RESUMEN

PURPOSE: The aim of our study was to evaluate, under real-life conditions, survival of patients with advanced HCC (BCLC-C), either initially presenting in that stage or migrating from BCLC-A to BCLC-C within 2 years after curative LR/RFA, treated either with Atezolizumab-Bevacizumab or TKIs. METHODS: Sixty-four cirrhotic patients with advanced HCC, who either initially presented as BCLC-C and were treated with Atezo-Bev (group A, N = 23) or TKIs (group B, N = 15) or who migrated from BCLC-A to BCLC-C stage within 2 years after LR/RFA and were either treated with Atezo-Bev (group C, N = 12) or TKIs (group D, N = 14), were retrospectively evaluated. RESULTS: The four groups were comparable for all baseline parameters (demographics/platelets/liver disease etiology/diabetes/varices/Child-Pugh stage/ALBI grade) except for CPT score and MELD-Na. Using Cox-regression analysis, we observed that survival of group C after systemic treatment onset was significantly higher compared to group A (HR 3.71, 1.20-11.46, p = 0.02) and presented a trend to statistical significance when compared to group D (HR 3.14, 0.95-10.35, p = 0.06), adjusted for liver disease severity scores. When all BCLC-C patients classified as such due to PS only were excluded from the study, a trend for the same survival benefit in group C was shown, even in the most difficult-to-treat population with extrahepatic disease or macrovascular invasion. CONCLUSION: Cirrhotic patients with advanced HCC initially diagnosed in BCLC-C, exhibit the worst survival irrespective of treatment schedule, whereas patients progressing to BCLC-C following disease recurrence after LR/RFA, seem to mostly benefit from Atezo-Bev, even patients with extrahepatic disease and/or macrovascular invasion. Liver disease severity seems to drive survival of these patients.

Asunto(s)

RESUMEN

ObjectiveTo investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017-2019). Data sourcesSecondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. Study DesignThis is a retrospective study. We used the hard copy of the patients health register records. Extraction methodsThe data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the Emergency department. The causes of admission were categorized in 14 different disease categories. All registered patient admitted to the Vlora regional hospital were included in the study. Patients that all data were not recorded and patients that data were not possible to be read were excluded. Principal FindingsStudy population included 44.917 patients during 2017-2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12.407) and the lowest in 2020 (n=9.266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract were observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of -7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval= -42.7% to 214.8%, p-value=0.27). ConclusionsDuring the study years the number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel. A specific focus should be put on the more vulnerable (elderly and unemployed) as their health status is in higher risk.

RESUMEN

BackgroundCoronavirus disease 2019 (COVID-19) vaccine uptake among children will be critical in limiting the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease. Parents are key decision-makers for whether their children will receive a COVID-19 vaccine. ObjectiveTo estimate parents willingness to vaccinate their children against the COVID-19, and to investigate the predictors for their decision. MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, and CINAHL from inception to August 11, 2021. The review protocol was registered with PROSPERO (CRD42021273125). We applied a random effect model to estimate pooled effects since the heterogeneity was very high. We used subgroup analysis and meta-regression analysis to explore sources of heterogeneity. ResultsWe found 17 studies including 45,783 parents. The overall proportion of parents that intend to vaccinate their children against the COVID-19 was 56.8% (95% confidence interval: 51.8-61.8%). Parents willingness ranged from 29% to 72.7%. Studies quality, sample size, data collection time, and the continent that studies were conducted did not affect the results. The main predictors of parents intention to vaccinate their children against COVID-19 were male gender, older age of parents and children, higher socio-economic status, white race, positive attitudes toward vaccination, higher levels of knowledge, and higher levels of perceived threat from the COVID-19, worry, fear, and anxiety. ConclusionsParents willingness to vaccinate their children against the COVID-19 is moderate and several factors affect this decision. Understanding parental COVID-19 vaccine hesitancy does help policy makers to change the stereotypes and establish broad community COVID-19 vaccination. Identification of the factors that affect parents willingness to vaccinate their children against COVID-19 will provide opportunities to enhance parents trust in the COVID-19 vaccines and optimize childrens uptake of a COVID-19 vaccine.

RESUMEN

Experiencing the second wave of COVID-19 pandemic, high vaccination coverage by a safe and effective vaccine globally would be a great achievement. Acceptance of vaccination by healthcare students is an important issue as they have a key role as future professionals in educating patients, informing and guiding them to the right clinical decision. The aim of this study was to explore the intention of nursing students to get vaccinated for SARS-CoV-2 infection and the factors acting either as motivators or barriers towards vaccination. A multicenter cross-sectional study was conducted in 7 countries (Greece, Albania, Cyprus, Spain, Italy, Czech Republic and Kosovo) through a web survey. In total 2249 undergraduate nursing students participated. Forty three point eight percent of students agreed to accept a safe and effective COVID-19 vaccine, while the acceptance was higher among Italian students. The factors for intention to get vaccinated were male gender (p=0.008), no working experience in healthcare facilities during the pandemic (p=0.001), vaccination for influenza in 2019 and 2020 (p<0.001), trust in doctors (p<0.001), governments and experts (p=0.012), high level of knowledge (p<0.001) and fear of COVID-19 (p<0.001). Understanding of factors that influence students decision to accept COVID-19 vaccination could increase the acceptance rate contributing to a management of the pandemic. HighlightsO_LILess than half of the sample intended to accept COVID-19 vaccination C_LIO_LIFactors that influenced nursing students to get vaccinated against COVID-19 were male gender, no working experience in healthcare facilities during the pandemic, vaccination for influenza in 2019 and 2020, trust in doctors, governments and experts, high level of knowledge and fear of COVID-19. C_LI

RESUMEN

Considering medical and economic burden of coronavirus disease 2019 (COVID-19), a high COVID-19 vaccination coverage among healthcare workers (HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched PubMed, MEDLINE, Scopus, Web of Science, ProQuest, CINAHL and medRxiv until July 14, 2021. The heterogeneity between results was very high; thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5% (95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs' willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.

RESUMEN

Considering medical and economic burden of coronavirus disease 2019 (COVID-19), a high COVID-19 vaccination coverage among healthcare workers (HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched PubMed, MEDLINE, Scopus, Web of Science, ProQuest, CINAHL and medRxiv until July 14, 2021. The heterogeneity between results was very high; thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5% (95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs' willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.

RESUMEN

BackgroundThe epidemic of COVID-19 has rapidly spread worldwide, with millions of confirmed cases and related deaths. Numerous efforts are being made to clarify how the infection progresses and potential factors associated with disease severity and mortality. We investigated the mortality in Greek hospitalized COVID-19 patients and also the predictors of this mortality. MethodsStudy population included 512 COVID-19 patients admitted to the hospitals of the Attica region of Greece. Patients demographic characteristics, comorbidities, allergies, previous vaccination for seasonal influenza virus, admission to ICU, intubation, and death were recorded. Potential predictors of in-hospital mortality were identified by regression analysis. ResultsThe mean age of hospitalized patients was 60.4 years, and was higher in patients who deceased. The most common comorbidities were respiratory diseases, hypertension, gastrointestinal disorders, dyslipidemia, mental health diseases, asthma, diabetes mellitus and cardiovascular diseases. The need for ICU care and intubation was significantly higher among patients who died. The mortality rate was 15.8% (81 out of 512). Age [≥]65 years, cancer, chronic kidney disease, endocrine diseases, central nervous system disorders, anemia, and intubation were independently associated with increased in-hospital mortality, while allergies and previous influenza vaccination were associated with decreased in-hospital mortality. ConclusionOur finding of a beneficial effect of allergies and influenza vaccination against COVID-19 infection merits further investigation, as it may shed light in the mechanisms underlying disease progression and severity. Most importantly, it may assist in the implementation of efficient protective measures and public healthcare policies.

RESUMEN

AIM: To examine the health status of immigrants living in Greece and investigate the factors that influence it. METHODOLOGY: A cross-sectional study with 1152 immigrants (response rate = 60%) was conducted during April 2013 to March 2014. Regarding the sampling method, as there is no accurate census of immigrants in Greece the snowball sampling was used. Data collection included demographic characteristics, health status, medication and self-reported preventive health examinations of immigrants (blood count, blood pressure, cholesterol, and blood sugar measurement). RESULTS: The majority of immigrants originated from Albania (51.4%), while 52.6% were males with mean age 37.6 years. Of those 63.5% were working, 80.9% had legal documents for living and working in Greece and 58.2% had valid health and social security. Most of the immigrants (66.6%) considered their health as good/very good. Immigrants without health insurance, lower monthly family income and worst self-reported health did not adhere with their medication treatment due to cost. Immigrants with legal documents and health insurance performed more often blood count measurement, blood pressure measurement, cholesterol measurement and blood sugar measurement. Increased monthly family income was also associated with higher probability of blood count measurement. Very poor/poor/average self-reported health and increased age were associated with higher probability of taking medicines for chronic diseases. CONCLUSIONS: Self-reported health of immigrants in Greece is good/very good while absence of health insurance and legal documents, lower income and worst self-reported health are associated with worst health outcomes.

RESUMEN

BACKGROUND: Employee job satisfaction and its relationship with health and quality of life has been an issue of major concern over the past decades. Nurses experience difficult working conditions that affect their job satisfaction, health, and quality of life. METHODS: A cross-sectional study was undertaken in three general hospitals and their respective health centers. Stratified random sampling by level of education was used, and 508 nurses and nursing assistants were included. A self-administered anonymous questionnaire, which included the Measure of Job Satisfaction, the 36-item Short Form Health Survey, as well as demographic details, education, and work conditions data, was used. RESULTS: Greek nurses were found to be dissatisfied with their job according to the total score of the job satisfaction scale, although personal satisfaction and satisfaction with support had had higher scores. Their general health was reported as average, because of physical and mental health problems, low vitality, low energy, and increased physical pain. Multivariate linear regression analysis revealed that males and those wishing to stay in the job had higher physical and mental health. Increased job satisfaction was related to increased physical and mental health. CONCLUSION: Although Greek nurses are not satisfied with their work, those with high levels of job satisfaction had better health-related quality of life. The findings suggest that improvement of the work environment would contribute to a healthier and more satisfied nursing workforce.

Asunto(s)