The new SARS-CoV-2 outbreak has rapidly spread to many countries and has pushed health systems to radical changes in healthcare provision. This study aims to investigate the impact of the COVID-19 pandemic on the management of chronic patients in Primary Health Care (PHC). A narrative review of the literature was carried out in the PubMed and Google Scholar databases. It was found that since the pandemic's onset, many regular medical visits have led to delays, postponements, and even cancellations. The reasons for this discontinuity of chronic care were individual (fear and reluctance, home isolation), but also collective (shortages of medical staff, weakening of PHC, and suspension of outpatient care). Therefore, postponements of scheduled medical visits, delayed seeking of help and lack of medication adherence could lead to deregulation of chronic diseases, posing a risk for catastrophic health consequences. In order to ensure the continuity of chronic care provision, health systems have adopted new practices such as telemedicine and self-monitoring. The inclusion of chronic care in national pandemic response plans, the strengthening of PHC and the improvement of communication between patients and public health officials are essential preconditions to mitigate the indirect effects of the pandemic on chronic care.

Objective is to evaluate the impact of occupational exposure to lignite dust on respiratory system. 103 blue-collar workers exposed to lignite dust and 62 controls completed a questionnaire on respiratory symptoms and underwent spirometry. Levels of lignite dust in workplace were measured. Univariate and multivariate analysis of the data were performed. The concentration of lignite dust varied from 0.6 to 1.4 mg/m 3 . Current smokers and workers exposed to lignite dust presented higher prevalence of chronic bronchitis symptoms and of FEV<80% and FEV1/FVC<70%. Multivariate analysis has shown that smoking and occupational exposure to lignite dust were independent predictors of chronic bronchitis symptoms, as well as of an obstructive ventilation pattern. Further analysis showed that exposed workers who were current smokers presented a five fold rate for developing an obstructive ventilation pattern in comparison to exposed workers non currently smokers. Occupational exposure to lignite dust and smoking were independent determinants of chronic bronchitis symptoms and obstructive ventilation pattern. There is some evidence for a combined effect of smoking and lignite dust exposure on respiratory system.

Background Tobacco use is a detrimental public health issue associated with a plethora of adverse health outcomes. The purpose of this report was to investigate the association between tobacco use and perceptions of tobacco price strategies to reduce consumption in a rural primary care setting in Northern Greece. METhodSThe study took place within a primary care setting, in Alonakia, in Northern Greece within a primary health care setting. Consecutive patients who were current smokers (n=121) with a routine appointment for any reason were invited to participate over a 6-week period, during the second semester of 2013.rESuLTS The mean daily cigarette consumption was 20.2 + 12.4 (range: 2-60) and their pack/year consumption was 31.8 + 30.4 (range: 1-150 pack/years). Within the context of a regression analysis, the likelihood for patients who were smokers to positively respond that the cost of tobacco has an effect on their daily cigarette consumption was found to decrease by 3% for every cigarette smoked more per day and by 2% for every more pack/year. Furthermore, the likelihood for participants to report that they would quit smoking in case of a doubling in the price of tobacco products decreased by 5% for every cigarette smoked more per day.concLuSIonS The above findings imply that the reduction in tobacco use in rural Greece, is complex and a population's sensitivity should be enhanced through primary care initiatives that are adjusted between health promotion and counseling in conditions of socioeconomic distress.