The laboratory diagnosis of infections is based on pathogen identification and antimicrobial susceptibility determination. The gold standard of cultivation, isolation and susceptibility testing is a time-consuming procedure and in some cases this can be threatening for patients' outcome. In the current review the applications of mass spectrometry in pathogen identification and especially in detecting biomarkers of antimicrobial resistance are analyzed. MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight) mass spectrometry is a new technology that has revolutionized pathogen identification and has also proven to accelerate detection of antimicrobial resistance compared to the traditional antibiotic susceptibility tests (AST) as well as DNA amplification methodologies. The technology has incorporated up to know four different methodologies: (I) the detection of differences of mass spectra of susceptible and resistant isolates of a given microorganism using the classical strain typing methodology; (II) the analysis of bacterial induced hydrolysis of β-lactam antibiotics; (III) the detection of stable (non-radioactive) isotope-labeled amino acids; and (IV) the analysis of bacterial growth in the presence and absence of antibiotics using an internal standard. The implementation of MALDI-TOF methodologies has improved detection of resistance in aerobic, Gram-positive and Gram-negative bacteria, mycobacteria, anaerobic bacteria, fungi and viruses. The MALDI-TOF is an easy to use, rapid, reliable, economical, and environmentally friendly methodology. However, this technology needs further development of research protocols that will be validated for routine application.

In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx—taking the global scale into account—might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called ‘refugee crisis’, we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees—that is, both the new and old population groups that are already residing in Europe—in the respective national health systems.

The greater muscle Na+ deficiency with higher than lower Na+ consumption shows that the risk of greater muscle Na+ deficiency is directly related to Na+ consumption. The higher Na+ loss with higher than lower muscle Na+ deficiency shows that the risk of greater muscle Na+ loss is directly related to muscle Na+ deficiency. It is concluded that muscle Na+ deficiency is more evident when Na+ consumption is higher and that muscle Na+ loss was more exacerbated with higher than lower muscle Na+ deficiency indicating that during prolonged HK the muscle Na+ deficiency is due to the inability of the body to use Na+, but not to Na+ shortage in diet.

In this article, we analyze the cascade of events since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in Greece, with emphasis on the crisis' management so as to preserve the functionality of the national health system, which remains vulnerable due to the financial recession of the previous decade and chronic shortcomings. We compare and contrast the situation during the first and second epidemic wave. Understanding what possibly went wrong and when, is crucial. Such knowledge provides valuable guidance for the confrontation of the strong second wave that we are currently facing in Europe and other regions around the globe, as well as for the future waves that may follow.

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