Hypoglycemic Drugs in Patients with Diabetes Mellitus and Heart Failure: A Narrative Review.

Over the last few years, given the increase in the incidence and prevalence of both type 2 diabetes mellitus (T2DM) and heart failure (HF), it became crucial to develop guidelines for the optimal preventive and treatment strategies for individuals facing these coexisting conditions. In patients aged over 65, HF hospitalization stands out as the predominant reason for hospital admissions, with their prognosis being associated with the presence or absence of T2DM. Historically, certain classes of glucose-lowering drugs, such as thiazolidinediones (rosiglitazone), raised concerns due to an observed increased risk of myocardial infarction (MI) and cardiovascular (CV)-related mortality. In response to these concerns, regulatory agencies started requiring CV outcome trials for all novel antidiabetic agents [i.e., dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose cotransporter-2 inhibitors (SGLT2is)] with the aim to assess the CV safety of these drugs beyond glycemic control. This narrative review aims to address the current knowledge about the impact of glucose-lowering agents used in T2DM on HF prevention, prognosis, and outcome.

Factors affecting public transport performance due to the COVID-19 outbreak: A worldwide analysis.

In this paper we investigate the public transport trip frequency variations, as well as the reasons that led to the shift away from public transport means, due to the COVID-19 pandemic. We studied relevant data from the Moovit platform, and we compared operational and trip frequency characteristics of public transport systems before and after the outbreak of the pandemic in 87 cities worldwide. On average, waiting times at public transport stops/stations increased while trip distances decreased, apparently due to the mobility restriction and social distancing measures implemented in 2020. Most of the Moovit users who said that they abandoned public transport in 2020 were found in Italy and Greece. We developed linear regression analysis models to investigate (among the 35 variables examined in the study) the relationship between public transport abandonment rates and socioeconomic factors, quality of service characteristics, and indicators of pandemic's spread. Empirical findings show that public transport dropout rates are positively correlated with the COVID-19 death toll figures, the cleanliness of public transport vehicles and facilities, as well as with the income inequality (GINI) index of the population, and thus reconfirm previous research findings. In addition, the waiting time at stops/stations and the number of transfers required for commute trips appeared to be the most critical public transport trip segments, which significantly determine the discontinuation of public transport use under pandemic circumstances. Our research findings indicate specific aspects of public transport services, which require tailored adjustments in order to recover ridership in the post-pandemic period.

MBL deficiency-causing B allele (rs1800450) as a risk factor for severe COVID-19.

The COVID-19 pandemic represents one of the greatest challenges in modern medicine. The disease is characterized by a variable clinical phenotype, ranging from asymptomatic carriage to severe and/or critical disease, which bears poor prognosis and outcome because of the development of severe acute respiratory distress syndrome (SARS) requiring ICU hospitalization, multi-organ failure and death. Therefore, the determination of risk factors predisposing to disease phenotype is of outmost importance. The aim of our study was to evaluate which predisposing factors, including MBL2 genotyping, affected clinical phenotype in 264 COVID-19 patients. We demonstrated that older age along with underlying comorbidities, primarily obesity, chronic inflammatory disorders and diabetes mellitus, represent the most important risk factors related to hospitalization, the development of pneumonia and SARS. Moreover, we found that the presence of the MBL deficiency-causing B allele (rs1800450) was significantly associated with almost 2-fold increased risk for developing pneumonia and requiring hospitalization, suggesting its usage as a molecular predictor of severe disease in SARS-CoV-2 infected individuals.

Efficacy of polydimethylsiloxane against Culex pipiens (Diptera: Culicidae).

We evaluated, under controlled laboratory conditions, the insecticidal activity of polydimethylsiloxane (PDMS) for the control of the house mosquito, Culex pipiens. In a first series of bioassays, we tested the residual effect of different PDMS doses to control 3rd instar larvae. The label dose caused high mortality rates (>80%) even after 50 days from the initial application. Mortality levels at half the label dose were significantly higher compared to control, during the entire experimental period following a gradual decrease over time. Similar trends were observed when the 1/4 and the 1/8 of the label dose were applied with a much steeper decrease at long time intervals since the initial application especially for the lowest dose. However, after the 10th day of the bioassays and until the end of the experiments, mortality rates in the case of the label dose were higher compared to all other doses after the initial 10 days post application. Conversely, the insecticidal efficacy of PDMS against pupae was generally lower in comparison with larvae. Indeed, 10 days after the application, mortality was notably reduced, regardless of the dose rate tested. In a second series of bioassays, we assessed the efficacy of short exposures of different instars of larvae and nymphs to registered formulation and label dose. Mortality was well over 95% for 2nd instar larvae at exposure intervals ranging from 1 to 4 days. Significant mortality was recorded to 3rd instar larvae even at 15 min of exposure. Exposures longer than 30 min caused high mortality rates to 3rd instar larvae. Similar results were also recorded in pupae. Finally, in a third series of bioassays, the efficacy of PDMS in egg hatch was tested. Egg hatch was completely suppressed in the treated substrate (all egg rafts were "sinking" at the bottom of the test cups). Moreover, there was no oviposition in the case of the application of the label dose, while some egg rafts were recorded at one-eighth of the label dose. In both cases, it was recorded that PDMS acts as an oviposition deterrent. Τhe results of this study show that PDMS is effective in a wide range of conditions and application scenarios.

COVID-19 lockdown measures and travel behavior: The case of Thessaloniki, Greece.

In this paper, we investigate the travel behavior changes in Thessaloniki, Greece aiming to understand them and explore the factors that affect them under the COVID-19 mobility restriction measures. Socioeconomic and mobility data from two questionnaire surveys, one year before and during the COVID-19 lockdown of April 2020 (with 1462 and 196 responses respectively), were compared by utilizing a wide variety of inductive statistical tests. Ordinary Least-Squares regression models and Cox proportional hazards duration models were employed to explore any concurrent socioeconomic effect on travel behavior patterns. Results showed that the number of daily trips per person was on average decreased by 50% during the lockdown. This decrease was much greater for the non-commuting trips. Trips on foot were increased, private car was mainly used for commuting and public transport modal shares were heavily reduced. Trip durations were generally increased, as travelling was considered a recreational activity per se. The starting times of the first trips of the day were more evenly distributed throughout the day and many travelers only started their first trips late in the afternoon. Older travelers generally maintained their mobility behavior patterns despite their higher vulnerability to COVID-19 disease. Lower-income travelers were likely to make more daily trips. Male travelers tended to make higher-duration trips compared to their female counterparts. Since pandemics may become recurring events in the future, our findings provide for a better understanding of their influence on mobility and support the design of customized policies to fulfill sustainable mobility objectives during lockdown circumstances.

Mapping travel behavior changes during the COVID-19 lock-down: a socioeconomic analysis in Greece.

Background: COVID-19 pandemic is a challenge that the world had never encountered in the last 100 years. In order to mitigate its negative effects, governments worldwide took action by prohibiting at first certain activities and in some cases by a countrywide lockdown. Greece was among the countries that were struck by the pandemic. Governmental authorities took action in limiting the spread of the pandemic through a series of countermeasures, which built up to a countrywide lockdown that lasted 42 days. Methodology: This research aims at identifying the effect of certain socioeconomic factors on the travel behaviour of Greek citizens and at investigating whether any social groups were comparatively less privileged or suffered more from the lockdown. To this end, a dynamic online questionnaire survey on mobility characteristics was designed and distributed to Greek citizens during the lockdown period, which resulted in 1,259 valid responses. Collected data were analysed through descriptive and inferential statistical tests, in order to identify mobility patterns and correlations with certain socioeconomic characteristics. Additionally, a Generalised Linear Model (GLM) was developed in order to examine the potential influence of socioeconomic characteristics to trip frequency before and during the lockdown period. Results: Outcomes indicate a decisive decrease in trip frequencies due to the lockdown. Furthermore, the model's results indicate significant correlations between gender, income and trip frequencies during the lockdown, something that is not evident in the pre-pandemic era.

Colon Adenocarcinoma Associated with Synchronous Extramural Gastrointestinal Stromal Tumor (GIST) of the Ileum.

BACKGROUND: GISTs are mesenchymal tumors representing approximately 1% of all gastrointestinal neoplasia. Their concurrence with colorectal cancers is rare. CASE REPORT: We present a case of coexistence of colon adenocarcinoma and GIST of the ileum in a 68-year-old white woman. CONCLUSIONS: The coexistence of mesenchymal and epithelial neoplasia is very challenging; further research is needed to clarify the role of oncogenic mutations and signalling pathways in carcinogenesis of neoplasia of various histiogenic origins.

Intramuscular myxoma of the soleus muscle: A rare tumor in an unusual location.

PATIENT: Female, 52 FINAL DIAGNOSIS: Myxoma Symptoms: - MEDICATION: - Clinical Procedure: - Specialty: Oncology. OBJECTIVE: Challenging differential diagnosis. BACKGROUND: Intramuscular myxoma is a benign intramuscular neoplasm. However, sometimes it is difficult to distinguish it from soft-tissue sarcomas that underwent myxomatous degeneration. To the best of our knowledge, only 2 cases of intramuscular myxoma in the soleus muscle have been previously reported. CASE REPORT: We present the case of a 52-year-old Caucasian woman who was referred to our tertiary anticancer hospital for magnetic resonance imaging (MRI) diagnosis for suspicion of mesenchymal tumor. Percutaneous core biopsy revealed an intramuscular myxoma (IM). Despite the benign nature of the lesion, the patient desired that the tumor be removed. She underwent wide local excision. The final histopathologic diagnosis was IM. She is doing well 3 years after the operation. CONCLUSIONS: Percutaneous core biopsy is the procedure of choice for providing preoperative tissue diagnosis. The treatment of choice is wide local excision. IM does not usually recur after surgical removal.

Primary ileocaecal B-cell non-Hodgkin lymphoma (NHL): a rare underlying cause of right iliac fossa pain.

Primary gastrointestinal non-Hodgkin lymphomas (NHL) account for about 0.9% of all gastrointestinal tract tumours. They are usually associated with ulcerative colitis, Crohn's disease, previous radiotherapy, renal transplantation and AIDS. We present a 36-year-old immunocompetent man, previously well with abdominal pain, weight loss and palpable mass in the right iliac fossa. A CT scan of the abdomen showed a thickening of the terminal ileum and the caecum with characteristic aneurysmal luminal dilation. Given the patient's presentation and radiology findings, a right hemicolectomy was performed. The suspected diagnosis of NHL, which was based on the imaging findings, was confirmed at histological analysis.

Pigmented epithelioid melanocytoma: a new concept encompassing animal-type melanoma and epithelioid blue nevus.

Pigmented epithelioid melanocytoma (PEM) is a recently proposed term which encompasses those melanocytic tumours previously designated as 'animal-type melanoma' or 'pigment-synthesising melanoma' and 'epithelioid blue nevus', the latter known to be associated with Carney's complex. We report a case of PEM in a previously well 26-year-old Caucasian woman who presented with a dark pigmented nodule on the anterior chest wall.

Granular cell breast tumour mimicking infiltrating carcinoma.

Granular cell tumour (GCT) is a rare, usually benign neoplasm that can mimic carcinoma on breast imaging. GCT can originate anywhere in the body but is most frequently found in the head and neck region, particularly in the tongue. Of the reported cases, 6% have occurred in the breast, most commonly in the upper inner quadrant. We report a case of GCT of the breast presenting as a spiculated mass infiltrating the greater thoracic muscle on breast screening mammogram.

Implication of human papillomavirus-66 in vulvar carcinoma: a case report.

INTRODUCTION: Vulvar cancer in older women is seldom associated with human papillomavirus infection. CASE PRESENTATION: We present the case of an 80-year-old Greek Caucasian woman with an undetermined obstetric and gynecologic history. The patient underwent radical vulvectomy and bilateral inguinal lymphadenectomy for a vulvar carcinoma. A human papillomavirus infection was suggested on the basis of histological and cytological examinations followed by human papillomavirus DNA typing, which revealed the presence of human papillomavirus-66. CONCLUSION: Even though human papillomavirus-16 and human papillomavirus-18 are most frequently implicated in the pathogenesis of vulvar carcinoma, human papillomavirus-66 can also be regarded as a causative factor. Suspicious lesions should be biopsied, and in the presence of carcinoma, vulvectomy with bilateral lymphadenectomy, if necessary, must be performed. Furthermore, polymerase chain reaction assay analysis with clinical arrays in cytological samples is an accurate test for the detection of a wide range of human papillomavirus genotypes and can be used to verify the infection and specify the human papillomavirus type implicated.

Primary glomangiosarcoma of the lung: A case report.

BACKGROUND: Glomus tumor is an uncommon neoplasm derived from cells of the neuromyoarterial glomus or glomus body. Most glomus tumours occur in the dermis and subcutaneous tissues. A case of a primary pulmonary glomus tumour originating in the right upper lobe is presented. CASE PRESENTATION: A 74-yr-old male was admitted with siccus cough, dyspnea and right-sided chest pain. Computed tomography of the thorax revealed a 4 cm growth of the right upper lobe. Fiberoptic bronchoscopy demonstrated an endobronchial hypervascular mass causing obstruction of the apical segmental bronchus. Pathology report was consistent with pulmonary glomus tumor. The patient underwent a typical right upper lobectomy with mediastinal lymph node dissection. Twelve months later he is free of disease. CONCLUSION: Occasionally glomus tumors can occur in extracutaneous sites such as the gastrointestinal tract, bone, genitourinary system and respiratory tract. Primary pulmonary glomus tumors are very rare (our case is the 19th one presented in the international literature) and are often confused with other solid neoplasms such as carcinoids, hemangiopericytomas and tumors belonging to the family of Ewing's sarcoma/primitive neuroectodermal tumours.

Calcifying epithelial odontogenic tumour or Pindborg's tumour: features and behaviour in relation to a case.

The calcifying epithelial odontogenic tumour (CEOT) or Pindborg's tumour is a rare benign odontogenic neoplasm composed of epithelioid cells, amorphous amyloid-like substance and calcifications. Its clinical and radiographical pictures are not characteristic depending upon the site, size and developmental stages in a range of its composition degeneration. A case of calcifying epithelial odontogenic tumour in the mandible is presented and the main aspects of the research about this tumour, such as the pathogenesis, histological features, developmental stages, malignancy, recurrence rate, differential diagnosis and therapeutic aspects are discussed.