David H. Close

The Effect of β-Blocker Premedication on the Surgical Field During Endoscopic Sinus Surgery

Objectives/Hypothesis: A number of previous studies have tried to assess the effects of hypotension on the surgical field during endoscopic sinus surgery. These studies have been limited by inadequate sample sizes, lack of a control group, and limited data collection. The aim of the present study was to determine whether the routine use of β‐blockers as a pre‐medication could improve the operative field in endoscopic sinus surgery.

The origins of the Greek civil war

Part 1 Greece after the First World War: dependency and schism the hydrocephalous state social structure the Greek Communist Party the bourgeois reaction. Part 2 Right-wing dictatorship, 1935-41: anti-Venizelist resurgence parliamentary democracy in crisis Metaxass tyranny its legacy axis invasion. Part 3 Invasion and collapse of authority, April 1941-March 1943: the old order in decay the birth of the National Liberation Front, EAM communist strategy. Part 4 EAM challenges the old order, April 1943-October 1944: reactions to EAM EAM predominant the start of civil strife communist agreement with the British nation-wide polarization liberation. Part 5 Revolution defeated, October 1944-February 1945: growing communist power the demobilization crisis the battle for Athens communist surrender. Part 6 The white terror, February 1945-March 1946: right-wing vendetta the British role communist revival election victory for the right communists on the brink. Part 7 Descent to civil war, April 1946-March 1947: the monarchist regime revival of guerrilla warfare the national army intervenes the Truman doctrine. Part 8 The Civil War, 1947-50 the Democratic Army right-wing victory aftermath.

Multiplanar reconstructed computed tomography images improves depiction and understanding of the anatomy of the frontal sinus and recess.

Aims The use of multiplanar reconstructed computed tomography (CT) images of frontal recess and sinuses was assessed with regard to depiction and understanding of anatomy and effect on surgical approach. Materials and Methods Three otorhinolaryngologists and one radiologist read CT scans of 43 patients referred for routine paranasal sinus scans. Spiral (helical) CT scans were obtained and coronal and parasagittal reconstructions were imaged. Three hundred forty-two readings were analyzed. The scans were assessed in the coronal plane and then in the parasagittal plane. The images were assessed for (i) Bent and Kuhn classification of frontal ethmoidal sinus air cells, (ii) size of frontal sinus ostium (assessed as unsure, normal, small, or large), (iii) use of parasagittal scans regarding additional understanding of the anatomy with particular reference as to how the agger nasi cell and frontal ethmoidal cells were arranged in a three-dimensional space, and (iv) if the parasagittal scan and subsequent three-dimensional picture created altered the surgical approach. The first two criteria were assessed in the coronal plane and then in the parasagittal plane. Results There was no statistically significant difference between the Bent and Kuhn classification of frontoethmoidal cells on coronal and reconstructed parasagittal images (t-test; p < 0.05). The parasagittal scans were significantly better than the coronal scans for identifying and assessing the size of the frontal sinus ostium (p > 0.001; chi-square test). Assuming an intraobserver change rate (repeat error) of 10% on CT scan observations, an exact binomial test was performed on S-PLUS, which showed that there was a significant (p < 0.001) proportion of observers who changed their rating after looking at the parasagittal scan. There also was significant improvement in observers’ abilities to identify and classify the size of the frontal ostium as reflected by the number of observers who changed from being unsure on the coronal scans to sure on the parasagittal scans. Observers felt that the parasagittal scans improved their three-dimensional understanding of the anatomy of the frontal recess by 58% on a 10-point Lickert scale. In 55% of these observations, the surgical plan was altered by a mean of 70.2% on a 10-point Lickert scale based on additional information obtained by viewing the parasagittal scans. Conclusions The three-dimensional understanding of the frontal recess is improved greatly by using both coronal and parasagittal reconstructed images as compared with coronal images alone. This had important implications on the planning of the surgery in the frontal recess.

Environmental NGOs in Greece: The Achelöos campaign as a case study of their influence

This case study tests the theory of Princen and Finger that environmental non‐government organisations (NGOs) transcend the nation‐state by linking local to international activity. Greece lends itself to this study because its government has for some years been influenced both by the European Union and by environmental protest from various sectors of Greek society: local communities, the media, lawyers, and professional groups. NGOs although small have proved more effective than previous studies have suggested, because they have worked effectively through all these groups and formed links between them. In the Acheloos campaign they also allied with European counterparts, which adopted the issue in attacking abuse of EU subsidies. The Commission of the EU has responded by witholding funding for the Acheloos project and thenceforth according higher status to environmental NGOs and their aims. The Greek government remains publicly committed to the Acheloos project, but is paying slightly more attention to NG...

Effect of using multiple culture media for the diagnosis of noninvasive fungal sinusitis

Background This study was designed to assess the relative efficiency of three different culture media for isolating fungi in patients suspected of having noninvasive fungal sinusitis. Methods A prospective study was performed of 209 operative samples of sinus “fungal-like” mucin from 134 patients on 171 occasions and processed for microscopy and fungal culture in Sabourauds dextrose agar, potato dextrose agar, and broth media. Results Ninety-three (69%) of 134 patients had evidence of fungal infection. Two-thirds of patients had negative microscopy samples yet 56% of these went on to positive cultures. Forty-five percent cultured Aspergillus genus. Discrepancy between the fungi cultured in different media and on different occasions was common. With a single culture medium up to 19% of patients and 15% of samples would have been falsely labeled fungal negative. Conclusion Increasing the number and type of fungal culture media used increases the number and range of fungal isolates from mucin in patients with the features of fungal sinusitis. Negative specimen microscopy is unreliable. All specimens should be cultured in multiple media and on multiple occasions when fungal sinusitis is suspected.

Environmental Movements and the Emergence of Civil Society in Greece

The generally acknowledged weakness of civil society in Greece has obstructed the solution of many urgent environmental problems. Since the 1970s these weaknesses have begun to be overcome by various environmental movements. Community protests have checked many state-backed construction projects and have been helped by increasingly self-assertive forces consisting of elected local authorities, private radio stations, courts of law, and voluntary environmental associations. The last have been staffed by the growing class of professionals, especially in schools and universities. These bodies have also shown growing readiness to cooperate in positive environmental initiatives. In response, governments have shown greater sensitivity to public opinion on environmental issues, and increasing readiness to consult outside bodies.

War, medical advance and the improvement of health in Greece, 1944-53

This article is a case study of the stimulus given by war and foreign intervention to the improvement of health in an under-developed country. British and American agencies - cooperating with the Greek government and with foreign and Greek NGOs - worked intensively to improve health in Greece during the decade after liberation from enemy occupation in 1944. They achieved impressive results, despite obstacles created by previous enemy destruction and ensuing civil war. They utilized diverse medical techniques, many of which had been recently discovered, developed or disseminated, partly in response to World War II. British and American policies were responses to the World War and civil war, for motives partly humanitarian, but more political.

Memory and migration

The subject of this book is memory of the events of the 1940s among Greek migrants to Australia and their children. These events were the German occupation of 1941–1944, and the civil war which grew out of it and lasted from 1943 to 1949. The author argues that experiences of war gave rise (directly and indirectly) to many migrants’ decision to leave Greece, and then shaped their sense of identity in Australia. The book focuses, in the author’s words (6), ‘on the way in which the fallout from war affects relationships between cultures and generations when people cross national borders’. Although at first sight it is limited in scope, the subject is treated with sensitivity and sophisticated attention to historiographical context. Herself the daughter of Greek migrants in the 1950s, the author quotes extensively from interviews with 42 migrants, as well as printed memoirs of several others. She supplements this evidence with archives of the Australian federal government, and several document collections. Many of the interviews are fascinating, and suggest skill on the interviewer’s part in eliciting memories which must have been painful for interviewees to recall. The strength of this book is the human interest of its subjects, and specifically their experiences of war and migration. The author reveals fascinating variation in attitudes. Some felt it important to enshrine their memories of war for their children, others found the memories too painful to revisit. Some resumed left-wing activities in Australia, others avoided all politics with revulsion. Their attitudes to their adopted country also diverged. Some embraced their new national identity, seeing migration as the start of a new life, and others rejected it, seeing migration as a painful necessity. Some saw the distance of Australia from Greece as a deterrent, others – wanting to avoid all risk of further wars – as an attraction. Especially interesting is the author’s investigation into a controversial aspect of the civil war, the large-scale separation of children from their parents to live in hostels in various other countries of Eastern Europe. The author cites printed memoirs and interviews, with both the mothers and those deported as children. She also reveals the efforts made in the 1950s, by the Australian Council of International Social Service, to reunite deported children with their parents in Australia. By May 1953, 78 had thus been brought to Australia.

Civil War and World War in Europe: Spain, Yugoslavia, Greece, 1936–1949

expressing their (in some cases, divergent) opinions on their chosen dimensions of EU–Turkey relations. This could even be considered a valuable contribution to the South European-based academic/policy networks working on the EU. Nevertheless, if one assesses this book from a strictly academic point of view, which requires coherence and considerable analytical input in an edited volume, then the above-mentioned criticisms would be in order.