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Vallée A, Saridogan E, Petraglia F, Keckstein J, Polyzos N, Wyns C, Gianaroli L, Tarlatzis B, Ayoubi JM, Feki A. Horizons in Endometriosis: Proceedings of the Montreux Reproductive Summit, 14-15 July 2023. Facts Views Vis Obgyn 2024; 16:1-32. [PMID: 38603778 DOI: 10.52054/fvvo.16.s1.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Endometriosis is a complex and chronic gynaecological disorder that affects millions of women worldwide, leading to significant morbidity and impacting reproductive health. This condition affects up to 10% of women of reproductive age and is characterised by the presence of endometrial-like tissue outside the uterus, potentially leading to symptoms such as chronic pelvic pain, dysmenorrhoea, dyspareunia, and infertility. The Montreux summit brought a number of experts in this field together to provide a platform for discussion and exchange of ideas. These proceedings summarise the six main topics that were discussed at this summit to shed light on future directions of endometriosis classification, diagnosis, and therapeutical management. The first question addressed the possibility of preventing endometriosis in the future by identifying risk factors, genetic predispositions, and further understanding of the pathophysiology of the condition to develop targeted interventions. The clinical presentation of endometriosis is varied, and the correlation between symptoms severity and disease extent is unclear. While there is currently no universally accepted optimal classification system for endometriosis, several attempts striving towards its optimisation - each with its own advantages and limitations - were discussed. The ideal classification should be able to reconcile disease status based on the various diagnostic tools, and prognosis to guide proper patient tailored management. Regarding diagnosis, we focused on future tools and critically discussed emerging approaches aimed at reducing diagnostic delay. Preserving fertility in endometriosis patients was another debatable aspect of management that was reviewed. Moreover, besides current treatment modalities, potential novel medical therapies that can target underlying mechanisms, provide effective symptom relief, and minimise side effects in endometriotic patients were considered, including hormonal therapies, immunomodulation, and regenerative medicine. Finally, the question of hormonal substitution therapy after radical treatment for endometriosis was debated, weighing the benefits of hormone replacement.
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Letsios A, Polyzos N, Poulopoulos C, Skamnakis C. Hospital managers' participation in operational planning: insights from a recent study in the Greek National Health System. Hippokratia 2022; 26:91-97. [PMID: 37324045 PMCID: PMC10266327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND The performance of the public hospitals of the National Health System (NHS) of Greece, as reflected in their financial and operational results, is related to their strategic planning and the factors that influence the accomplishment of their objectives. METHOD The organizational performance of NHS hospitals was assessed by analyzing their operational and financial data for the period 2010-2020 (recorded by the "BI-Health" system of the Ministry of Health). Based on internationally accepted factors that influence the successful implementation of strategic planning and the achievement of its objectives, a structured questionnaire consisting of 11 demographic and 93 (on a scale of 1 to 7) factor-related questions was developed and addressed to 56 managers and senior executives. Their response was analyzed using descriptive statistical methods and inference, and "significant" factors were extracted using Principal Components Analysis. RESULTS Hospitals reduced their expenditure from 2010 to 2015 by 34.6 %, while the number of inpatients increased by 5.9 %. However, expenditure increased by 41.2 % in the period 2016-2020, while concurrently, inpatients rose by 14.7 %. Outpatient and emergency department visits remained almost stable (6.5 and 4.8 million/year, respectively), during 2010-2015, while increased by 14.5 % till 2020. The average length of stay decreased from 4.1 in 2010 to 3.8 in 2015 and 3.4 in 2020. The survey data showed that NHS hospitals' strategic plan is well "documented", but its "actual implementation" is moderate; The "achievement of the objectives" related to clinical work, quality improvement of services, human resources development, financial strategy, asset strategy, digital strategy, communication and engagement strategy, and research might be good; chief executive officers, nurses, laboratory physicians, and administrators receive a positive grade of participation while the Board of Directors, physicians, employee representatives and the School of Medicine/University receive a moderate grade. The factors: "elements of strategic planning" (33.6 %), "evaluation of services and staff" (20.5 %), "employees' commitment and involvement" (20.1 %), and "operational outcomes and performance" (8.9 %), as derived from the principal component analysis, had the highest impact on achieving their financial and operational objectives, as assessed by the views of the managers of the 35 NHS hospitals. CONCLUSION The NHS hospitals increased their efficiency from 2010 to 2020 but failed to maintain control over their expenditure. Through their clinical managers and other employees' representatives, chief executive officers and the Board of Directors need to improve planning formulation, staff involvement and utilization, financial performance, and outcomes as their primary commitment among health policy and management sectors in the Greek NHS. HIPPOKRATIA 2022, 26 (3):91-97.
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Affiliation(s)
- A Letsios
- Department of Social Work, School of Social, Political & Economical Sciences, Democritus University of Thrace, Komotini, Greece
| | - N Polyzos
- Department of Social Work, School of Social, Political & Economical Sciences, Democritus University of Thrace, Komotini, Greece
| | - Ch Poulopoulos
- Department of Social Work, School of Social, Political & Economical Sciences, Democritus University of Thrace, Komotini, Greece
| | - Ch Skamnakis
- Department of Social Policy, Panteion University, Athens, Greece
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Gonzalez-Foruria I, García S, Racca A, Álvarez M, Polyzos N, Coroleu B. O-241 Elevated serum progesterone levels before frozen embryo transfer do not negatively impact reproductive outcomes: a large retrospective cohort study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Do patients with high serum progesterone levels before frozen embryo transfer (FET) under hormonal replacement therapy (HRT) present worse reproductive outcomes?
Summary answer
Elevated serum progesterone levels before FET in artificially prepared cycles with vaginal or vaginal plus subcutaneous progesterone do not impair reproductive outcomes.
What is known already
Low serum progesterone levels before FET do negatively affect reproductive outcomes in terms of live birth rate. However, there is not robust data regarding the impact of high serum progesterone levels in the luteal phase of patients who undergo HRT for FET.
Study design, size, duration
Retrospective cohort study of 3183 blastocyst FET cycles under HRT performed in a university-affiliated fertility centre between March 2009 and December 2020. All the cycles presented adequate serum progesterone levels before FET (≥10.6 ng/ml). A total of 1360 cycles corresponded to frozen homologous embryo transfer (ET) (hom-FET), 1024 were euploid ET (eu-FET) after preimplantational genetic testing for aneuploidies (PGT-A), and 799 cycles were frozen heterologous ET (het-FET). The primary objective was live birth rate (LBR).
Participants/materials, setting, methods
Standard HRT was used. Luteal phase was covered with vaginal progesterone 200 mg/8h, or vaginal plus a daily subcutaneous injection of progesterone (25 mg). Serum progesterone levels were measured the day before FET. Elevated progesterone levels were considered in the 90th and 95th centiles. A generalized additive model (GAM) was performed to study the functional relationships between progesterone and LBR. A multivariable logistic regression was used to evaluate the effect of high progesterone over LBR.
Main results and the role of chance
Mean serum progesterone level before FET was 16.77±8.43 ng/ml. Progesterone levels were significantly higher in the group under vaginal plus subcutaneous progesterone (21.87±14.17 vs. 15.56±5.72, p < 0.001). No differences in clinical pregnancy, miscarriage and LBR were found according to the use of vaginal or vaginal plus subcutaneous progesterone for each of the groups (hom-FET, eu-FET and het-FET). Live birth rates were comparable among patients in the highest centile of serum progesterone levels (≥p90, ≥22.33 ng/ml) and the rest of patients (p < 90) (43.9 vs 41.3%; p = 0.381). Patients with progesterone levels ≥p90 presented lower BMI compared to those in the lower centiles (<p90) (22.62±3.82 vs. 23.32±4.06; P = 0.009). After dividing patients in deciles according to serum progesterone levels before, no differences in LBR were observed among groups (P = 0.938). No association was observed with GAM model between progesterone levels and LBR. A multivariable logistic regression adjusted by oocyte age, type of treatment and number of embryos transferred was applied for centile 90 and centile 95 of progesterone, and showed that serum progesterone in their highest levels did not negatively impact LBR.
Limitations, reasons for caution
The main limitation of this study is its retrospective design. The results only apply for patients under HRT with vaginal micronized progesterone alone or plus subcutaneous progesterone. Progesterone determination was measured before blastocyst FET. Extrapolation to other HRT protocols or timings of progesterone measurement needs to be validated.
Wider implications of the findings
The results of this study suggest that once a threshold of serum progesterone before FET is achieved, progesterone levels are not predictive of the clinical outcome. Actually, LBR are not negatively affected when progesterone levels are found in their highest centiles after luteal phase rescue with vaginal plus subcutaneous progesterone.
Trial registration number
Not applicable
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Affiliation(s)
- I Gonzalez-Foruria
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
| | - S García
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
| | - A Racca
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
| | - M Álvarez
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
| | - N Polyzos
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
| | - B Coroleu
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine , Barcelona, Spain
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Clua Obradó E, Palacios-Verdú G, Sumarroca M, Martínez F, Polyzos N. O-144 Adverse pregnancy and neonatal outcomes in an oocyte donation program. Expanded Carrier Screening can substantially decrease the risk of recessive conditions. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
How frequent are adverse outcomes in oocyte donation (OD) programs and how many recessive conditions can be prevented with the implementation of expanded carrier screening(ECS)?
Summary answer
Adverse outcomes were reported only in 1.55% of cases. ECS prevented 2.66% autosomal recessive and X-linked-conditions, interpreted in a 63% decrease in adverse outcomes.
What is known already
Nowadays, oocyte donors undergo a rigorous selection process, including the evaluation of genetic risks. ECS has been widely implemented in the screening of gamete donors. Nevertheless, pregnancies conceived after OD cycles are still at risk for genetic adverse outcomes. There are very few reports in the literature regarding children born with an inherited genetic condition from a gamete donor, and they are reported in sperm donation-conceived offspring. To our knowledge, there is no published review of genetic adverse outcomes in oocyte donation offspring so far.
Study design, size, duration
This is a retrospective observational study that analyses the adverse events reported in 4573 OD cycles carried out between January 2014 and December 2021 in the Reproductive Medicine Unit of Dexeus University Hospital. The study also reviews the number of high-risk assignations that has been identified in the OD program where ECS was applied to the oocyte donors and the recipient’s male partner to avoid high-risk assignations.
Participants/materials, setting, methods
The study includes patients who underwent OD cycles and reported an adverse outcome with a potential genetic aetiology from 2014 to 2021. Moreover, genetic matchings were revised in the OD program and high-risk assignations were defined as matchings where oocyte donors and recipients’ male partners were carriers of the same autosomal recessive condition or as matchings where oocyte donor candidates were found to be carriers of X-linked conditions.
Main results and the role of chance
A total of 4.573 OD cycles were performed, including 1696 oocyte donors. Seventy-one recipients (1.55%) reported an adverse outcome of the pregnancy or children born from the OD. A confirmed genetic aetiology was reported in 23 (32.4%) cases including chromosomal abnormalities, microduplications and monogenic disorders. The reported remaining cases were due to congenital malformations, stillbirth, neurodevelopmental disorders, and other conditions for which a genetic aetiology has not been established to our knowledge.
Moreover, we identified 211 (4.6%) high-risk assignations due to oocyte donors and recipient’s male partners being carriers of the same autosomal recessive condition when initially assigned, which would have led to an additional 1,15% of children born with an autosomal recessive conditions (25% of 4.6% high-risk assignations). Additionally, we rejected 52 (3.07%) oocyte donor candidates that were carriers of X-linked conditions, which would have led to an additional 1.5% of children born with an X-linked disorder.
Based on our results, implementation of ECS, resulted in 63% risk reduction in adverse outcomes observed in our oocyte donation program from a potential adverse event rate of 4.2% to an actual 1.55% incidence of adverse outcomes.
Limitations, reasons for caution
The actual number of adverse outcomes and high-risk assignations in an OD program could be underestimated given that not all patients report the adverse outcome or in some cases adverse events have not yet developed. Additionally, the number of rejected/avoided high-risk assignations in ECS is not always collected.
Wider implications of the findings
This study provides evidence that ECS reduces the probability that children born from OD could inherit some autosomal recessive or X-linked conditions. However, there are still several genetic adverse events that cannot be avoided by implementing ECS, mostly caused by de novo monogenic changes, chromosomal abnormalities, or congenital malformations.
Trial registration number
Not applicable
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Affiliation(s)
- E Clua Obradó
- Reproductive Medicine Unit of Dexeus University Hospital, Reproductive Medicine Unit , Barcelona, Spain
| | - G Palacios-Verdú
- Dexeus University Hospital, Unit of Genomic Medicine , Barcelona, Spain
| | - M Sumarroca
- Dexeus University Hospital, Unit of Genomic Medicine , Barcelona, Spain
| | - F Martínez
- Dexeus University Hospital, Reproductive Medicine Unit , Barcelona, Spain
| | - N Polyzos
- Dexeus University Hospital, Reproductive Medicine Unit , Barcelona, Spain
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Mavridoglou G, Polyzos N. Sustainability of Healthcare Financing in Greece: A Relation Between Public and Social Insurance Contributions and Delivery Expenditures. INQUIRY 2022; 59:469580221092829. [PMID: 35635453 PMCID: PMC9158418 DOI: 10.1177/00469580221092829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The economic crisis in Greece, which began in 2010 and lasted for 10 years, highlighted the serious problems and challenges of the Greek Social Health Insurance system. The reforms that mainly took place during the crisis provided a temporary solution. They focused on establishing a new National Organization for Healthcare Services (named EOPYY) and merging all the old insurance funds. This paper aims to examine whether this social health insurance fund has been sustainable in the long run. An actuarial model was created to project future expenses and revenues. Demographic and economic trends were considered, while it was assumed that medical technology remains unaltered. The assessment of the system solvency was based on the ratio (Revenue/Liabilities) calculated for each year, from 2020 to 2050. The results led to deficits, the amount and the time point in which they appear depends on how optimistic or pessimistic demographic and economic assumptions were. A new financial flow model was proposed to address the deficits. The results show that under the new model, the system remains solvent until 2050. The state subsidy amount on the employees’ health insurance premium was estimated as a percentage of the employees’ wage.
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Affiliation(s)
- George Mavridoglou
- Department of Accounting and Finance, University of Peloponnese, Kalamata, Greece
| | - Nikolaos Polyzos
- Department of Social Work, University of Thrace, Komotini, Greece
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Hart R, D’Hooghe T, Dancet E, Aurell R, Lunenfeld B, Orvieto R, Pellicer A, Polyzos N, Zheng W. P–593 Self-monitoring of hormones via a urine-based hormonal assay — a topical endeavour into telemedicine in medically-assisted reproduction (MAR). Hum Reprod 2021. [PMCID: PMC8385867 DOI: 10.1093/humrep/deab130.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Study question How can cycle monitoring using a urine-based hormonal assay device improve current clinical practice in medically assisted reproduction (MAR)? Summary answer A urine-based hormonal assay has the potential to overcome the inconvenience of blood tests and reduce the frequency of appointments, waiting times and patient burden. What is known already Cycle monitoring via ultrasound and serum-based hormonal assays during MAR can provide information on the ovarian response and assist in optimising treatment strategies and reducing complications, such as ovarian hyperstimulation syndrome (OHSS). However, blood tests may cause inconvenience to patients due to repeated venepuncture and the need for frequent clinic appointments. Urine-based assays have been historically used by fertility specialists in clinics, but since got replaced by more practical and automated serum-based assays. Novel technology utilising rapid chromatographic immunoassay to test urinary reproductive hormones in a home setting could provide an alternative to current serum-based testing at clinics. Study design, size, duration A questionnaire was disseminated among 24 fertility specialists (2019–2020) on the use of ultrasound and serum-based hormone monitoring in clinical practice. In addition, the literature on the reliability of urine-based hormonal assays compared to serum-based hormonal assays during MAR was reviewed in order to examine if urine-based hormonal monitoring could be re-introduced in clinical practice using novel state-of-the-art technology. Participants/materials, setting, methods All 24 surveyed fertility specialists responded, representing 10 countries from across Europe, Asia and Latin America. Questions assessed the frequency and role of hormonal monitoring, the hormones tested and the drawbacks of blood tests. The PubMed search engine was used to search the Medline database for publications between 1960–2020 with (MeSH-) search terms related to cycle monitoring (e.g. fertility monitoring, controlled ovarian stimulation, ovulation confirmation) and hormonal assays (e.g. estrone–3-glucuronide or E1–3G). Main results and the role of chance The survey confirmed that many fertility practitioners (n = 22/24) routinely conducted hormone monitoring during MAR, primarily for guiding dose adjustments (n = 20/24) and indicating risk of OHSS (n = 20/24). The reported drawbacks of blood tests included validity of results from different service providers, long waiting times and discomfort to patients due to travelling to clinics for tests and repeated venepunctures. The hormones routinely checked were E2 (n = 22/22), P4 (n = 18/22) and LH (n = 15/22). The literature review revealed a relatively high correlation (correlation coefficients 0.85–0.95) between serum E2 and urinary E1–3G in gonadotrophin stimulated cycles (Lessing 1987, Catalan 1989, Rapi 1992 and Alper 1994). No studies assessed the correlation between serum P4 and urinary PdG or between serum LH and urinary LH in stimulated cycles. In natural cycles, the correlation coefficients between serum P4 and urinary PdG seemed to be slightly higher than those between serum E2 and urinary E1–3G (0.73–0.94 vs. 0.54–0.88) (Denari 1981, Munro 1991, Roos 2015, Stanczyk 1980). One study reported a moderate correlation coefficient (0.72) between serum and urinary LH in natural cycles (Roos 2015). Limitations, reasons for caution There is risk of selection-bias for fertility specialists included in survey, however, the 100% response rate is reassuring. The correlation coefficients between serum- and urine-based hormonal assay and the cost-effectiveness and time-efficiency of urinary assay should be confirmed in further clinical studies using a novel state-of-the-art remote urinary monitoring device. Wider implications of the findings: Remote hormonal monitoring can be part of a novel digital health solution that includes remote ultrasound and tele-counselling to link clinics and patients at home. Especially during the unprecedented times of the COVID–19 pandemic, the prospect of remote monitoring system has the potential to improve patient experience during fertility treatment. Trial registration number Not applicable
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Affiliation(s)
- R Hart
- University of Western Australia & Fertility Specialists of WA, Division of Obstetrics and Gynaecology, Perth- Western Australia, Australia
| | - T D’Hooghe
- Merck KGaA, Global Medical Affairs Fertility, Darmstadt, Germany
| | - E Dancet
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - R Aurell
- Fertility Campus Hospital Quirónsalud, IVF Unit, Barcelona, Spain
| | - B Lunenfeld
- Bar-Ilan University, Faculty of Life Sciences, Ramat Gan, Israel
| | - R Orvieto
- Chaim Sheba Medical Center Tel Hashomer, Infertility and IVF Unit- Department of Obstetrics and Gynecology, Ramat Gan, Israel
| | - A Pellicer
- IVIRMA, Reproductive Medicine, Rome, Italy
| | - N Polyzos
- Dexeus Mujer- Dexeus University Hospital, Department of Obstetrics Gynecology and Reprodutive Medicine, Barcelona, Spain
| | - W Zheng
- Merck KGaA, Global Medical Affairs Fertility- R&D Biopharma, Darmstadt, Germany
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Shahrajabian MH, Chaski C, Polyzos N, Tzortzakis N, Petropoulos SA. Sustainable Agriculture Systems in Vegetable Production Using Chitin and Chitosan as Plant Biostimulants. Biomolecules 2021; 11:biom11060819. [PMID: 34072781 PMCID: PMC8226918 DOI: 10.3390/biom11060819] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/25/2022] Open
Abstract
Chitin and chitosan are natural compounds that are biodegradable and nontoxic and have gained noticeable attention due to their effective contribution to increased yield and agro-environmental sustainability. Several effects have been reported for chitosan application in plants. Particularly, it can be used in plant defense systems against biological and environmental stress conditions and as a plant growth promoter—it can increase stomatal conductance and reduce transpiration or be applied as a coating material in seeds. Moreover, it can be effective in promoting chitinolytic microorganisms and prolonging storage life through post-harvest treatments, or benefit nutrient delivery to plants since it may prevent leaching and improve slow release of nutrients in fertilizers. Finally, it can remediate polluted soils through the removal of cationic and anionic heavy metals and the improvement of soil properties. On the other hand, chitin also has many beneficial effects such as plant growth promotion, improved plant nutrition and ability to modulate and improve plants’ resistance to abiotic and biotic stressors. The present review presents a literature overview regarding the effects of chitin, chitosan and derivatives on horticultural crops, highlighting their important role in modern sustainable crop production; the main limitations as well as the future prospects of applications of this particular biostimulant category are also presented.
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Affiliation(s)
- Mohamad Hesam Shahrajabian
- Department of Agriculture, Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece; (C.C.); (N.P.)
- Correspondence: (M.H.S.); (S.A.P.); Tel.: +30-24210-93196 (S.A.P.)
| | - Christina Chaski
- Department of Agriculture, Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece; (C.C.); (N.P.)
| | - Nikolaos Polyzos
- Department of Agriculture, Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece; (C.C.); (N.P.)
| | - Nikolaos Tzortzakis
- Department of Agricultural Sciences, Biotechnology and Food Science, Cyprus University of Technology, 3603 Limassol, Cyprus;
| | - Spyridon A. Petropoulos
- Department of Agriculture, Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece; (C.C.); (N.P.)
- Correspondence: (M.H.S.); (S.A.P.); Tel.: +30-24210-93196 (S.A.P.)
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Shahrajabian MH, Chaski C, Polyzos N, Petropoulos SA. Biostimulants Application: A Low Input Cropping Management Tool for Sustainable Farming of Vegetables. Biomolecules 2021; 11:biom11050698. [PMID: 34067181 PMCID: PMC8150747 DOI: 10.3390/biom11050698] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Biostimulants, are a diverse class of compounds including substances or microorganism which have positive impacts on plant growth, yield and chemical composition as well as boosting effects to biotic and abiotic stress tolerance. The major plant biostimulants are hydrolysates of plant or animal protein and other compounds that contain nitrogen, humic substances, extracts of seaweeds, biopolymers, compounds of microbial origin, phosphite, and silicon, among others. The mechanisms involved in the protective effects of biostimulants are varied depending on the compound and/or crop and mostly related with improved physiological processes and plant morphology aspects such as the enhanced root formation and elongation, increased nutrient uptake, improvement in seed germination rates and better crop establishment, increased cation exchange, decreased leaching, detoxification of heavy metals, mechanisms involved in stomatal conductance and plant transpiration or the stimulation of plant immune systems against stressors. The aim of this review was to provide an overview of the application of plant biostimulants on different crops within the framework of sustainable crop management, aiming to gather critical information regarding their positive effects on plant growth and yield, as well as on the quality of the final product. Moreover, the main limitations of such practice as well as the future prospects of biostimulants research will be presented.
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Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, Kolibianakis E, Kunicki M, Marca AL, Lainas G, Clef NL, Massin N, Mastenbroek S, Polyzos N, Sunkara SK, Timeva T, Töyli M, Urbancsek J, Vermeulen N, Broekmans F. Erratum: ESHRE guideline: ovarian stimulation for IVF/ICSI. Hum Reprod Open 2020; 2020:hoaa067. [PMID: 33409381 PMCID: PMC7770487 DOI: 10.1093/hropen/hoaa067] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.1093/hropen/hoaa009.][This corrects the article DOI: 10.1093/hropen/hoaa009.].
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Affiliation(s)
| | | | - Simone Broer
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, The Netherlands
| | - Georg Griesinger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Michael Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hopital Antoine Béclère, Clamart, France
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, Skive, Denmark
| | - Estratios Kolibianakis
- Unit for Human Reproduction, 1st Dept of ObGyn, Medical School, Aristotle University, Thessaloniki, Greece
| | - Michal Kunicki
- INVICTA Fertility and Reproductive Centre, Department of Gynaecological Endocrinology, Medical University of Warsaw, Poland
| | - Antonio La Marca
- Department of Obstetrics and Gynaecology, University of Modena Reggio Emilia and Clinica Eugin, Modena, Italy
| | | | | | - Nathalie Massin
- Department of Obstetrics, Gynaecology and Reproduction, University Paris-Est Créteil, Centre Hospitalier Intercommunal, Créteil, France
| | | | | | | | | | - Mira Töyli
- Kanta-Häme Central Hospital, Hämeenlinna, Mehiläinen Clinics, Helsinki, Finland
| | - Janos Urbancsek
- Department of Obstetrics and Gynaecology, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | | | - Frank Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, The Netherlands
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Liberal Â, Fernandes Â, Polyzos N, Petropoulos SA, Dias MI, Pinela J, Petrović J, Soković M, Ferreira IC, Barros L. Bioactive Properties and Phenolic Compound Profiles of Turnip-Rooted, Plain-Leafed and Curly-Leafed Parsley Cultivars. Molecules 2020; 25:molecules25235606. [PMID: 33260591 PMCID: PMC7730503 DOI: 10.3390/molecules25235606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
Petroselinum crispum Mill., Fuss., is a culinary vegetable used as an aromatic herb that garnishes and flavours a great variety of dishes. In the present study, the chemical profiles and bioactivities of leaf samples from 25 cultivars (three types: plain- and curly-leafed and turnip-rooted) from this species were assessed. Seven phenolic compounds were identified in all the varieties, including apigenin and kaempherol derivates. Apigenin-O-pentoside-O-hexoside was the major compound in all the tested parsley types (20, 22 and 13 mg/g of extract, respectively) and responsible for its excellent antioxidant activity, also investigated in this study. Antimicrobial activities were also explored, and the results revealed a good bioactivity against specific tested pathogens, such as bacteria and fungi. In conclusion, the leaves of all the types of P. crispum are a good source of natural bioactive compounds that confer health benefits, and thus, they should be part of a balanced and diversified diet.
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Affiliation(s)
- Ângela Liberal
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
| | - Ângela Fernandes
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
| | - Nikolaos Polyzos
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece;
| | - Spyridon A. Petropoulos
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Street, 38446 Volos, Greece;
- Correspondence: (S.A.P.); (L.B.); Tel.: +30-2421-093-196 (S.A.P.); +351-2733-309-01 (L.B.)
| | - Maria Inês Dias
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
| | - José Pinela
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
| | - Jovana Petrović
- Institute for Biological Research “Siniša Stanković”-National Institute of Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, 11000 Belgrade, Serbia; (J.P.); (M.S.)
| | - Marina Soković
- Institute for Biological Research “Siniša Stanković”-National Institute of Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, 11000 Belgrade, Serbia; (J.P.); (M.S.)
| | - Isabel C.F.R. Ferreira
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
| | - Lillian Barros
- Mountain Research Center (CIMO), Institute Polytechnic of Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (Â.L.); (Â.F.); (M.I.D.); (J.P.); (I.C.F.R.F.)
- Correspondence: (S.A.P.); (L.B.); Tel.: +30-2421-093-196 (S.A.P.); +351-2733-309-01 (L.B.)
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Cruz LRO, Fernandes Â, Di Gioia F, Petropoulos SA, Polyzos N, Dias MI, Pinela J, Kostić M, Soković MD, Ferreira ICFR, Barros L. The Effect of Nitrogen Input on Chemical Profile and Bioactive Properties of Green- and Red-Colored Basil Cultivars. Antioxidants (Basel) 2020. [PMID: 33114065 DOI: 10.3390/agronomy10111824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
In the present study, three red-colored (Dark Opal, Basilico Rosso, and Red Basil) and one green-colored landrace (Mitikas) of basil (Ocimum basilicum L.) were grown under four nitrogen regimes, namely Control (no fertilizer added), 200 ppm, 400 ppm, and 600 ppm of nitrogen (N). Fresh yield varied depending on N input following a quadratic function in all four genotypes, and green basil performed better compared to the red cultivars. A significant interaction of genotype × N input was recorded for most of the chemical parameters measured. Tocopherols contents of leaves were consistently higher in plants that received 200 ppm of N and lower in those receiving 600 ppm of N, especially in Dark Opal and Red Basil cultivars. Polyunsaturated fatty acids (PUFA) were the major category of fatty acids and Red Basil had the lowest ratio of omega-6/omega 3 (0.29) and thus the best fatty acid profile. Polyphenols content was the highest in Red Basil and Dark Opal (25 mg/g of extract on average) and the lowest in Mitikas and decreased with increasing N input. Similarly, antioxidant activity was the highest in Dark Opal and Red Basil fertigated with 200 ppm of N, whereas all the leaf extracts tested had good antibacterial and antifungal activity. In conclusion, basil chemical and bioactive profile was significantly influenced by both genotype and N input. Red-colored basil, although less productive, had the best chemical profile, and moderate levels of N input may provide the best compromise between yield, nutritional value, and bioactivity for the species.
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Affiliation(s)
- Luís R O Cruz
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Departamento de Ciências da Saúde, Instituto Superior Politécnico Jean Piaget de Benguela, Estrada Nacional 100 Lobito, Benguela 1393, Angola
| | - Ângela Fernandes
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Francesco Di Gioia
- Department of Plant Science, Pennsylvania State University, 207 Tyson Building, University Park, PA 16802, USA
| | - Spyridon A Petropoulos
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Street, N. Ionia, 38446 Magnissia, Greece
| | - Nikolaos Polyzos
- Department of Agriculture Crop Production and Rural Environment, University of Thessaly, Fytokou Street, N. Ionia, 38446 Magnissia, Greece
| | - Maria Inês Dias
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - José Pinela
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Marina Kostić
- Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, 11000 Belgrade, Serbia
| | - Marina D Soković
- Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, 11000 Belgrade, Serbia
| | - Isabel C F R Ferreira
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Lillian Barros
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
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Karampli E, Souliotis K, Polyzos N, Chatzaki E. Why do physicians prescribe new antidiabetic drugs? A qualitative study in the Greek healthcare setting. Health Policy and Technology 2020. [DOI: 10.1016/j.hlpt.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ovarian Stimulation TEGGO, Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, Kolibianakis E, Kunicki M, La Marca A, Lainas G, Le Clef N, Massin N, Mastenbroek S, Polyzos N, Sunkara SK, Timeva T, Töyli M, Urbancsek J, Vermeulen N, Broekmans F. ESHRE guideline: ovarian stimulation for IVF/ICSI †. Hum Reprod Open 2020; 2020:hoaa009. [PMID: 32395637 PMCID: PMC7203749 DOI: 10.1093/hropen/hoaa009] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/05/2019] [Indexed: 12/29/2022] Open
Abstract
STUDY QUESTION What is the recommended management of ovarian stimulation, based on the best available evidence in the literature? SUMMARY ANSWER The guideline development group formulated 84 recommendations answering 18 key questions on ovarian stimulation. WHAT IS KNOWN ALREADY Ovarian stimulation for IVF/ICSI has been discussed briefly in the National Institute for Health and Care Excellence guideline on fertility problems, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologist has published a statement on ovarian stimulation in assisted reproduction. There are, to our knowledge, no evidence-based guidelines dedicated to the process of ovarian stimulation. STUDY DESIGN, SIZE, DURATION The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 8 November 2018 and written in English were included. The critical outcomes for this guideline were efficacy in terms of cumulative live birth rate per started cycle or live birth rate per started cycle, as well as safety in terms of the rate of occurrence of moderate and/or severe ovarian hyperstimulation syndrome (OHSS). PARTICIPANTS/MATERIALS, SETTING, METHODS Based on the collected evidence, recommendations were formulated and discussed until consensus was reached within the guideline group. A stakeholder review was organized after finalization of the draft. The final version was approved by the guideline group and the ESHRE Executive Committee. MAIN RESULTS AND THE ROLE OF CHANCE The guideline provides 84 recommendations: 7 recommendations on pre-stimulation management, 40 recommendations on LH suppression and gonadotrophin stimulation, 11 recommendations on monitoring during ovarian stimulation, 18 recommendations on triggering of final oocyte maturation and luteal support and 8 recommendations on the prevention of OHSS. These include 61 evidence-based recommendations—of which only 21 were formulated as strong recommendations—and 19 good practice points and 4 research-only recommendations. The guideline includes a strong recommendation for the use of either antral follicle count or anti-Müllerian hormone (instead of other ovarian reserve tests) to predict high and poor response to ovarian stimulation. The guideline also includes a strong recommendation for the use of the GnRH antagonist protocol over the GnRH agonist protocols in the general IVF/ICSI population, based on the comparable efficacy and higher safety. For predicted poor responders, GnRH antagonists and GnRH agonists are equally recommended. With regards to hormone pre-treatment and other adjuvant treatments (metformin, growth hormone (GH), testosterone, dehydroepiandrosterone, aspirin and sildenafil), the guideline group concluded that none are recommended for increasing efficacy or safety. LIMITATIONS, REASON FOR CAUTION Several newer interventions are not well studied yet. For most of these interventions, a recommendation against the intervention or a research-only recommendation was formulated based on insufficient evidence. Future studies may require these recommendations to be revised. WIDER IMPLICATIONS OF THE FINDINGS The guideline provides clinicians with clear advice on best practice in ovarian stimulation, based on the best evidence available. In addition, a list of research recommendations is provided to promote further studies in ovarian stimulation. STUDY FUNDING/COMPETING INTEREST(S) The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the dissemination of the guideline. The guideline group members did not receive payment. F.B. reports research grant from Ferring and consulting fees from Merck, Ferring, Gedeon Richter and speaker’s fees from Merck. N.P. reports research grants from Ferring, MSD, Roche Diagnositics, Theramex and Besins Healthcare; consulting fees from MSD, Ferring and IBSA; and speaker’s fees from Ferring, MSD, Merck Serono, IBSA, Theramex, Besins Healthcare, Gedeon Richter and Roche Diagnostics. A.L.M reports research grants from Ferring, MSD, IBSA, Merck Serono, Gedeon Richter and TEVA and consulting fees from Roche, Beckman-Coulter. G.G. reports consulting fees from MSD, Ferring, Merck Serono, IBSA, Finox, Theramex, Gedeon-Richter, Glycotope, Abbott, Vitrolife, Biosilu, ReprodWissen, Obseva and PregLem and speaker’s fees from MSD, Ferring, Merck Serono, IBSA, Finox, TEVA, Gedeon Richter, Glycotope, Abbott, Vitrolife and Biosilu. E.B. reports research grants from Gedeon Richter; consulting and speaker’s fees from MSD, Ferring, Abbot, Gedeon Richter, Merck Serono, Roche Diagnostics and IBSA; and ownership interest from IVI-RMS Valencia. P.H. reports research grants from Gedeon Richter, Merck, IBSA and Ferring and speaker’s fees from MSD, IBSA, Merck and Gedeon Richter. J.U. reports speaker’s fees from IBSA and Ferring. N.M. reports research grants from MSD, Merck and IBSA; consulting fees from MSD, Merck, IBSA and Ferring and speaker’s fees from MSD, Merck, IBSA, Gedeon Richter and Theramex. M.G. reports speaker’s fees from Merck Serono, Ferring, Gedeon Richter and MSD. S.K.S. reports speaker’s fees from Merck, MSD, Ferring and Pharmasure. E.K. reports speaker’s fees from Merck Serono, Angellini Pharma and MSD. M.K. reports speaker’s fees from Ferring. T.T. reports speaker’s fees from Merck, MSD and MLD. The other authors report no conflicts of interest. Disclaimer This guideline represents the views of ESHRE, which were achieved after careful consideration of the scientific evidence available at the time of preparation. In the absence of scientific evidence on certain aspects, a consensus between the relevant ESHRE stakeholders has been obtained. Adherence to these clinical practice guidelines does not guarantee a successful or specific outcome, nor does it establish a standard of care. Clinical practice guidelines do not replace the need for application of clinical judgment to each individual presentation, nor variations based on locality and facility type. ESHRE makes no warranty, express or implied, regarding the clinical practice guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. (Full disclaimer available atwww.eshre.eu/guidelines.) †ESHRE Pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Affiliation(s)
- The Eshre Guideline Group On Ovarian Stimulation
- IVI-RMS Valencia, Valencia, Spain.,Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Reproductive Medicine & Fertility Preservation, Hopital Antoine Béclère, Clamart, France.,The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, Skive, Denmark.,Unit for Human Reproduction, 1 Dept of ObGyn, Medical School, Aristotle University, Thessaloniki, Greece.,INVICTA Fertility and Reproductive Centre, Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland.,Department of Obstetrics and Gynaecology, University of Modena Reggio Emilia and Clinica Eugin, Modena, Italy.,Eugonia Assisted Reproduction Unit, Athens, Greece.,European Society of Human Reproduction and Embryology, Grimbergen, Belgium.,Department of Obstetrics, Gynaecology and Reproduction, University Paris-Est Créteil, Centre Hospitalier Intercommunal Créteil, Créteil, France.,Amsterdam Reproduction & Development, Center for Reproductive Medicine, University Medical Center Amsterdam, Amsterdam, The Netherlands.,Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.,Department of Women and Children's Health, King's College London, London, UK.,Hospital "Dr. Shterev", Sofia, Bulgaria.,Kanta-Häme Central Hospital, Hämeenlinna, Mehiläinen Clinics, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | | | - Simone Broer
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Georg Griesinger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Michael Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hopital Antoine Béclère, Clamart, France
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, Skive, Denmark
| | - Estratios Kolibianakis
- Unit for Human Reproduction, 1 Dept of ObGyn, Medical School, Aristotle University, Thessaloniki, Greece
| | - Michal Kunicki
- INVICTA Fertility and Reproductive Centre, Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Antonio La Marca
- Department of Obstetrics and Gynaecology, University of Modena Reggio Emilia and Clinica Eugin, Modena, Italy
| | | | - Nathalie Le Clef
- European Society of Human Reproduction and Embryology, Grimbergen, Belgium
| | - Nathalie Massin
- Department of Obstetrics, Gynaecology and Reproduction, University Paris-Est Créteil, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Sebastiaan Mastenbroek
- Amsterdam Reproduction & Development, Center for Reproductive Medicine, University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Nikolaos Polyzos
- Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Sesh Kamal Sunkara
- Department of Women and Children's Health, King's College London, London, UK
| | | | - Mira Töyli
- Kanta-Häme Central Hospital, Hämeenlinna, Mehiläinen Clinics, Helsinki, Finland
| | - Janos Urbancsek
- Department of Obstetrics and Gynaecology, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Nathalie Vermeulen
- European Society of Human Reproduction and Embryology, Grimbergen, Belgium
| | - Frank Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
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Mauri D, Kamposioras K, Tzachanis D, Tolia M, Valachis A, Dambrosio M, Alongi F, De Mello RA, Lövey J, Anthoney A, Christopoulos C, Saraireh HH, Kountourakis P, Kampletsas E, Tsali L, Tsakiridis T, Kosovitsas I, Soukovelos A, Lymperatou D, Polyzos N, Zarkavelis G. Patient and family support in the era of fake e-medicine: food for thought from an international consensus panel. ESMO Open 2020; 5:e000696. [PMID: 32340999 PMCID: PMC7204800 DOI: 10.1136/esmoopen-2020-000696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Davide Mauri
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina, Greece
- Oncology, EMEKEN, Ioannina, Greece
| | | | | | - Maria Tolia
- Department of Radiotherapy/Radiation Oncology, University of Thessaly Faculty of Medicine, Larissa, Greece
| | - Antonis Valachis
- Department of Oncology, Örebro Universitet Institutionen för Medicinska Vetenskaper, Orebro, Sweden
| | - Mario Dambrosio
- Division of Medical Oncology, Clinica San Carlo, Paderno Dugnano, Lombardia, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, University of Brescia, Verona, Italy
| | - Ramon Andrade De Mello
- Medicine, Univ Porto, Porto, Portugal
- Medical Oncology / Research Center, Jorge Valente Hospital, Institute of Oncology, Salvador, Brazil
| | - Jozsef Lövey
- Center of Radiotherapy, National Institute of Oncology, Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Alan Anthoney
- Department of Medical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Christos Christopoulos
- Service de Radiothérapie Oncologique, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, Île-de-France, France
| | - Haytham Hamed Saraireh
- Radiation Oncology Department, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | | | | | | | | | | | | | | | - Nikolaos Polyzos
- Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
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Martínez F, Rodriguez-Purata J, Clua E, Garcia S, Coroleu B, Polyzos N. Ovarian response in oocyte donation cycles under LH suppression with GnRH antagonist or desogestrel progestin: retrospective and comparative study. Gynecol Endocrinol 2019; 35:884-889. [PMID: 31081407 DOI: 10.1080/09513590.2019.1604662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), under endogenous luteinizing hormone (LH) suppression with GnRH antagonist (antGnRH) vs. desogestrel (DSG) (progesterone-primed [PP]). OD underwent ovarian stimulation with gonadotropins at a private, university-based, infertility center between January 2017 and March 2018. Endogenous LH peak was controlled with either daily injections of antGnRH or with daily oral 75 mcg DSG (PP) until triggering. LH and progesterone were measured at trigger and the following day. A total of 404 OD cycles were included. There were no differences in age (26.7 ± 4.9 vs. 27.1 ± 4.8 years), AMH (3.7 ± 2.1 vs. 4.1 ± 2.7 ng/ml), and body mass index (BMI) (22.4 ± 2.8 vs. 22.1 ± 3.0 kg/m2) between PP and antGnRH groups, respectively. On the day of trigger, progesterone was lower in PP compared to antGnRH (0.9 ± 0.7, vs. 1.5 ± 1.2 ng/ml, p < .001), whereas no significant differences existed in estradiol or LH. On the day after trigger, lower progesterone in PP vs. antGnRH (10.8 ± 6.0 vs. 13.4 ± 7.9 ng/ml, p=.002) was observed. No differences were observed in the number of retrieved oocytes or the clinical pregnancies among recipients. Our study shows that endocrine response to DSG differs significantly as compared to antGnRH use for the control of endogenous LH without apparent impact on number of retrieved oocytes or the clinical pregnancies among recipients.
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Affiliation(s)
- Francisca Martínez
- Hospital Universitari Dexeus, Reproductive Medicine Service, Barcelona, Spain
| | | | - Elisabet Clua
- Hospital Universitari Dexeus, Reproductive Medicine Service, Barcelona, Spain
| | - Sandra Garcia
- Hospital Universitari Dexeus, Reproductive Medicine Service, Barcelona, Spain
| | | | - Nikolaos Polyzos
- Hospital Universitari Dexeus, Reproductive Medicine Service, Barcelona, Spain
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Gaggiotti-Marre S, Martinez F, Coll L, Garcia S, Álvarez M, Parriego M, Barri PN, Polyzos N, Coroleu B. Low serum progesterone the day prior to frozen embryo transfer of euploid embryos is associated with significant reduction in live birth rates. Gynecol Endocrinol 2019; 35:439-442. [PMID: 30585507 DOI: 10.1080/09513590.2018.1534952] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
A retrospective cohort study was performed to examine whether, in artificial endometrial preparation for frozen embryo transfer (FET) cycles, progesterone (P) levels the day prior to embryo transfer of euploid embryos have an impact on pregnancy outcomes. In a private university clinic, 244 FETs between January 2016 and June 2017 were analyzed. Endometrial preparation was achieved with estradiol valerate and vaginal micronized progesterone. Serum P and estradiol levels the day prior to embryo transfer were measured. A multivariable analysis to assess the relationship between serum P level and pregnancy outcomes was performed, adjusted for confounding variables. Mean P value was 11.3 ± 5.1 ng/ml. Progesterone levels were split in quartiles: Q1: ≤ 8.06 ng/ml; Q2: 8.07-10.64 ng/ml; Q3: 10.65-13.13 ng/ml; Q4: > 13.13 ng/ml. Patients included in the lower P quartile had a significantly higher miscarriage rate and significantly lower live birth rate (LBR) compared to the higher ones. A low serum P level (≤ 10.64 ng/ml) one day before FET is associated with a lower pregnancy and LBR following FET of euploid embryos.
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Affiliation(s)
- S Gaggiotti-Marre
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - F Martinez
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - L Coll
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - S Garcia
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - M Álvarez
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - M Parriego
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - P N Barri
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - N Polyzos
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
| | - B Coroleu
- a Dexeus Mujer, Department of Obstetrics, Gynecology and Reproduction , University Hospital Dexeus , Barcelona , Spain
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Polyzos N, Drakopoulos P, Tournaye H, Schiettecatte J, Anckaert E, Donner H, Bobba G, Miles G, Verhagen-Kamerbeek W, Bosch E. Estradiol and progesterone in in vitro fertilization (ESPRIT): evaluation of the third versus second generation estradiol and progesterone elecsys® assays. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sole M, Polyzos N, Llagostera CG, Carrasco B, Coroleu B, Veiga A, Boada M. Automatic vs manual vitrification of human oocytes. preliminary results of the first randomised controlled trial using sibling oocytes. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Xenos P, Yfantopoulos J, Nektarios M, Polyzos N, Tinios P, Constantopoulos A. Efficiency and productivity assessment of public hospitals in Greece during the crisis period 2009-2012. Cost Eff Resour Alloc 2017; 15:6. [PMID: 28450811 PMCID: PMC5405486 DOI: 10.1186/s12962-017-0068-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 04/19/2017] [Indexed: 12/03/2022] Open
Abstract
Background This study is an initial effort to examine the dynamics of efficiency and productivity in Greek public hospitals during the first phase of the crisis 2009–2012. Data were collected by the Ministry of Health after several quality controls ensuring comparability and validity of hospital inputs and outputs. Productivity is estimated using the Malmquist Indicator, decomposing the estimated values into efficiency and technological change. Methods Hospital efficiency and productivity growth are calculated by bootstrapping the non-parametric Malmquist analysis. The advantage of this method is the estimation efficiency and productivity through the corresponding confidence intervals. Additionally, a Random-effects Tobit model is explored to investigate the impact of contextual factors on the magnitude of efficiency. Results Findings reveal substantial variations in hospital productivity over the period from 2009 to 2012. The economic crisis of 2009 had a negative impact in productivity. The average Malmquist Productivity Indicator (MPI) score is 0.72 with unity signifying stable production. Approximately 91% of the hospitals score lower than unity. Substantial increase is observed between 2010 and 2011, as indicated by the average MPI score which fluctuates to 1.52. Moreover, technology change scored more than unity in more than 75% of hospitals. The last period (2011–2012) has shown stabilization in the expansionary process of productivity. The main factors contributing to overall productivity gains are increases in occupancy rates, type and size of the hospital. Conclusions This paper attempts to offer insights in efficiency and productivity growth for public hospitals in Greece. The results suggest that the average hospital experienced substantial productivity growth between 2009 and 2012 as indicated by variations in MPI. Almost all of the productivity increase was due to technology change which could be explained by the concurrent managerial and financing healthcare reforms. Hospitals operating under decreasing returns to scale could achieve higher efficiency rates by reducing their capacity. However, certain social objectives should also be considered. Emphasis perhaps should be placed in utilizing and advancing managerial and organizational reforms, so that the benefits of technological improvements will have a continuing positive impact in the future. Electronic supplementary material The online version of this article (doi:10.1186/s12962-017-0068-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P Xenos
- School of Finance and Statistics, University of Piraeus, 80 Karaoli & Dimitriou Str, 18534 Piraeus, Greece
| | - J Yfantopoulos
- School of Economics and Political Science, University of Athens, 6 Themistokleous Str., 10678 Athens, Greece
| | - M Nektarios
- School of Finance and Statistics, University of Piraeus, 80 Karaoli & Dimitriou Str, 18534 Piraeus, Greece
| | - N Polyzos
- School of Social, Political and Economic Science, University of Thrace, 12 Vasilisis Sofias Str, 67100 Xanthi, Greece
| | - P Tinios
- School of Finance and Statistics, University of Piraeus, 80 Karaoli & Dimitriou Str, 18534 Piraeus, Greece
| | - A Constantopoulos
- School of Economics and Political Science, University of Athens, 6 Themistokleous Str., 10678 Athens, Greece
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Mitropoulos P, Mitropoulos I, Karanikas H, Polyzos N. The impact of economic crisis on the Greek hospitals' productivity. Int J Health Plann Manage 2017; 33:171-184. [PMID: 28393385 DOI: 10.1002/hpm.2410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/08/2022] Open
Abstract
During the recent economic crisis, Greece implemented a comprehensive reform in the health care system. The 2010 health reform occurred under the constraints imposed by the memorandum of understanding that the Greek Government signed with its EU/International Monetary Fund creditors to control its deficit. The objective of the study is to examine the impact of the reform on the efficiency and productivity of public hospitals in Greece. We use the Malmquist productivity index to comparatively examine the potential changes before and after the reform years. We compare productivity, efficiency, and technological changes using panel data of 111 public acute hospitals operating in Greece throughout the recession period of 2009 to 2012. Bootstrapping methods are applied to allow for uncertainty owing to sampling error and for statistical inference for the Malmquist productivity index and its decompositions. The analysis indicates that the productivity has been increased following the policy changes. It appears that the expected benefits from the reform in general have been achieved, at least in the short-term. This result is examined in the light of management and operations activities, which are related with the reform process. Therefore, at a second stage, the Malmquist index is regressed on variables that may potentially be statistically associated with productivity growth.
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Affiliation(s)
- Panagiotis Mitropoulos
- Department of Business Administration; Technological Educational Institute of Western Greece; Patras Greece
| | - Ioannis Mitropoulos
- Department of Business Administration; Technological Educational Institute of Western Greece; Patras Greece
| | - Haralampos Karanikas
- Department of Informatics and Computer Technology; Technological Educational Institute of Central Greece; Lamia Greece
| | - Nikolaos Polyzos
- Department of Social Management; Democritus University of Thrace; Komotini Greece
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Karakolias S, Kastanioti C, Theodorou M, Polyzos N. Primary Care Doctors' Assessment of and Preferences on Their Remuneration. Inquiry 2017; 54:46958017692274. [PMID: 28240040 PMCID: PMC5798707 DOI: 10.1177/0046958017692274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/06/2016] [Accepted: 01/09/2017] [Indexed: 11/17/2022]
Abstract
Despite numerous studies on primary care doctors' remuneration and their job satisfaction, few of them have quantified their views and preferences on certain types of remuneration. This study aimed at reporting these views and preferences on behalf of Greek doctors employed at public primary care. We applied a 13-item questionnaire to a random sample of 212 doctors at National Health Service health centers and their satellite clinics. The results showed that most doctors deem their salary lower than work produced and lower than that of private sector colleagues. Younger respondents highlighted that salary favors dual employment and claim of informal fees from patients. Older respondents underlined the negative impact of salary on productivity and quality of services. Both incentives to work at border areas and choose general practice were deemed unsatisfactory by the vast majority of doctors. Most participants desire a combination of per capita fee with fee-for-service; however, 3 clusters with distinct preferences were formed: general practitioners (GPs) of higher medical grades, GPs of the lowest medical grade, residents and rural doctors. Across them, a descending tolerance to salary-free schemes was observed. Greek primary care doctors are dissatisfied with the current remuneration scheme, maybe more than in the past, but notably the younger doctors are not intended to leave it. However, Greek policy makers should experiment in capitation for more tolerable to risk GPs and introduce pay-for-performance to achieve enhanced access and quality. These interventions should be combined with others in primary care's new structure in an effort to converge with international standards.
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22
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Kastanioti C, Mavridoglou G, Karanikas H, Polyzos N. ABC analysis: a tool of effectively controlling pharmaceutical expenditure in Greek NHS hospitals. J Pharm Health Serv Res 2016. [DOI: 10.1111/jphs.12137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Catherine Kastanioti
- Department of Health and Welfare Unit Management; Technological Educational Institute of Peloponnese; Kalamata Greece
| | - George Mavridoglou
- Department of Health and Welfare Unit Management; Technological Educational Institute of Peloponnese; Kalamata Greece
| | - Haralampos Karanikas
- Department of Informatics and Computer Technology; Technological Educational Institute of Sterea Ellada; Lamia Greece
| | - Nikolaos Polyzos
- Department of Social Management; Democritus University of Thrace; Komotini Greece
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23
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Agathokleous MN, Nena E, Chadolias D, Zissimopoulos A, Polyzos N, Jelastopoulou E, Constantinidis TC. Estimating life expectancy of the population in Cyprus with the use of life tables. Hippokratia 2016; 20:99-103. [PMID: 28416904 PMCID: PMC5388527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM The aim of this study was to investigate the life expectancy of the Cypriot population between 1986 and 2012. MATERIAL AND METHODS We used the data reported in the annual editions of the Statistical Service of Cyprus and constructed life tables of the Cypriot population between 1986 and 2012. RESULTS For both genders, and for males and females separately, in the year 1986 life expectancy accounted 74.47, 72.2, and 76.76 years respectively, while in 2012 values increased to about 81.28, 79.02, and 83.50 years respectively. The longitudinal trend of life expectancy is to increase over the calendar years. The largest increase in life expectancy occurred at birth and was approximately seven years for both males and females. Until the age of 55, this gain was approximately six years of life. From age 60 to 65 years, the gain was about five years of life, and in the oldest age groups, the gain was four years of life. The values corresponding to male were lower compared to those corresponding to females, with the exception of the age 0 (at birth). CONCLUSIONS A significant increase in life expectancy of the Cypriot population was noted in the period 1986-2012, which was more obvious at younger ages and in females. Hippokratia 2016, 20(2): 99-103.
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Affiliation(s)
- M N Agathokleous
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - E Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - D Chadolias
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Zissimopoulos
- Laboratory of Nuclear Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - N Polyzos
- Department of Social Administration and Political Science, Democritus University of Thrace, Komotini, Greece
| | - E Jelastopoulou
- Laboratory of Hygiene, Medical School, University of Patras, Patras, Greece
| | - T C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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24
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Polyzos N, Kastanioti C, Zilidis C, Mavridoglou G, Karakolias S, Litsa P, Menegakis V, Kani C. Greek National E-Prescribing System: Preliminary Results of a Tool for Rationalizing Pharmaceutical Use and Cost. Glob J Health Sci 2016; 8:55711. [DOI: 10.5539/gjhs.v8n10p241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/17/2016] [Accepted: 02/01/2016] [Indexed: 11/12/2022] Open
Abstract
<p><strong>BACKGROUND:</strong> In Greece, due to the ongoing economic crisis a number of measures aiming at rationalising expenditure implemented. A new e-prescribing system, under a unified healthcare fund was the main pillar of these reforms focus on monitoring and auditing prescribing patterns.</p><p><strong>OBJECTIVE:</strong> Main objective of this study was to document the Greek experience with the new national e-prescribing system.</p><p><strong>METHODS:</strong> We analyse the dispensed prescriptions over the period 2013-2014, stratified into four levels: therapeutic subgroup, patent status, physician's specialty and geographical region.</p><p><strong>RESULTS</strong>: Data analysis offered a comprehensive insight into pharmaceutical expenditure over the timeframe and revealed discrepancies regarding composition of spending, brand-generic substitution within certain therapeutic subgroups, physicians’ prescribing behaviour based on medical specialty, therapeutic subgroup as well as regional per capita measures.</p><p><strong>CONCLUSIONS:</strong> E-prescribing system is a valuable tool providing sound information to health policymakers in order to monitor and rationalize pharmaceutical expenditure, in value and volume terms.</p>
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25
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Nikolentzos A, Kontodimopoulos N, Polyzos N, Thireos E, Tountas Y. Reengineering NHS Hospitals in Greece: Redistribution Leads to Rational Mergers. Glob J Health Sci 2015; 7:272-87. [PMID: 26156925 PMCID: PMC4803861 DOI: 10.5539/gjhs.v7n5p272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to record and evaluate existing public hospital infrastructure of the National Health System (NHS), in terms of clinics and laboratories, as well as the healthcare workforce in each of these units and in every health region in Greece, in an attempt to optimize the allocation of these resources. An extensive analysis of raw data according to supply and performance indicators was performed to serve as a solid and objective scientific baseline for the proposed reengineering of the Greek public hospitals. Suggestions for “reshuffling” clinics and diagnostic laboratories, and their personnel, were made by using a best versus worst outcome indicator approach at a regional and national level. This study is expected to contribute to the academic debate about the gap between theory and evidence based decision-making in health policy.
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Affiliation(s)
- Athanasios Nikolentzos
- School of Social Science, Hellenic Open University & Institute for Social and Preventative Medicine.
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26
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Gourzoulidis G, Kontodimopoulos N, Kastanioti C, Bellali T, Goumas K, Voudigaris D, Polyzos N. Do self-perceptions of emotional intelligence predict health-related quality of life? A case study in hospital managers in Greece. Glob J Health Sci 2014; 7:210-9. [PMID: 25560350 PMCID: PMC4796501 DOI: 10.5539/gjhs.v7n1p210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/23/2014] [Accepted: 07/09/2014] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to examine HRQoL outcome and EI of managers of Health Organizations. We collected data from 120 general managers of Greek public hospitals who completed the Assessing Emotions Scale (AES) and the SF-36 Health Survey. The results showed that male managers generally exhibited better HRQoL and slightly worse EI than females, although differences were not significant throughout. The three EI factors of the AES addressing appraisal, optimism/regulation and utilization of emotions correlated from 0.18 to 0.39 with sub-dimensions of HRQoL mostly related to mental -rather than physical- aspects of health, and were also significant predictors of HRQoL. There was a noteworthy gender difference in the manner in which EI predicted HRQoL and this suggests more testing. Overall, this study might enrich the potential for EI studies in Greece as well as to contribute to the international literature.
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27
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Karampli E, Souliotis K, Polyzos N, Kyriopoulos J, Chatzaki E. Pharmaceutical innovation: impact on expenditure and outcomes and subsequent challenges for pharmaceutical policy, with a special reference to Greece. Hippokratia 2014; 18:100-6. [PMID: 25336869 PMCID: PMC4201392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Over the recent decades, advances in healthcare technology have led to significant improvements in the quality of healthcare and in population health. At the same time, technological change in healthcare, rising national income and expansion of insurance coverage have been acknowledged as the main determinants of the historical growth in health spending in industrialized countries. The pharmaceutical sector is of particular interest as it constitutes a market characterized by rapid technological change and high expenditure growth rates. The purpose of this article is to provide an overview of research findings on the impact of pharmaceutical innovation on pharmaceutical expenditure growth, total health expenditure and population health outcomes and to bring forward the challenges that arise for pharmaceutical policy in Greece.
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Affiliation(s)
- E Karampli
- Department of Health Economics, National School of Public Health, Athens, Greece ; Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - K Souliotis
- Faculty of Social Sciences, University of Peloponnese, Corinth, Greece
| | - N Polyzos
- Department of Social Administration, Democritus University of Thrace, Komotini, Greece
| | - J Kyriopoulos
- Department of Health Economics, National School of Public Health, Athens, Greece
| | - E Chatzaki
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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28
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Charalambous C, Maniadakis N, Polyzos N, Fragoulakis V, Theodorou M. The efficiency of the public dental services (PDS) in Cyprus and selected determinants. BMC Health Serv Res 2013; 13:420. [PMID: 24139100 PMCID: PMC4016280 DOI: 10.1186/1472-6963-13-420] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 09/04/2013] [Indexed: 12/02/2022] Open
Abstract
Background Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it. Methods Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants). Results The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency. Conclusion The results suggest that many of the rural PDS are underperforming. Given that the option of shutting them down is undesirable, measures should be taken to reduce inputs (e.g. by reducing the personnel’s working hours) and to increase outputs (remove barriers, make PDS more accessible and increase the number of patients).
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Affiliation(s)
- Chrystalla Charalambous
- Open University of Cyprus, Lemesou Avenoue 2, Aluminium Tower, 2003, Strovolos, Lefkosia, Cyprus.
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Kontodimopoulos N, Kastanioti C, Thireos E, Karanikas H, Polyzos N. The contribution of generic substitution to rationalizing pharmaceutical expenditure in Greek public hospitals under recent economic crisis. Journal of Pharmaceutical Health Services Research 2013. [DOI: 10.1111/jphs.12032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Catherine Kastanioti
- Health Procurement Committee; Ministry of Health; Athens Greece
- Department of Health and Welfare Unit Management; TEI of Kalamata; Antikalamos Kalamata Greece
| | | | - Haralampos Karanikas
- Health Procurement Committee; Ministry of Health; Athens Greece
- Department of Informatics and Computer Technology; TEI of Lamia; Lamia Greece
| | - Nikolaos Polyzos
- Department of Social Management; Democritus University of Thrace; Komotini Greece
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30
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Nazzaro A, Salerno A, Di Iorio L, Landino G, Marino S, Pastore E, Fabregues F, Iraola A, Casals G, Creus M, Peralta S, Penarrubia J, Manau D, Civico S, Balasch J, Lindgren I, Giwercman YL, Celik E, Turkcuoglu I, Ata B, Karaer A, Kirici P, Berker B, Park J, Kim J, Rhee J, Krishnan M, Rustamov O, Russel R, Fitzgerald C, Roberts S, Hapuarachi S, Tan BK, Mathur RS, van de Vijver A, Blockeel C, Camus M, Polyzos N, Van Landuyt L, Tournaye H, Turhan NO, Hizli D, Kamalak Z, Kosus A, Kosus N, Kafali H, Lukaszuk A, Kunicki M, Liss J, Bednarowska A, Jakiel G, Lukaszuk K, Lukaszuk M, Olszak-Sokolowska B, Lukaszuk K, Kunicki M, Liss J, Jakiel G, Bednarowska A, Wasniewski T, Neuberg M, Lukaszuk M, Cavalcanti V, Peluso C, Lechado BL, Cordts EB, Christofolini DM, Barbosa CP, Bianco B, Venetis CA, Kolibianakis EM, Bosdou J, Tarlatzis BC, Onal M, Gungor DN, Acet M, Kahraman S, Kuijper E, Twisk J, Caanen M, Korsen T, Hompes P, Kushnir M, Rockwood A, Meikle W, Lambalk CB, Hizli D, Kamalak Z, Kosus A, Kosus N, Turhan NO, Kafali H, Yan X, Dai X, Wang J, Zhao N, Cui Y, Liu J, Yarde F, Maas AHEM, Franx A, Eijkemans MJC, Drost JT, van Rijn BB, van Eyck J, van der Schouw YT, Broekmans FJM, Martyn F, Anglim B, Wingfield M, Fang T, Yan GJ, Sun HX, Hu YL, Chrudimska J, Krenkova P, Macek M, Macek M, Teixeira da Silva J, Cunha M, Silva J, Viana P, Goncalves A, Barros N, Oliveira C, Sousa M, Barros A, Nelson SM, Lloyd SM, McConnachie A, Khader A, Fleming R, Lawlor DA, Thuesen L, Andersen AN, Loft A, Smitz J, Abdel-Rahman M, Ismail S, Silk J, Abdellah M, Abdellah AH, Ruiz F, Cruz M, Piro M, Collado D, Garcia-Velasco JA, Requena A, Kollmann Z, Bersinger NA, McKinnon B, Schneider S, Mueller MD, von Wolff M, Vaucher A, Kollmann Z, Bersinger NA, Weiss B, Stute P, Marti U, von Wolff M, Chai J, Yeung WYT, Lee CYV, Li WHR, Ho PC, Ng HYE, Kim SM, Kim SH, Jee BC, Ku S, Suh CS, Choi YM, Kim JG, Moon SY, Lee JH, Kim SG, Kim YY, Kim HJ, Lee KH, Park IH, Sun HG, Hwang YI, Sung NY, Choi MH, Cha SH, Park CW, Kim JY, Yang KM, Song IO, Koong MK, Kang IS, Kim HO, Haines C, Wong WY, Kong WS, Cheung LP, Choy TK, Leung PC, Fadini R, Coticchio G, Renzini MM, Guglielmo MC, Brambillasca F, Hourvitz A, Albertini DF, Novara P, Merola M, Dal Canto M, Iza JAA, DePablo JL, Anarte C, Domingo A, Abanto E, Barrenetxea G, Kato R, Kawachiya S, Bodri D, Kondo M, Matsumoto T, Maldonado LGL, Setti AS, Braga DPAF, Iaconelli A, Borges E, Iaconelli C, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Kitaya K, Taguchi S, Funabiki M, Tada Y, Hayashi T, Nakamura Y, Snajderova M, Zemkova D, Lanska V, Teslik L, Calonge RN, Ortega L, Garcia A, Cortes S, Guijarro A, Peregrin PC, Bellavia M, Pesant MH, Wirthner D, Portman L, de Ziegler D, Wunder D, Chen X, Chen SHL, Liu YD, Tao T, Xu LJ, Tian XL, Ye DSH, He YX, Carby A, Barsoum E, El-Shawarby S, Trew G, Lavery S, Mishieva N, Barkalina N, Korneeva I, Ivanets T, Abubakirov A, Chavoshinejad R, Hartshorne GM, Marei W, Fouladi-nashta AA, Kyrkou G, Trakakis E, Chrelias CH, Alexiou E, Lykeridou K, Mastorakos G, Bersinger N, Kollmann Z, Mueller MD, Vaucher A, von Wolff M, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Pellicer A, Turienzo A, Lledo B, Guerrero J, Ortiz JA, Morales R, Ten J, Llacer J, Bernabeu R, De Leo V, Focarelli R, Capaldo A, Stendardi A, Gambera L, Marca AL, Piomboni P, Kim JJ, Choi YM, Kang JH, Hwang KR, Chae SJ, Kim SM, Yoon SH, Ku SY, Kim SH, Kim JG, Moon SY, Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM, Lee HJ, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Barad DH, Gleicher NN, Shavit T, Shalom-Paz E, Fainaru O, Michaeli M, Kartchovsky E, Ellenbogen A, Gerris J, Vandekerckhove F, Delvigne A, Dhont N, Madoc B, Neyskens J, Buyle M, Vansteenkiste E, De Schepper E, Pil L, Van Keirsbilck N, Verpoest W, Debacquer D, Annemans L, De Sutter P, Von Wolff M, Kollmann Z, Vaucher A, Weiss B, Bersinger NA, Verit FF, Keskin S, Sargin AK, Karahuseyinoglu S, Yucel O, Yalcinkaya S, Comninos AN, Jayasena CN, Nijher GMK, Abbara A, De Silva A, Veldhuis JD, Ratnasabapathy R, Izzi-Engbeaya C, Lim A, Patel DA, Ghatei MA, Bloom SR, Dhillo WS, Colodron M, Guillen JJ, Garcia D, Coll O, Vassena R, Vernaeve V, Pazoki H, Bolouri G, Farokhi F, Azarbayjani MA, Alebic MS, Stojanovic N, Abali R, Yuksel A, Aktas C, Celik C, Guzel S, Erfan G, Sahin O, Zhongying H, Shangwei L, Qianhong M, Wei F, Lei L, Zhun X, Yan W, Vandekerckhove F, De Baerdemaeker A, Gerris J, Tilleman K, Vansteelandt S, De Sutter P, Oliveira JBA, Baruffi RLR, Petersen CG, Mauri AL, Nascimento AM, Vagnini L, Ricci J, Cavagna M, Massaro FC, Pontes A, Franco JG, El-khayat W, Elsadek M, Foroozanfard F, Saberi H, Moravvegi A, Kazemi M, Gidoni YS, Raziel A, Friedler S, Strassburger D, Hadari D, Kasterstein E, Ben-Ami I, Komarovsky D, Maslansky B, Bern O, Ron-El R, Izquierdo MP, Ten J, Guerrero J, Araico F, Llacer J, Bernabeu R, Somova O, Feskov O, Feskova I, Bezpechnaya I, Zhylkova I, Tishchenko O, Oguic SK, Baldani DP, Skrgatic L, Simunic V, Vrcic H, Rogic D, Juras J, Goldstein MS, Garcia De Miguel L, Campo MC, Gurria A, Alonso J, Serrano A, Marban E, Peregrin PC, Hourvitz A, Shalev L, Yung Y, Yerushalmi G, Giovanni C, Dal Canto M, Fadini R, Has J, Maman E, Monterde M, Gomez R, Marzal A, Vega O, Rubio JM, Diaz-Garcia C, Pellicer A, Eapen A, Datta A, Kurinchi-selvan A, Birch H, Lockwood GM, Ornek MC, Ates U, Usta T, Goksedef CP, Bruszczynska A, Glowacka J, Kunicki M, Jakiel G, Wasniewski T, Jaguszewska K, Liss J, Lukaszuk K, Oehninger S, Nelson S, Verweij P, Stegmann B, Ando H, Takayanagi T, Minamoto H, Suzuki N, Maman E, Rubinshtein N, Yung Y, Shalev L, Yerushalmi G, Hourvitz A, Saltek S, Demir B, Dilbaz B, Demirtas C, Kutteh W, Shapiro B, Witjes H, Gordon K, Lauritsen MP, Loft A, Pinborg A, Freiesleben NL, Mikkelsen AL, Bjerge MR, Andersen AN, Chakraborty P, Goswami SK, Chakravarty BN, Mittal M, Bajoria R, Narvekar N, Chatterjee R, Bentzen JG, Johannsen TH, Scheike T, Andersen AN, Friis-Hansen L, Sunkara S, Coomarasamy A, Faris R, Braude P, Khalaf Y, Makedos A, Kolibianakis EM, Venetis CA, Masouridou S, Chatzimeletiou K, Zepiridis L, Mitsoli A, Lainas G, Sfontouris I, Tzamtzoglou A, Kyrou D, Lainas T, Tarlatzis BC, Fermin A, Crisol L, Exposito A, Prieto B, Mendoza R, Matorras R, Louwers Y, Lao O, Kayser M, Palumbo A, Sanabria V, Rouleau JP, Puopolo M, Hernandez MJ, Diaz-Garcia C, Monterde M, Marzal A, Vega O, Rubio JM, Gomez R, Pellicer A, Ozturk S, Sozen B, Yaba-Ucar A, Mutlu D, Demir N, Olsson H, Sandstrom R, Grundemar L, Papaleo E, Corti L, Rabellotti E, Vanni VS, Potenza M, Molgora M, Vigano P, Candiani M, Andersen AN, Fernandez-Sanchez M, Bosch E, Visnova H, Barri P, Garcia-Velasco JA, De Sutter P, Fauser BJCM, Arce JC, Sandstrom R, Olsson H, Grundemar L, Peluso P, Trevisan CM, Cordts EB, Cavalcanti V, Christofolini DM, Fonseca FA, Barbosa CP, Bianco B, Bakas P, Vlahos N, Hassiakos D, Tzanakaki D, Gregoriou O, Liapis A, Creatsas G, Adda-Herzog E, Steffann J, Sebag-Peyrelevade S, Poulain M, Benachi A, Fanchin R, Gordon K, Zhang D, Andersen AN, Aybar F, Temel S, Kahraman S, Hamdine O, Macklon NS, Eijkemans MJC, Laven JS, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom CAG, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Broekmans FJ, Bhattacharya J, Mitra A, Dutta GB, Kundu A, Bhattacharya M, Kundu S, Pigny P, Dassonneville A, Catteau-Jonard S, Decanter C, Dewailly D, Pouly J, Olivennes F, Massin N, Celle M, Caizergues N, Fleming R, Gaudoin M, Messow M, McConnachie A, Nelson SM, Dewailly D, Vanhove L, Peigne M, Thomas P, Robin G, Catteau-Jonard S. Reproductive endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Polyzos N, Karanikas H, Thireos E, Kastanioti C, Kontodimopoulos N. Reforming reimbursement of public hospitals in Greece during the economic crisis: Implementation of a DRG system. Health Policy 2012; 109:14-22. [PMID: 23062311 DOI: 10.1016/j.healthpol.2012.09.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 09/18/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Until recently, in-patient NHS hospital care in Greece was reimbursed via an anachronistic and under-priced retrospective per diem system, which has been held primarily responsible for continuous budget deficits. The purpose of this paper is to present the efforts of the Ministry of Health (MoH) to implement a new DRG-based payment system. METHODS As in many countries, the decision was to adopt a patient classification from abroad and to refine it for use in Greece with national data. Pricing was achieved with a combination of activity-based costing with data from selected Greek hospitals, and "imported" cost weights. Data collection, IT support and monitoring are provided via ESY.net, a web-based facility developed and implemented by the MoH. RESULTS After an initial pilot testing of the classification in 20 hospitals, complete DRG reimbursement data was reported by 113 hospitals (85% of total) for the fourth quarter of 2011. The recorded monthly increase in patient discharges billed with the new system and in revenue implies increasing adaptability by the hospitals. However, the unfavorable inlier vs. outlier distribution of discharges and revenue observed in some health regions signifies the need for corrective actions. CONCLUSIONS The importance of this reimbursement reform is discussed in light of the current crisis faced by the Greek economy. There is yet much to be done and many projects are currently in progress to support this effort; however the first cost containment results are encouraging.
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Affiliation(s)
- Nikolaos Polyzos
- Department of Social Management, Democritus University of Thrace, Komotini, Greece
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Polyzos N. A three-year Performance Evaluation of the NHS Hospitals in Greece. Hippokratia 2012; 16:350-355. [PMID: 23935316 PMCID: PMC3738611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The purpose of this study was to access the performance of 117 Greek National Health System (NHS) hospitals for the year 2011, to compare the findings with the results from similar studies of the previous years (2009 and 2010) and to investigate the changes during the last three years of financial crisis. METHOD An input-oriented Data Envelopment Analysis was used to measure three indicators, technical, pure technical and scale efficiency indicators. Data was collected from the reports of the web-based facility (ESY.net) which was developed by the General Secretary of Ministry of Health and Social Solidarity. The input variables were the number of physicians, the number of nurses and other personnel, the number of beds and expenditures of every hospital. The output variables were the number of inpatient and outpatient visits. Hospitals were categorized into three size groups. RESULTS Between the years 2009-2011, all hospitals, especially middle-sized hospitals showed performance improvement on all three indicators. Specific problems were noticed mainly in large-sized hospitals. The technical efficiency of Large-sized hospitals was estimated at 80%, of Middle-sized hospitals at 82% and of Small hospitals-Health Care Centres at 89%. Pure technical and scale efficiency varied between satisfactory levels throughout the study period. CONCLUSION Comparing the 2009-2011 data, an improvement of technical efficiency in NHS hospitals has been achieved up to 100%, mainly in the middle-sized hospitals. Specifically, an increase of best practice hospitals has been noted, especially in the middle and small-sized hospitals, when certain units were added the technical efficiency reached over 80%. The consequences of the spending-cuts and the constant reforms appear to have a positive effect on hospitals' efficiency.
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Affiliation(s)
- N Polyzos
- Department of Social Administration, Democritus University of Thrace, Komotini, Greece
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Anifandis G, Dafopoulos K, Messini CI, Polyzos N, Messinis IE. The BMI of men and not sperm parameters impact on embryo quality and the IVF outcome. Andrology 2012; 1:85-9. [PMID: 23258634 DOI: 10.1111/j.2047-2927.2012.00012.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 08/02/2012] [Accepted: 08/06/2012] [Indexed: 11/29/2022]
Abstract
It has been reported that increased body mass index (BMI) of men influences fecundity but it is not clear if it impacts on sperm parameters. Whether or not BMI of men influence sperm parameters and subsequently in vitro fertilization (IVF) result remains to be clarified. The aim of the present study was primarily to investigate the relationship between the BMI of men and sperm parameters (volume, concentration and motility) and whether or not it impacts on embryo quality and IVF outcome. Secondly, to investigate the impact of BMI of both men and women, in combination with their age, on IVF result. Three hundred and one couples were categorized according to their BMI. Group 1 (n = 64, both men and women had BMI l ≤ 25 kg/m(2) ), group 2 (n = 79, both men and women had BMI > 25 kg/m(2) ), group 3 (n = 142, men had BMI > 25 kg/m(2) and their wives had BMI ≤ 25 kg/m(2) ) and group 4 (n = 16, men had BMI ≤ 25 kg/m(2) and their wives had BMI > 25 kg/m(2) ). Overall (n = 301) BMI and age of men did not correlate with sperm parameters. Group 1 and group 4, regardless of the BMI of their women, demonstrated the highest quality of embryos and consequently the highest percentage of pregnancy. Furthermore, the score of the combination of both BMI and age of both men and women resulted in a threshold level of less than 800 with a relative high per cent of pregnancy. BMI of men does not correlate with sperm parameters, but influences the quality of produced embryos in such a way that impacts on pregnancy rate.
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Affiliation(s)
- G Anifandis
- Department of Obstetrics and Gynaecology, University of Thessalia, Medical School of Larisa, Larisa, Greece.
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Dervenis C, Kastanioti C, Polyzos N. Restructuring the Finances of the Greek Health Care System in the Era of Economic Crisis. World J Surg 2012; 37:707-9. [DOI: 10.1007/s00268-012-1755-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kastanioti C, Kontodimopoulos N, Stasinopoulos D, Kapetaneas N, Polyzos N. Public procurement of health technologies in Greece in an era of economic crisis. Health Policy 2012; 109:7-13. [PMID: 22502936 DOI: 10.1016/j.healthpol.2012.03.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 03/18/2012] [Accepted: 03/19/2012] [Indexed: 11/17/2022]
Abstract
Public procurement is generally an important sector of the economy and, in most countries, is controlled by the introduction of regulatory and policy mechanisms. In the Greek healthcare sector, recent legislation redefined centralized procurement through the reestablishment of a state Health Procurement Committee (EPY), with an aim to formulate a plan to reduce procurement costs of medical devices and pharmaceuticals, improve payment time, make uniform medical requests, transfer redundant materials from one hospital to another and improve management of expired products. The efforts described in this paper began in early 2010, under the co-ordination of the Ministry of Health (MoH) and with the collaboration of senior staff from the International Monetary Fund (IMF), the European Commission (EC) and the European Central Bank (ECB). The procurement practices and policies set forth by EPY and the first measurable outcomes, in terms of cost savings, resulting from these policies are presented. The importance of these measures is discussed in light of the worst economic crisis faced by Greece since the restoration of democracy in 1974, as a result of both the world financial crisis and uncontrolled government spending.
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Affiliation(s)
- Catherine Kastanioti
- Health Procurement Committee (EPY), Ministry of Health and Social Solidarity, Athens, Greece
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Kamijo T, Milart P, Wojcik K, Szkodziak P, Wozniak S, Czuczwar P, Paszkowski T, Landolsi H, Yacoubi MT, Stita W, Gribaa M, Hmissa S, Molenaar N, van Besouw NH, Steegers EAP, Visser W, de Kuiper P, de Krijger R, Exalto N, Lagrand R, Kaandorp SP, Mellink CHM, van Wely M, Redeker EJW, Knegt AC, Goddijn M, Vidal C, Giles J, Meseguer M, Zuzuarregui JL, Bosch E, Pellicer A, Schust D, Sugimoto M, Sugimoto J, Reus AD, Stephenson MD, Steegers EAP, Krijger de RR, Dunne van FM, Exalto N, Exacoustos C, Vaquero E, Di Giovanni A, Romeo V, Lazzarin N, Arduini D, Brahem S, Mehdi M, Atig F, Ghedir H, Ibala S, Ajina M, Saad A, Chang C, Wang H, Huang S, Pai S, Soong Y, Papanikolaou E, Pantos G, Grimbizis G, Bili E, Polyzos N, Karastefanou K, Humaidan P, Esteves S, Tarlatzis B, McNamee K, Topping A, Farquharson RG, Dawood F, Ruiz Galdon M, Lendinez AM, Palomares AR, Martinez F, Perez-Nevot B, Jimenez Fernandez A, Reyes-Engel A, Horcajadas JA, Savaris RF, Kovac V, Reljic M, Vlaisavljevic V, Colicchia A, Pergolini I, Gilio B, Rampini MR, Alfano P, Marconi D, Verlengia C, Alviggi E, Bellver J, Cruz F, Martinez MC, Ramirez J, Ferro J, Garrido N, Brown JK, Lauer KB, Inglis NF, Critchley HOD, Horne AW, Samli H, Cetinkaya Demir B, Ozgoz A, Atalay MA, Uncu G, Yan Y, Cai-hong MA, Jie QIAO, Xin-na CHEN, Weimar CHE, Kavelaars A, Gellersen B, Brosens JJ, de Vreeden-Elbertse JMT, Heijnen CJ, Macklon NS, Castillo JC, Dolz M, Caballero O, Abad L, Perez-Panades J, Bonilla-Musoles F, Eggert - Kruse W, Scholz S, Klopsch I, Strowitzki T. POSTER VIEWING SESSION - EARLY PREGNANCY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yarde F, Oudendijk JF, Broekmans FJ, Broer SL, Setti AS, Braga DPAF, Figueira RCS, Pasqualotto FF, Iaconelli Jr. A, Borges Jr. E, Rittenberg V, Seshadri S, Sunkara S, Sobaleva S, Oteng-Ntim E, El-Toukhy T, Peeraer K, Debrock S, De Legher C, Laenen A, De Neubourg D, De Loecker P, Spiessens C, D'Hooghe TM, Ochalski M, Wakim K, Wakim A, Nyboe Andersen A, Pellicer A, Devroey P, Arce JC, Blockeel C, Polyzos N, Ermini B, Riva A, Stoop D, Tournaye H, Devroey P. SELECTED ORAL COMMUNICATION SESSION, SESSION 72: FEMALE FERTILITY AND ART Wednesday 6 July 201114:00 - 15:45. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tang AW, Alfirevic Z, Turner MA, Drury J, Topping J, Dawood F, Farquharson R, Quenby S, Adam K, Entwisle M, O'Toole K, Bhima G, Palep-Singh M, Edi-Osagie E, Abediasl Z, Moini M, Jansen E, Stoop D, Ermini B, Haentjens P, De Vos M, Polyzos N, Verheyen G, Devroey P, Cabar FR, P. Pereira P, Francisco RP, Zugaib M, Horiuchi R, Miyaji S, Haruki A, Fukuda A, Morimoto Y. SELECTED ORAL COMMUNICATION SESSION, SESSION 34: EARLY PREGNANCY LOSS PROGNOSIS AND TREATMENT, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vassena R, Boue S, Gozalez-Roca E, Aran B, Auer H, Veiga A, Izpisua Belmonte JC, Ermini B, Stoop D, Haentjens P, De Vos M, Polyzos N, Verheyen G, Devroey P, Montag M, Ebner T, Xanthopoulou L, Mantzouratou A, Mania A, Ghevaria H, Ghebo C, Serhal P, Delhanty JDA, Martikainen H, Niinimaki M, Suikkari AM, Hiraoka K, Tamaki T, Matsumura Y, Kiriake C, Uto H, Yoshida H, Kitamura S, Monzo C, Assou S, Haouzi D, Bruno C, Dechaud H, Hamamah S. SELECTED ORAL COMMUNICATION SESSION, SESSION 68: EMBRYOLOGY - THE OOCYTE Wednesday 6 July 2011 14:00 - 15:45. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Papanikolaou E, Humaidan P, Polyzos N, Tarlatzis B. Identification of the High-Risk Patient for Ovarian Hyperstimulation Syndrome. Semin Reprod Med 2010; 28:458-62. [DOI: 10.1055/s-0030-1265671] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
An examination of Greece's experience with health care reform planning over the past half century reveals a remarkable consistency in reform themes pursued by planners. However, few of the plans resulted in legislation, and of the legislation that was passed even fewer were implemented. The present paper traces out reform plans since the early 1950s and argues that legislative and implementation failures have been due to a lack of political will, insufficient attention to consensus-forming mechanisms, and inadequate consideration of the technical, administrative, and institutional feasibility of reform plans. By contrast, developments in the 1990s, which have seen three pieces of health care reform legislation, suggest that processes of health care planning and change are becoming more focused, rational and pragmatic. Macroeconomic constraints, and consensus on broader economic policies focusing on the EU convergence requirements have produced a consensus regarding the imperative of change in the health sector, and have given rise to mechanisms which facilitate the task of implementation. The most recent health care reform act (of 17 July 1997) is less radical than many of its predecessors, but includes issues that had entered the health care reform agenda as early as 1952, as well as the more current issues of health care reform agenda as early as 1952, as well as the more current issues of health sector rationalization. Implementation of the most recent legislative act has already begun.
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Affiliation(s)
- E Tragakes
- WHO, Regional Office for Europe, Athens, Greece
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