Title: SARCOPENIA AND FRAILTY IN ADVANCED LIVER DISEASE

Abstract:

SARCOPENIA AND FRAILTY IN ADVANCED LIVER DISEASE

ABSTRACT

Background & Aims: It is important that malnutrition associated with the progression of liver failure be recognized quickly, because it plays an important role in the evolution, the prognosis of patients with advanced liver disease. Severe malnutrition also plays an important role in susceptibility to the development of infections, hepatic encephalopathy, ascites and also as an independent predictor of lower survival in cirrhosis and in patients undergoing liver transplantation. The aim of the study was to establish similarities or differences between sarcopenia and frailty in patients with advanced liver disease in an Emergency Hospital in Bucharest.

Results: We included in the study 159 patients with advanced liver disease, 22% (35 patients) of them had compensated disease and 55.34% (88 patients) had decompensated liver disease. During the study, data on age, body mass index (BMI), weight loss (BW), declining skeletal muscle function, self-reported exhaustion, low physical activity, and low walking speed (WS) were collected. Sarcopenia was identified in 28.30% of cases (45 patients) and fragility in 22% of cases (35 patients). The prevalence of sarcopenia and fragility was well stratified according to age and stage of liver disease. In the multivariate analysis, significant factors for sarcopenia were identified such as age, stage of cirrhosis according to Child-Pugh class, body mass index, and extracellular water ratio (ECW) to total body water (TBW), while for frailty only the ECW / TBW ratio was significant.

Conclusion: Sarcopenia and fragility must be quickly recognized by the clinician as a complication of advanced liver disease and with an important role in the prognosis of these patients.

Title: Response of a multinational shipping company to the COVID19 Pandemic, on board the vessels and ashore.

Abstract:

The response of a multinational shipping company to the COVID19 Pandemic, onboard the vessels and ashore.

A Shipping Group with approximately 3500 employees, following the COVID19 2020 Pandemic established new procedures to comply with all measures required by WHO (World Health Organization), Greek Public Authorities, and the National Organization of Public Health. Measures taken are summarized below

1.         COVID-19 Crisis Committee

A COVID-19 Crisis Committee has been formed to coordinate efforts for Business Continuity, employee health, safety, and wellbeing and to ensure that critical Corporate Functions will perform uninterruptedly.

2.         Safety, Hygiene, Wellbeing Measures

The Human Resources Department and the Fleet Medical Advisor following recommendations from the Hellenic Ministry of Labour, the Hellenic Institute for Occupational Health and Safety, take all necessary measures and provide employees with the required guidance regarding personal hygiene.

1.         Non-essential meetings have been canceled and have been replaced by teleconferences.

2.         Common spaces gym, restaurant, pool, auditorium, and training Center have been shut off.

3.         Employee wellbeing:  Pilates classes have been offered through teleconference.

4.         Hand sanitizers (more than 60% alcohol) available.

5.         N95 and simple surgical masks are provided to the building visitors. Masks and gloves are also available to all employees. No shortage throughout the pandemic.

6.         Diminished staff throughout the pandemic.30% of the employees were working in the headquarters.

7.         Regular disinfection and Cleaning rounds held more regularly.

8.         Molecular (RT-PCR) and antibody testing available.

9.         Mental Health wellbeing: Stress-related issues are rising in the COVID19 era. Group had an in-house clinical psychologist to provide mental health guidance. (Up to 250 words)

Biography:

Dr. Liakou is a Senior Consultant at LK Medical and the Fleet Medical Advisor at a multinational Shipping Group. Dr. Liakou received her MD from the University of Ioannina and her PhD from the University of Athens in Greece. She completed her internship and residency in Internal Medicine at the University of Kentucky, and her post-doctoral fellowship in Immunology at the University of Texas, MD Anderson Cancer Center. She is certified in psychology by the University of Aegean. She serves as a Deputy Editor to the Journal of General Internal Medicine.

Title: Cardiovascular risk factors in the Greek population: Database from the Dyslipidemia Reference Centre of our Hospital

Abstract:

Cardiovascular risk factors in the Greek population: Database from the Dyslipidemia Reference Centre of our Hospital

Introduction: Cardiovascular adverse events are a great public health issue and the leading death cause globally (WHO 2018). Especially, high cholesterol levels in blood have been recognized as a serious, independent risk factor for cardiovascular disease(CVD) as well as a part of the metabolic syndrome.

Methods: We evaluated the cardiovascular risk score of the patients from the dyslipidemia reference center of our hospital using the well-established HeartScore created by the European Society of Cardiology, standardized for the Greek population (Greek HeartScore) because of its role as the leading prevention tool in Europe. The parameters included were age (>30), sex, smoking habits, total and HDL-Cholesterol levels, blood pressure and the use of antihypertensive medication. Individuals with diabetes mellitus and cardiovascular disease were instantly identified as very high risk patients.

Results: We assessed 330 individuals, who have been examined and followed-up from the Lipidology experts because of high Cholesterol or Triglycerides levels in blood. We found that 22% of them had high 10-year risk of fatal CVD (10-14%), 40% of the patients had a 5-9% 10-year risk of an  adverse event whereas the 11% had a very high risk of fatal CVD (15% and over) and the rest 27% had a lower than 5% risk of Cardiovascular Death. Women were found to score lower than men.

Conclusion: Although many of the individuals participating in our research were relatively young and physically active, the present cardiovascular risks found were alarming, thus indicating the need for intensification of preventive and therapeutic measures.

Biography:

Dr. Georgios Sfikas graduated from the Medical School of the Aristotle University of Thessaloniki as a medical doctor and the Corps Officers Military School as an officer of the Medical Corps. He specialized in Internal Medicine in the Hippokrateion University of Thessaloniki and he is about to present his PhD thesis in dyslipidemia and NFLAD. He has served in various military units, military hospital and peace-keeping missions. He is currently Consultant in Internal Medicine and Chief of the Lipidology and Atherosclerosis Department in the 424 General Military Hospital of Thessaloniki.