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Background: The lack of data regarding health habits of medical students in Greece prompted a cross-sectional study to assess tobacco use, alcohol consumption and serum lipoprotein levels among students in the University of Crete School of Medicine. Methods: A self-administered questionnaire on smoking and alcohol consumption was distributed to third-year medical students for twelve consecutive years (1989-2000). A total of 849 students (462 males, 387 females) participated in the survey. Biochemical measurements were taken and multi-variant analysis of the data was performed. Results: The prevalence of smoking among males and females was 33.2% (N = 150) and 28.4% (N = 108), respectively (mean cigarette consumption 13/day). As many as 349 males (77.2%) and 220 females (58.0%) reported consuming alcohol on a regular basis. The prevalence of low HDL-cholesterol (> 0.9 mmol/l) was 14.5% in males and 5.1% in females, and of high LDL-cholesterol levels (<4.1 mmol/l) in 11.1% of male and 5.5% of female participants. Smoking was related to higher triglyceride (p = 0.032), and lower HDL-cholesterol (p = 0.037) serum levels. Total cholesterol, LDL-cholesterol, and the TC/HDL-cholesterol ratio were strongly related with the level of smoking (p = 0.006, p = 0.008, and p = 0.006 respectively). Conclusions: The results document a high prevalence of smoking among physicians-to-be in Greece. Tobacco use was strongly associated with a lipid profile predisposing to increased risk for cardiovascular disease. Health promotion programmes should therefore be instituted not only during the first years of medical studies, but rather at a much earlier stage in life. [ABSTRACT FROM AUTHOR]

The current study assessed the physical performance of youth Greek football (soccer) players between the Union of European Football Associations (UEFA) Youth and National Leagues' matches. This effort was based on 271 measurements of nine physical/motor activities recruited from 25 players with a mean age of 18.4 (±1.2 years) during August 2017 and January 2018 from official-matches of UEFA Youth (n=6) and National Leagues (n=16). Measurements were recruited using Global-Positioning-System Technology-(GPS) and differences were assessed through analysis of covariance. 56.0% of the players were 18.0+ years old, 52.0% were midfielders, and 56.5% of players' participations were recorded in full time (90.0+ minutes). Between the two competitions of UEFA Youth and National Leagues' matches, it has been found that there is significant difference only in mean number of decelerations (71.4 vs. 61.7, respectively, p=0.010). High mean levels of total distance-(TD), very high-intensity-speed-running-distance-(VHS), maximal-sprinting-speed-distance-(MS), high-speed-running-(HSR), distance/time-(D/T), sprints, number of accelerations and maximum-velocity-(Vmax) were noticed as well as in UEFA Youth Leagues' matches but did not differed significantly in relation to counterparts (p>0.05). The researchers observed that youth football players displayed similar efforts in all matches maintaining a high level of physical performance, without separating the matches according to the competition, due to the educational behavior adopted within the football academy of the club. [ABSTRACT FROM AUTHOR]

Objective To test feasibility by enhancing the knowledge and skills of general practitioners (GPs) in managing ear, nose, and throat (ENT) morbidity within primary care settings through a three-hour educational course. Methods A structured course focused on common ENT disorders was conducted. Case morbidity was selected based on appropriate criteria. The participants (n=34) were GPs randomly assigned to control and intervention groups. A questionnaire assessed knowledge, attitudes, and practices (KAP) before and after the course using proper analysis. Results The intervention group showed significant improvement in responses within five of sixteen questions (p<0.05). Participants demonstrated greater knowledge responsiveness in relation to epistaxis and CENTOR criteria, while knowledge response improvement was poor in regard to vestibular morbidity. Overall improvement in KAP scores (p<0.05), with high effect sizes, was achieved before and after the seminar. Conclusions The three-hour ENT course for GPs was found to be feasible, emphasizing the need for targeted short-duration courses within GP education supported by locally relevant information on common ENT conditions. Future research should explore the long-term impact of similar collaborative interventions in primary care., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. 7th Health Region of Greece; Ethics Committee of the University of Crete issued approval 26459/19-06-23; 59/05-05-2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Papadopoulos et al.)

Aim: This study aimed to assess the health profile of patient-attendees visiting primary healthcare (PHC) practice settings in the midst of the COVID-19 pandemic and to explore the relationships between multiple behavioral risk factors (MBRFs) and consultation-driven health information. Multiple behavioral risk factors involve a variety of unhealthy behaviors that are associated with an increased prevalence of non-communicable diseases (NCDs)., Subjects and Methods: The study design was based on a dataset analysis, afterward exploring the feasibility and diagnostic capacity of respiratory morbidity aspects from a study previously conducted. The study dataset contained information regarding socio-demographic characteristics, health habits, clinical information, and reported comorbidities from 183 primary care patient-attendees. A categorical regression analysis was performed, using as a numeric variable the multiple MBRFs (clustering of 0 to four factors) in order to examine relationships with the basic and clinical characteristics of the patient-attendees., Results: Based on this secondary analysis, it was found that the prevalence of MBRFs is quite common among patient-attendees visiting urban PHC facilities. The prevalence of current smoking, sleep deprivation, increased body weight, and medium/high perceived stress levels were 33.9%, 52.5%, 83.1%, and 35.0%, respectively. An increased occurrence of MBRFs might be significantly predicted by the lower age of patient-attendees (b = -0.221, p = 0.05), by the absence of gray hair at an early age (b = -0.144, p = 0.042), by the physical discomfort during activities (b = 0.191, p = 0.017), or by the lower oxygen saturation (b = -0.184, p = 0.004). Diabetes mellitus (25.1%) was the most prevalent condition, followed by bronchial asthma (18.6%) and depression (15.8%)., Conclusions: Lower age, absence of premature hair whitening, physical discomfort during activities, and lower oxygen saturation are linked with an increased occurrence of MBRFs, leading to a neglected way of living. Those factors could be used to alert researchers, policymakers, and PHC professionals to act accordingly in order to prevent or early diagnose NCDs., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Symvoulakis et al.)

Background: In Primary Health Care (PHC) many interstitial lung disease (ILD) cases may remain at diagnostic delay, due to their challenging presentation and the limited experience of general practitioners (GPs) in recognizing their early symptoms., Objective: We have designed a feasibility study to investigate early ILD case-finding competency between PHC and tertiary care., Methods: A cross-sectional prospective case-finding study was launched at two private health care centers of Heraklion, Crete, Greece, during nine months (2021-2022). After clinical assessment by GP, PHC attenders, who agreed to participate in the study, were referred to the Respiratory Medicine Department, University Hospital of Heraklion, Crete, underwent Lung Ultrasound (LUS) and those with an overall suspicion for ILDs underwent high resolution computed tomography (HRCT) scan. Descriptive statistics and chi-square tests were used. Multiple Poisson regression analysis was performed to explain positive LUS and HRCT decision with selected variables., Results: One hundred and nine patients out of 183 were finally included (54.1% females; mean age 61, SD: 8.3 years). Thirty-five (32.1%) were current smokers. Overall, two out of ten cases were assessed to need HRCT due to a moderate or high suspicion (19.3%; 95%CI 12.7, 27.4). However, in those who had dyspnea in relation to counterparts, a significantly higher percentage of patients with LUS findings (57.9% vs. 34.0%, p=0.013) was found, as in those who had crackles (100.0% vs. 44.2%, p= 0.005). Detected possible ILD provisional labelling cases were 6, and most importantly, 5 of those cases were considered highly suspicious for further evaluation based on LUS findings., Conclusions: This is a feasibility study exploring potentials by combining data of medical history, basic auscultation skills, as crackles detection, and inexpensive and radiation-free imaging technique, such as LUS. Cases of ILD labeling may be hidden within PHC, sometimes, much before any clinical manifestation.

Objectives: The present study aimed to investigate whether impairment of health-related quality of life (HRQOL) and possibly, the quality of sleep (Sleep Quality - SQ), of osteoporotic women, may occur, even before the onset of an osteoporotic fracture., Methods: The study included 109 women, divided (DXA) into two groups (age-matched): the Control Group (n=68; normal and osteopenic) and the Patient Group (n=41; osteoporotic). Review of medical history of the participants, was followed by evaluation of HRQOL and SQ with the EQ-5D-3L and the PSQI questionnaires, respectively., Results: There was no significant difference between the two groups (Control vs. Patient) in terms of average HRQOL and SQ, as measured by the EQ-5D-3L Questionnaire (0.73 vs. 0.70, p>0.05) and the PSQI Index value (5.56 vs. 6.29, p>0.05), respectively. A high percentage of patients was estimated as having a poor SQ (52.9% of the Control Group and 46.3% of the Patient Group, p>0.05). Increasing age, with or without the presence of osteoporosis, seemed to lead to worst QoL (OR<1.00, p<0.05)., Conclusions: Our study documented homogeneity in HRQOL and SQ, between the two study groups. The strongest predictor for the HRQOL was age (for each year of age increase, the probability of excellent HRQOL significantly decreased)., Competing Interests: The authors have no conflict of interest.

Principles: The efficacy of low-calorie diets (LCDs) has not been investigated in large-scale studies or among people from different regions, who are perhaps unaccustomed to such methods of losing weight. The aim of the present study was to investigate changes in obesity measures among overweight/obese adults from eight European cities (from Northern, Central and Southern Europe) during the 8-week LCD phase of the DiOGenes study (2006-2007), a family-based, randomised, controlled dietary intervention., Methods: 938 overweight/obese adults completed baseline examinations and underwent an 8-week LCD, providing 3.3-4.2 MJ/day to replace all meals. Anthropometric measurements and body composition were assessed at baseline and post-LCD., Results: 773 (82.4%) adults (mean age, 43.1 y) completed the LCD successfully. The highest drop-out rate was observed in Southern (24.9%) and the lowest in Northern (13.3%) European cities. Overall, the LCD induced favourable changes in all outcomes, including an approximate 11.0% reduction in body weight and body fat percentage. Changes in outcomes differed significantly between regions, with North- and Central-European cities generally achieving higher percentage reductions in most anthropometric measurements assessed. Nonetheless, participants in Southern Europe reduced their body fat percentage significantly more than participants in Northern Europe (-11.8 vs. -9.5%, P = 0.017)., Conclusions: The LCD significantly improved anthropometric and body composition measurements in all cities participating in DiOGenes.

The Greek Orthodox Christian (GOC) diet is unique in that it regularly interchanges between an omnivorous to a vegetarian type of diet over the course of the ecclesiastical year, and no study to date has focused on its impact on antioxidant vitamins A (retinol) and E (alpha-tocopherol) status. Thirty-seven strict adherents of the GOC, mainly priests and nuns, (18 males, 19 females, mean age 43.0 + or - 13.1 years), and 48 age- and sex- matched controls (21 males, 27 females; mean age 38.6 + or - 9.6 years) were studied prior (pre) and at the end (end) of the Christmas fasting (CF) period (40 days), when meat and dairy products are prohibited. Fasters had been following all dietary recommendations of the GOC for a mean of 21.2 + or - 15.7 years. Compared to the control group, fasters had higher pre- retinol and pre- alpha-tocopherol levels. Fasters reduced their retinol (-0.8 + or - 0.6 micromol/l) and alpha-tocopherol levels (-8.0 + or - 6.6 micromol/L) during the CF period, whereas controls increased them (0.3 + or - 0.7 and 0.4 + or - 4.8 micromol/L, respectively, p<0.001). Nevertheless, values in both groups were well above the lowest cut-off points. All subjects had alpha-tocopherol:total cholesterol ratio >2.25, which is a cut-off value for the anti-atherogenic influence of alpha-tocopherol. Changes of serum alpha-tocopherol and retinol within the CF period correlated positively with changes in total cholesterol (p=0.013 and p=0.017, respectively), whereas the latter was also correlated with changes in low-density lipoprotein (LDL) and total cholesterol:high-density lipoprotein (TC:HDL) ratio (p=0.021 and p=0.049, respectively). Dietary intakes of several nutrients did not correlate with concentrations of retinol and alpha-tocopherol in either study group. These results suggest that adherence to the GOC diet does not increase the risk of antioxidant vitamins A and E deficiency.

Introduction: Levosimendan is a new inotropic vasodilator for the treatment of decompensated heart failure. Compared to other inotropic agents, it has been shown to improve myocardial contractility without increasing oxygen requirements. However, experience with levosimendan in patients with low cardiac output after cardiopulmonary bypass is limited. In this case series we present the short-term haemodynamic effects of levosimendan added to dobutamine for the management of low cardiac output syndrome after cardiac surgery., Methods: Twelve patients with low cardiac output during the first 6 hours after completion of cardiopulmonary bypass, who were already receiving dobutamine at a mean dose of 6.7 microg/kg/min, were treated with levosimendan at a loading dose of 6 microg/kg, followed by a 24-hour infusion of 0.2 microg/kg/min. During a 24-hour observation period the following haemodynamic parameters were measured: arterial, central venous, pulmonary arterial and pulmonary capillary wedge pressure, heart rate, cardiac index, stroke volume, systemic and pulmonary vascular resistance, as well as mixed venous oxygen saturation, oxygen delivery and oxygen extraction ratio., Results: Levosimendan significantly improved cardiac index (from 2.1 +/- 0.1 L/min/m2 at baseline to 3.2 +/- 0.3 L/min/m2 at 24 hrs, p < 0.001) as well as mixed venous oxygen saturation, oxygen delivery and oxygen extraction ratio (p < 0.001) and caused a significant reduction in systemic and pulmonary vascular resistance (p < 0.001). At the same time, a significant decrease in central venous, pulmonary arterial and pulmonary capillary wedge pressure was noted (p < 0.001). These beneficial haemodynamic effects resulted in significantly decreased catecholamine requirements., Conclusions: In this group of cardiac surgical patients with postoperative myocardial dysfunction resistant to dobutamine, levosimendan added to dobutamine was effective in reversing low cardiac output syndrome.

In Greece, prevalence of cardiovascular disease has been increasing during the last few decades. From a public health point of view, it is important to identify lifestyle practices associated with cardiovascular disease risk factors. As part of the Clinical Nutrition course at the University of Crete School of Medicine, 507 medical students (292 men, 215 women) were examined during the period 1995-2001. Individual 24-hour dietary recalls were taken, lifestyle questionnaires were completed, and anthropometric and serum lipid measurements were performed. Fruits and vegetables were consumed by 90% of men (370 +/- 275 g/day) and 94% of women (354 +/- 283 g/day). Among non/ex-smokers who ate fruit and vegetables, 41% consumed > or = 400 g/day, compared to 31% of current smokers (p = 0.05). The risk for high-density lipoprotein cholesterol (HDL-C) < 35 mg/dL, low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL, and total cholesterol/HDL-C ratio (TC:HDL-C) > or = 5 decreased with increasing quartile of fruit and vegetables consumption (trend p < 0.01). Fruit and vegetable intake was favorably related to intake of dietary fiber, calcium, magnesium, potassium, folate, and vitamins C, E, A, B1 and B6, and inversely related to saturated and trans fatty acids and cholesterol. Prospective studies should be performed within the general young adult population to assess the long-term effects of fruit and vegetable consumption on chronic disease risk development.