health problems, mortality, use of public health care service(s), and implications on healthcare workers roles were included and analysed. A content analysis methodology of the articles retrieved was then performed.Results. The economic downturn that has unfolded in recent years is expected to produce adverse social and health effects. Extended research data reveal that people’s health status is definitely affected by the economic crisis and consequently the healthcare sector will have to be reformed to meet the new challenges more efficiently. Economics depressions have a direct impact on overall health, on public spending directed to the healthcare system, on the quality of the services provided and on restructuring of the roles and functions of healthcare personnel.Conclusions. Preliminary lessons learnt from the current global financial crisis suggest undertaking several strategies at the: a) social and public health level, b) healthcare system level; c) healthcare workers education level and, d) at the nursing professional level. (PNN 2012;1(4):164–169)Cel. Ukazanie wpływu światowego kryzysu finansowego na zdrowie, systemy zdrowotne oraz pracowników ochrony zdrowia.Materiał i metody. Dokonano przeglądu literatury w bazach MedLine/Cinahl i Scopus, na podstawie następujących słów kluczowych i terminów Me SH pojawiających się w tytule lub streszczeniu: kryzys ekonomiczny, kryzys finansowy, konsekwencje zdrowotne, zdrowie publiczne, bezrobocie, zdrowie psychiczne, pielęgniarstwo, ochrona zdrowia i wykształcenie. W celu uzyskania najbardziej aktualnych informacji zawężono okres, z którego pochodzi literatura, do 10 lat (2001–2011). Analizie poddano artykuły dotyczące związków między kryzysem finansowym a problemami zdrowotnymi, śmiertelnością, dostępem do usług medycznych i konsekwencjami dla ról pełnionych przez pracowników ochrony zdrowia.Wyniki. Bez wątpienia kryzys ekonomiczny, który pogłębia się od kilku lat, ma negatywny wpływ na zdrowie publiczne, co wynika z licznych badań. W konsekwencji, sektor zdrowia publicznego będzie wymagał reform, aby sprostać nowym wyzwaniom. Problemy ekonomiczne mają bezpośredni wpływ na ogólne zdrowie, na wydatki publiczne przeznaczone na ochronę zdrowia, na jakość opieki oraz na konieczność ponownego zdefiniowania ról pracowników ochrony zdrowia.Wnioski. Wczesne wnioski płynące z obserwacji wpływu kryzysu na zdrowie wskazują na konieczność zastosowania pewnych strategii na następujących poziomach: a) społecznym i zdrowia publicznego; b) systemu ochrony zdrowia; c) edukacji pracowników ochrony zdrowia oraz d) na poziomie pielęgniarstwa. (PNN 2012;1(4):164-169

Παλινδρόμηση, τεχνικές συρρίκνωσης και δέντρα στην ανάλυση επιβίωσης

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Μαθηματική Προτυποποίηση σε Σύγχρονες Τεχνολογίες και στα Χρηματοοικονομικά

A semifluorinated alkane (F4H5) as novel carrier for cyclosporine A: a promising therapeutic and prophylactic option for topical treatment of dry eye

Cyclosporine A (Cs) has been used as effective topical therapy for inflammatory dry eye disease since more than a decade. However, due to its lipophilic character, Cs is formulated as emulsions or oily solutions for topical application. This experimental study aimed to test if the use of semifluorinated alkanes (SFAs) as a preservative-free, well-tolerated non-stinging or burning vehicle maintains or even improves the benefits of Cs in the topical therapy of dry-eye disease. Desiccating stress was applied to C57BL/6 mice for 14 consecutive days to induce experimental dry-eye. Cs dissolved in SFA (perfluorobutylpentane = F4H5with 0.5% Ethanol), F4H5 with 0.5% ethanol only, 0.05% Cs (RestasisA (R)), and dexamethasone (MonodexA (R)) were applied three times daily beginning either at day 4 or day 11 of desiccating stress for up to 3 weeks after end of dry-eye induction. In comparison to other groups, Cs/F4H5 demonstrated high efficacy and earlier reduction of corneal staining. In this study, Cs/F4H5 had the ability to maintain conjunctival goblet cell density once applied on day 4. Flow cytometry analysis from cervical lymphnodes demonstrated a significantly lower CD4+ and CD8+ T-cells in the Cs/F4H5 group following 3 weeks of therapy than at baseline, but no difference in regulatory T cells from regional lymphnodes were seen. Overall, compared to a commercially available Cs formulation (RestasisA (R)) and dexamethasone, Cs/F4H5 was shown to be equally effective but with a significantly faster therapeutic response in reducing signs of dry-eye disease in an experimental mouse model

A sex-specific evaluation of predicted lean and fat mass composition and cardiovascular disease onset and progression: A combined analysis of the ATTICA and GREECS prospective epidemiological studies

Objectives: To evaluate the association of predicted lean and fat mass on 10-year first and recurrent CVD incidence separately for men and women. Methods: Two prospective studies, ATTICA (2002-2012, n = 3042 subjects free-of-CVD, n = 1514 men (46 ± 13 years) and n = 1528 women (45 ± 14 years)) and GREECS (2004-2014, n = 2172 subjects with acute coronary syndrome (ACS), n = 1649 men (65 ± 13 years) and n = 523 women (62 ± 11 years)) were used. Lean mass index (LMI) and fat mass index (FMI) were created through total body lean and fat mass (indirectly calculated through population formulas based on body weight, height and waist circumference) divided by height squared. Follow-up was performed in n = 2020 of ATTICA (n = 317 first CVD events) and in n = 2172 patients of GREECS (n = 811 recurrent CVD events). Results: In ATTICA study, CVD rate from 1st to 3rd FMI tertile was 9.4%, 16.1% and 19.9% while in GREECS 36.2%, 37.0%, 38.3%. The LMI-related rates were 17.1%, 15.0% and 11.9% vs. 38.8%, 35.8% and 36.7%. Multiadjusted analysis revealed U-shape trend between LMI and CVD recurrence with 2nd LMI tertile having the best prognosis; this observation was more evident in women. In apparently healthy subjects, LMI-cardioprotective association was revealed only in 3rd tertile (HR = 0.91 95%CI (0.74, 0.95)); this was more evident in men. The FMI aggravating association (3rd tertile) was retained significant only in healthy women and ACS men. Conclusion: This work expands previous findings regarding body composition and cardiac health, implying that the association of lean and fat mass on long-term CVD incidence varies according to sex and prevention stage

UV light-blocking contact lenses protect against short-term UVB-induced limbal stem cell niche damage and inflammation

UVB irradiation has been linked to pathogenesis of pterygium, a conjunctival tumor growing onto transparent cornea, the windscreen of the eye. Due to corneal anatomy, ambient UVB irradiation is amplified at the stem cell-containing nasal limbus. The aim of this study was to analyse the effect of a UV-blocking contact lens (UVBCL, senofilcon A, Class 1 UV blocker) on limbal epithelial cells and fibroblasts under UVB irradiation compared to a non-UVB-blocking contact lens. UVBCL prevented UVB-induced DNA damage (as assessed by cyclobutane pyrimidine dimer immunostaining) as well as a decrease in proliferation and scratch wound closure rate of both limbal epithelial and fibroblast cells. Similarly, UVBCL protected limbal epithelial cells from UVB-induced loss of their phenotype in terms of colony forming efficiency and stem cell marker expression (ABCB5, P63α, integrin β1) compared to controls. Moreover, with UVBCL pro-inflammatory cytokines such as TNFα and MCP1 remained unchanged. These data demonstrate the significance of UV-protection in preserving the limbal niche in response to at least short-term UVB. Our data support the use of UVBCL in protecting limbal niche cells, especially after limbal stem cell transplantation and in patients after pterygium surgery, to help prevent recurrences

UV light-blocking contact lenses protect against short-term UVB-induced limbal stem cell niche damage and inflammation

UVB irradiation has been linked to pathogenesis of pterygium, a conjunctival tumor growing onto transparent cornea, the windscreen of the eye. Due to corneal anatomy, ambient UVB irradiation is amplified at the stem cell-containing nasal limbus. The aim of this study was to analyse the effect of a UV-blocking contact lens (UVBCL, senofilcon A, Class 1 UV blocker) on limbal epithelial cells and fibroblasts under UVB irradiation compared to a non-UVB-blocking contact lens. UVBCL prevented UVB-induced DNA damage (as assessed by cyclobutane pyrimidine dimer immunostaining) as well as a decrease in proliferation and scratch wound closure rate of both limbal epithelial and fibroblast cells. Similarly, UVBCL protected limbal epithelial cells from UVB-induced loss of their phenotype in terms of colony forming efficiency and stem cell marker expression (ABCB5, P63α, integrin β1) compared to controls. Moreover, with UVBCL pro-inflammatory cytokines such as TNFα and MCP1 remained unchanged. These data demonstrate the significance of UV-protection in preserving the limbal niche in response to at least short-term UVB. Our data support the use of UVBCL in protecting limbal niche cells, especially after limbal stem cell transplantation and in patients after pterygium surgery, to help prevent recurrences

Increased Anti-Inflammatory Therapeutic Potential and Progenitor Marker Expression of Corneal Mesenchymal Stem Cells Cultured in an Optimized Propagation Medium

There is a huge unmet need for new treatment modalities for ocular surface inflammatory disorders (OSIDs) such as dry eye disease and meibomian gland dysfunction. Mesenchymal stem cell therapies may hold the answer due to their potent immunomodulatory properties, low immunogenicity, and ability to modulate both the innate and adaptive immune response. MSC-like cells that can be isolated from the corneal stroma (C-MSCs) offer a potential new treatment strategy; however, an optimized culture medium needs to be developed to produce the ideal phenotype for use in a cell therapy to treat OSIDs. The effects of in vitro expansion of human C-MSC in a medium of M199 containing fetal bovine serum (FBS) was compared to a stem cell medium (SCM) containing knockout serum replacement (KSR) with basic fibroblast growth factor (bFGF) and human leukemia inhibitory factor (LIF), investigating viability, protein, and gene expression. Isolating populations expressing CD34 or using siRNA knockdown of CD34 were investigated. Finally, the potential of C-MSC as a cell therapy was assessed using co-culture with an in vitro corneal epithelial cell injury model and the angiogenic effects of C-MSC conditioned medium were evaluated with blood and lymph endothelial cells. Both media supported proliferation of C-MSC, with SCM increasing expression of CD34, ABCG2, PAX6, NANOG, REX1, SOX2, and THY1, supported by increased associated protein expression. Isolating cell populations expressing CD34 protein made little difference to gene expression, however, knockdown of the CD34 gene led to decreased expression of progenitor genes. C-MSC increased viability of injured corneal epithelial cells whilst decreasing levels of cytotoxicity and interleukins-6 and -8. No pro-angiogenic effect of C-MSC was seen. Culture medium can significantly influence C-MSC phenotype and culture in SCM produced a cell phenotype more suitable for further consideration as an anti-inflammatory cell therapy. C-MSC show considerable potential for development as therapies for OSIDs, acting through anti-inflammatory action

Consecutive dosing of UVB irradiation induces loss of ABCB5 expression and activation of EMT and fibrosis proteins in limbal epithelial cells similar to pterygium epithelium

Pterygium pathogenesis is often attributed to a population of altered limbal stem cells, which initiate corneal invasion and drive the hyperproliferation and fibrosis associated with the disease. These cells are thought to undergo epithelial to mesenchymal transition (EMT) and to contribute to subepithelial stromal fibrosis. In this study, the presence of the novel limbal stem cell marker ABCB5 in clusters of basal epithelial pterygium cells co-expressing with P63α and P40 is reported. ABCB5-positive pterygium cells also express EMT-associated fibrosis markers including vimentin and α-SMA while their β-catenin expression is reduced. By using a novel in vitro model of two-dose UV-induced EMT activation on limbal epithelial cells, we could observe the dysregulation of EMT-related proteins including an increase of vimentin and α-SMA as well as downregulation of β-catenin in epithelial cells correlating to downregulation of ABCB5. The sequential irradiation of limbal fibroblasts also induced an increase in vimentin and α-SMA. Taken together, these data demonstrate for the first time the expression of ABCB5 in pterygium stem cell activity and EMT-related events while the involvement of limbal stem cells in pterygium pathogenesis is exhibited via sequential irradiation of limbal epithelial cells. The later in vitro approach can be used to further study the involvement of limbal epithelium UV-induced EMT in pterygium pathogenesis and help identify novel treatments against pterygium growth and recurrence

Dietary patterns, weight perception and obesity status, among 10–12-year-old children; an epidemiological study in Greece

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation