Atrial fibrillation (AF) is the most common arrhythmia with a high burden of morbidity including impaired quality of life and increased risk of thromboembolism. Early detection and management of AF could prevent thromboembolic events. Artificial intelligence (AI)--based methods in healthcare are developing quickly and can be proved as valuable for the detection of atrial fibrillation. In this metanalysis, we aim to review the diagnostic accuracy of AI-based methods for the diagnosis of atrial fibrillation. A predetermined search strategy was applied on four databases, the PubMed on 31 August 2022, the Google Scholar and Cochrane Library on 3 September 2022, and the Embase on 15 October 2022. The identified studies were screened by two independent investigators. Studies assessing the diagnostic accuracy of AI-based devices for the detection of AF in adults against a gold standard were selected. Qualitative and quantitative synthesis to calculate the pooled sensitivity and specificity was performed, and the QUADAS-2 tool was used for the risk of bias and applicability assessment. We screened 14,770 studies, from which 31 were eligible and included. All were diagnostic accuracy studies with case–control or cohort design. The main technologies used were: (a) photoplethysmography (PPG) with pooled sensitivity 95.1% and specificity 96.2%, and (b) single-lead ECG with pooled sensitivity 92.3% and specificity 96.2%. In the PPG group, 0% to 43.2% of the tracings could not be classified using the AI algorithm as AF or not, and in the single-lead ECG group, this figure fluctuated between 0% and 38%. Our analysis showed that AI-based methods for the diagnosis of atrial fibrillation have high sensitivity and specificity for the detection of AF. Further studies should examine whether utilization of these methods could improve clinical outcomes.
Background: The Pancreatic Stone Protein (PSP) is an acute-phase protein that is mainly secreted by pancreatic cells in response to stress. The current literature supports its use as a predictor of sepsis. Its prognostic role has recently been evaluated in a point-of-care setting, mostly in high-risk patients. We conducted a prospective observational cohort study to evaluate its utility in the prognosis of patients admitted to the hospital with a diagnosis of intra-abdominal infection. Methods: Adult patients consecutively admitted to the Internal Medicine Department of the University Hospital of Patras, Greece, with a diagnosis of intra-abdominal infection were enrolled. PSP levels were measured within 24 h of admission in whole blood. Results: a total of 40 patients were included after being diagnosed with IAI. PSP was used as an independent predictive factor for sepsis after adjusting for age with OR = 7.888 (95% CI: 1.247–49.890). PSP also predicted readmission and the need for treatment escalation (p: <0.01) and was an excellent prognostic factor regarding these outcomes (AUC = 0.899, 95% CI: 0.794–1.0, and AUC = 0.862, 95% CI: 0.748–0.976, respectively). PSP also proved superior to CRP, ferritin, and fibrinogen in sepsis diagnosis, treatment escalation, and readmission prediction with an AUC of 0.862, 0.698, and 0.899, respectively. Conclusions: PSP can predict unfavorable outcomes, such as sepsis development, readmission, and the need for treatment escalation among patients with intra-abdominal infections.
Aims and Objectives: the present study aimed to assess the knowledge and attitudes of medical and nursing students at the University of Patras, western Greece, regarding sexually transmitted infections (STIs), sexual behavior and STI prevention measures, as well as the level of future healthcare professionals’ education. Method: A descriptive, cross-sectional study was conducted. A total of 231 medical and nursing students (n = 106 medical, and n = 125 nursing) completed and returned the pre-tested study questionnaire. Results: Most participants (77.5%) were females and46.1% were in the age group of 18–21 years. Syphilis, HIV/AIDS, and Hepatitis B were regarded as STIs by 65.8% of them. Medical students could predominantly list the widely known STIs compared to nursing students (p = 0.004). Regarding HIV/AIDS, 72.7% of the respondents reported that it is transmitted sexually and through blood transfusion. However, medical students were better informed than nursing students (p = 0.001). Medical students as well as students in the final year of their studies were found to be better informed about the vaccines available to prevent STIs. Regarding the question about what constitutes a risky sexual behavior, 71.4% answered sexual intercourse without the use of condom and 18.6% indicated having sex with an unknown partner. Most participants (69.7%) were satisfied with the education provided by their institution and no statistically significant difference was observed between medical and nursing students. Almost all students (97.8%) agreed that the course/subject of sex education must be included in school programs. Conclusions: A comprehensive analysis of knowledge and attitudes of Greek medical and nursing students regarding STIs, prevention measures and education level was conducted. The results of the present study could assist in the development of targeted training courses that can improve healthcare professionals’ knowledge and ability to manage STIs.
Antibiotic resistance (ABR) and antimicrobial stewardship arethe two sides of the same coin that constitute a public health hydra. This study aimed to assessthe knowledge and attitude of healthcare workers (HCWs), on antibiotic use and antimicrobial resistance in Western Greece. A total of 200 healthcare workers (doctors, nurses, and others) from the two largest tertiary hospitals in Western Greece were included in our survey. HCWs seem not to decide based on patient opinion in order to prescribe antibiotics. Approximately 97% of them are aware of their main adverse effects. Remarkably, 25% of respondents prescribe antibiotics due to diagnostic uncertainty, and 32.5% of them prescribe antibiotics based on their experience. HCWs statedthat they do not report adverse effects often. Inappropriate antibiotic prescriptions were mentioned as the main reason for bacterial resistance to antimicrobials. Monitoring the patient’s treatment progress, using electronic prescriptions, and adhering to international guidelines were suggested as solutions to the problem. Post Hoc analysis showed that nursing staff apply to the national guidelines (p: 0.011) and use electronic prescriptions (p: 0.003) less often compared to consultants, doctor directors, and trainees. The findings of our survey may be useful for the development of future national education programs and interventions thatmay improve healthcare workers’ knowledge and ability to manage antibiotics.
Pancreatic stone protein (PSP) is an acute-phase reactant mainly produced in response to stress. Its diagnostic and prognostic accuracy for several types of infection has been studied in several clinical settings. The aim of the current review was to assess all studies examining a possible connection of pancreatic stone protein levels with the severity and possible complications of patients diagnosed with infection. We performed a systematic search in PubMed, Scopus, the Cochrane Library and Clinicaltrials.gov to identify original clinical studies assessing the role of pancreatic stone protein in the diagnosis and prognosis of infectious diseases. We identified 22 eligible studies. Ten of them provided diagnostic aspects, ten studies provided prognostic aspects, and another two studies provided both diagnostic and prognostic information. The majority of the studies were performed in an intensive care unit (ICU) setting, five studies were on patients who visited the emergency department (ED), and three studies were on burn-injury patients. According to the literature, pancreatic stone protein has been utilized in patients with different sites of infection, including pneumonia, soft tissue infections, intra-abdominal infections, urinary tract infections, and sepsis. In conclusion, PSP appears to be a useful point-of-care biomarker for the ED and ICU due to its ability to recognize bacterial infections and sepsis early. Further studies are required to examine PSP’s kinetics and utility in specific populations and conditions.