Trametes species represents a rich source of nutritive compounds with important pharmacological properties like antioxidant, antiinflammatory and anti-cancer properties. However, factors like genetic background, harvesting period, geographic location, climatic conditions and others are influencing the biosynthesis of bioactive compounds, their fingerprint and their concentration. The aim of this study was to determine the antioxidant capacity, total phenolic compounds and total flavonoids content of two mushroom species, namely Tramestes versicolor (TV) and Trametes gibbosa (TG), mushrooms with potential health benefits, harvested from north-west part of Romania. In order to determine the phenolic compounds profile, water, methanol, and acetone mushroom extracts were analyzed using UV-Vis spectroscopy, FTIR spectroscopy and LC-MS analysis. In total 28 compounds were tentatively identified as phenolic acids (11 compounds), flavonols (6 compounds), flavones (6 compounds), coumarins (2 compounds), flavanols, isoflavonoids and biflavonoids (1 compound). The highest antioxidant activity was determined for the methanolic extract while the highest total polyphenols content and total flavonoids content were determined for the water extract. The results obtained suggested that Trametes species can be considered important sources of bioactive compounds, their phenolics composition and content being influenced by a series of factors like geographic area origin and genetic background.
Introduction Telemedicine has emerged as a critical technology to mitigate SARS-CoV-2 infection. We aim in this work to explore how general practitioners (GPs) perceived the use of telemedicine, recently recognized and reimbursed by the Public Health Insurance House (PHIH) for primary care (PC) provision. Methods A cross-sectional study was performed in 2020 in one county of Romania using an anonymous questionnaire that assessed physicians’ perceptions regarding teleconsultation, reliability in tele-decision, remote pathology management, pregnant women’s surveillance, patients’ satisfaction with telemedicine, the need for its further reimbursement. Bivariate correlation was used to measure associations between the investigated issues. Results More than a quarter of GPs (28.6%) found it easier to address patients’ healthcare needs remotely, while 60.7% considered time-consuming teleconsultations compared to face-to-face visits. Tele-diagnostic uncertainty was expressed by 64.3% of physicians, and a quarter were confident in tele-decisions. Almost half of GPs (43%) observed patients’ satisfaction with tele-visits, while half said patients encountered difficulties using technology. A large percentage of doctors (62.5%) perceived that patients felt as well treated by virtual as in-person visit and 91.1% suggested post-pandemic reimbursement. The results of the bivariate correlation showed that physicians who perceived positive patient feedback on telemedicine were more supportive of subsequent reimbursement. Conclusion This study showed the GPs’ positive perception of the use of telemedicine. Its adoption in PC has shed light on the shadows of the pandemic. The time-consuming nature of teleconsultations, uncertainty in tele-decisions, patients’ difficulties in using technology were seen as shadows of telecare. However, most of the GPs surveyed agreed with the need for further reimbursement. Future work should focus on innovative solutions for integrating telemedicine as complementary form of PC, the need for telemedicine-based training for GPs to improve capacity building, and patients’ perceptions of virtual care, helping to build trust and satisfaction.
ObjectivesCancer survival rates vary widely between European countries, with differences in timeliness of diagnosis thought to be one key reason. There is little evidence on the way in which different healthcare systems influence primary care practitioners’ (PCPs) referral decisions in patients who could have cancer.This study aimed to explore PCPs’ diagnostic actions (whether or not they perform a key diagnostic test and/or refer to a specialist) in patients with symptoms that could be due to cancer and how they vary across European countries.DesignA primary care survey. PCPs were given vignettes describing patients with symptoms that could indicate cancer and asked how they would manage these patients. The likelihood of taking immediate diagnostic action (a diagnostic test and/or referral) in the different participating countries was analysed. Comparisons between the likelihood of taking immediate diagnostic action and physician characteristics were calculated.SettingCentres in 20 European countries with widely varying cancer survival rates.ParticipantsA total of 2086 PCPs answered the survey question, with a median of 72 PCPs per country.ResultsPCPs’ likelihood of immediate diagnostic action at the first consultation varied from 50% to 82% between countries. PCPs who were more experienced were more likely to take immediate diagnostic action than their peers.ConclusionWhen given vignettes of patients with a low but significant possibility of cancer, more than half of PCPs across Europe would take diagnostic action, most often by ordering diagnostic tests. However, there are substantial between-country variations.
Pancreatico-duodenal artery aneurysm (PDAA) associated with stenosis or occlusion of the celiac trunk is a rare condition. Furthermore, PDAAs associated with stenosis of the superior mesenteric artery (SMA) are even more uncommon, with only six cases reported in the literature. We report a case of a 61-year old male patient who presented with hematemesis, haematochezia and haemorrhagic shock. The upper gastrointestinal endoscopy revealed an ulcerous lesion at the third portion of the duodenum, without achieving the haemostasis. The emergency laparotomy (suture of the lesion and gastro-entero-anastomosis) permitted temporary haemostasis. Computed tomography angiography identified the PDAA ruptured into the third portion of the duodenum and the SMA stenosis at its origin; a dense network of collateral vessels was present. The patient was successfully managed with coil embolization. Short and mid-term follow-up were without incidents.
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