Corfu General Clinic

Introduction Social media has become a powerful influence on adolescent body image. Platforms like Instagram and TikTok, which focus on appearance, often promote idealized body standards, leading young users to internalize unrealistic beauty ideals. This has resulted in increasing body dissatisfaction and negative mental health outcomes, as adolescents seek validation through likes and comments. Objectives This review examines how social media exposure affects body image and emotional wellbeing in adolescents, particularly whether it contributes to negative outcomes like low self-esteem, body dissatisfaction, and mental health issues. Methods A review of international studies published in the last five years was conducted using PubMed and Google Scholar. Search terms included “social media,” “body image dissatisfaction,” “mental health,” and “adolescents.” A total of 26 studies that met the criteria were analyzed. Keywords social media, body image dissatisfaction, adolescents, mental health, eating disorders, self-esteem, COVID-19 Results The studies consistently revealed a strong link between frequent social media use and negative body image. Both male and female adolescents reported increased body dissatisfaction, though most studies focused on females. Social media exposure was also linked to higher risks of eating disorders and a drive for thinness. Frequent users of appearance-focused platforms experienced reduced self-esteem and heightened levels of anxiety and depression, with social comparison behavior worsening these effects. Adolescents’ body image was further influenced by peer and parental validation, with peer approval playing a critical role in shaping their self-perception. The negative impacts of social media were particularly exacerbated during the COVID-19 lockdown due to increased isolation. Conclusions Social media platforms centered on appearance have a significant negative impact on adolescents’ body image and mental health. These findings highlight the need for interventions promoting media literacy, critical social media engagement, and support from parents and educators to mitigate these effects. Disclosure of Interest None Declared

Over the last decades the study of schizophrenia-spectrum disorders has been focused on early and comprehensive intervention during the first episode of psychosis (FEP), but studies in rural settings are only rare. In Greece mental healthcare in rural areas is mostly delivered by the locally-based Mobile Mental Health Units (MMHUs). The aim of the present study was to address treatment of FEP patients by the MMHUs in rural areas in Greece, focusing on patients with a first episode of schizophrenia. This is a multicenter, retrospective observational study with the participation of nine MMHUs across several areas in rural mainland and some islands of Greece. Patients of the age range of 15 to 55 years with a diagnosis of non-affective psychosis were included in the study. The study sample consisted of 216 patients, while analysis was performed for patients with a diagnosis of schizophrenia (n = 153, 70.8% of the sample). Most patients were males (n = 93, 60.8%), with a mean age at first presentation 34.9 years (Md = 34.5, SD = 11.94). The mean duration of untreated psychosis (DUP) was 7.85 months (Md = 3, IQR = 10.00) and was shorter in younger (15-25 years) patients. More than 60% of patients had been successfully engaged to treatment with the MMHUs, with a mean follow-up duration of 5.17 years (Md = 5.00, IQR = 5.00). Younger patients (26-35 years) tend to disengage from treatment, while those aged 36 to 45 years were more likely to continue follow-up. A reduction of 47.22% in hospital admissions among patients with schizophrenia was observed over follow-up of patients by the MMHUS. The most noteworthy findings of the study are the low percentage of patients seeking help from the MMHUs, compared to the expected cases and the high attendance rate of those that are examined in this context. Further research on psychosis/schizophrenia in the rural context is warranted.

IntroductionAn undeniably significant amount of psychotropic medication can evidently affect the corrected QT (QTc) interval, which puts patients’ lives at risk. More specifically, certain anti-psychotic medication can increase the risk of QTc prolongation and by extension the risk of a potentially fatal arrhythmia or sudden cardiac death.ObjectivesElectrocardiograms (ECG) were contacted in one hundred and four (104) chronic patients, with psychosis, through out their hospitalization in several enclosed psychiatric facilities in Corfu. Almost the entirety of the patients along side their anti-psychotic medication were also taking various other medication for their individual pathological issues. We observed any changes that might have occurred on the ECG in comparison with each patient’s medication and it’s potential effect on the QTc.MethodsThe measurements of the QT interval were made manually in lead V5 and the mathematical conversion was contacted using the Hodges correction formula.ResultsAt least one ECG (n = 104) was performed. Among them 29,8% (n=31) had ECG abnormalities, including 13,5% (n=13) with a prolonged Qtc (481.2 ± 26,8 ms). Covariates significantly associated with the QTc were gender (+17.2 ms if female, p < 0.0001) and age (+0.4 ms/year, p = 0.0001).ConclusionsThe QTc prolongation that was evident in a notable number of patients, emphasizes the importance of QTc monitoring in patients who are taking anti-psychotic medication. QTc prolongation risk factors should be assessed before the administration or prescription of any anti-psychotic medication.Disclosure of InterestNone Declared

IntroductionHyperprolactinemia (HPL) is a condition associated with disturbing consequences. Antipsychotic medications are one of the main causes of nontumoral hyperprolactinemia. Prolactin release in the hypothalamic tuberoinfundibular tract is increased through dopaminergic inhibition, which occurs more frequently with high- potency typical antipsychotics (40%–90%). Less commonly than typical antipsychotics, atypical antipsychotics can also result in hyperprolactinemia. In the presence of symptoms, clinicians frequently struggle with the decision of whether to stop using the suspected offending agent, lower the dosage, switch to another medication, or even add a full or partial dopamine agonist to the patient's current treatment. The issue is exacerbated by the fact that finding a suitable agent for each patient is sometimes a challenging task.ObjectivesDue to the partial D2 receptor agonistic activity of aripiprazole, there is enough dopaminergic tone to continue the inhibition of prolactin release. Aripiprazole has been recommended in literature either as an adjunctive treatment in low doses or as a switch in therapy.MethodsIn the Psychiatric clinic of the General Hospital of Corfu, a low-dose (5mg/day) of aripiprazole is being used as adjunctive therapy in patients with antipsychotic-induced hyperprolactinemia. More specifically in total 42 subjects, 19 male and 22 female, with a mean prolactin level of 862ng/ml, were introduced to the prior therapy. We whereupon conducted prolactin measurements to evaluate the response at the first, the third, and the sixth month of treatment.ResultsOf the 42 subjects, 38 responded with an average reduction of prolactin to the level of 530ng/ml (mean reduction 38,5%).ConclusionsHaving noticed the beneficial effect of low-dose Aripiprazole in patients with antipsychotic-induced hyperprolactinemia, we consider it appropriate that the literature recommendations concerning this additional use of aripiprazole should not be overlooked in clinical practice.Disclosure of InterestNone Declared

The COVID-19 pandemic has resulted in a growing number of patients experiencing persistent symptoms and physiological changes after recovering from acute SARS-CoV-2 infection, known as Long COVID. Long COVID is characterized by recurring symptoms and inflammation across multiple organ systems. Diagnosis can be challenging, influenced by factors like demographics, comorbidities, and immune responses. Long COVID impacts various organ systems and can have neuropsychological effects. Health disparities, particularly related to race, contribute to a higher burden of infection and ongoing symptoms in minority populations. Managing Long COVID entails addressing a spectrum of symptoms that encompass physical, cognitive, and psychological aspects. The recovery period for patients with Long COVID can vary significantly, influenced by factors like the severity of the disease, hospitalization, comorbidities, and age. Currently, there are no universally effective treatments, although certain interventions show promise, necessitating further research. Self-management and rehabilitation programs can provide relief, but more research is needed to establish their effectiveness. Preventive measures such as vaccination and the use of antiviral medications and metformin. It is imperative to conduct further research to develop evidence-based guidelines and gain a better understanding of the long-term implications of COVID-19. Long COVID could have substantial economic impact on the labor market, productivity, healthcare expenditures, and overall economic growth. To address the challenges patients with long-term complications face, there is a focus on strategies like promoting telework and flexible work arrangements to accommodate diverse symptoms, particularly chronic fatigue and other Long COVID effects. In conclusion, this review emphasizes the multifaceted complexity of Long COVID and the ongoing need to address its potential long-term health and economic impacts.

Chloride anions are the most abundant in humans. For many years, it has been believed that chloride is simply a counterion of all other cations, ensuring the electroneutrality of the extracellular space. Recent data suggests that chloride anions possess a broad spectrum of important activities that regulate vital cellular functions. It is now evident that, apart from its contribution to the electroneutrality of the extracellular space, it acts as an osmole and contributes to extracellular and intracellular volume regulation. Its anionic charge also contributes to the generation of cell membrane potential. The most interesting action of chloride anions is their ability to regulate the activity of with-no-lysine kinases, which in turn regulate the activity of sodium chloride and potassium chloride cotransporters and govern the reabsorption of salt and excretion of potassium by nephron epithelia. Chloride anions seem to play a crucial role in cell functions, such as cell volume regulation, sodium reabsorption in the distal nephron, potassium balance, and sodium sensitivity, which lead to hypertension. All of these functions are accomplished on a molecular level via complicated metabolic pathways, many of which remain poorly defined. We attempted to elucidate some of these pathways in light of recent advances in our knowledge, obtained mainly from experimental studies.

Abstract Background and Aims Introduction The purpose of our research topic was to study the survival of immunocompromised or non-immunosuppressed patients as well as patients with Chronic Kidney Disease who were hospitalized due to covid-19 infection during a two-year period (2020-2022). Method Material and Methods A total of 1270 patients (of whom 570 were women) with a mean age of 63 years (+/- 24 years) were studied. From these, 1000 patients were without immunosuppression and 270 were theoretically and practically immunosuppressed, including 30 patients with Chronic Kidney Disease and of these 10 were with end-stage Chronic Kidney Disease. It is important to mention that 87 patients had to be hospitalized in the ICU, of which 74 died. The rest were hospitalized in the Biocontainment Unit, where 92 deaths were observed. 100 patients without immunosuppression died and 66 with immunosuppression. From the patients with End-Stage Chronic Kidney Disease, 3 died, theoretically falling into the immunocompromised category. The treatment protocol included all the therapeutic measures recommended by CCD. Results There was no statistically significant difference betweem the rate of death in immunocompromised patients and those who belonged in non immunocompromised group. However, there was a simple difference in deaths (66 out of 270 immunosuppresed patients) and 100 in non-immunocompromised patients, while there was also a difference in their need for hospitalization in the ICU and the Unit for Special Infections, but not statistically significant. Conclusion In conclusion, it appears that the immunocompromised are more prone to severe diseases having poor outcome. Furthermore, it was observed that patients with End Stage Chronic Kidney Disease had a fairly low mortality rate even though they are considered immunocompromised.

Background and objectives: Migraine is considered the most clinically important primary headache due to its high prevalence and significant burden. Although globally categorized as one of the leading causes of disability, it is still largely underdiagnosed and undertreated. Worldwide, migraine care is in most cases provided by primary care physicians. The aim of our study was to assess the attitudes of Greek primary care physicians toward treating migraine compared to other common neurological and general medical disorders. Methods: We surveyed 182 primary care physicians with the use of a 5-point questionnaire regarding their preference in treating ten common medical conditions, including migraine, hypertension, hyperlipidemia, upper respiratory tract infections, diabetes mellitus, lower back pain, dizziness, transient ischemic attack, diabetic peripheral neuropathy, and fibromyalgia. Results: Overall, with regards to preference to treat, migraine scored very low (3.6 ± 1.0), next to diabetic peripheral neuropathy (3.6 ± 1.0), and third from the bottom to fibromyalgia (3.25 ± 1.06). In contrast, physicians reported a much higher preference to treat hypertension (4.66 ± 0.60) and hyperlipidemia (4.6 ± 1.0). Conclusions: Our results indicate that Greek primary care physicians dislike treating migraines but also other neurological diseases. Topics for further investigation include the reasons for this dislike, any associations with poor patient satisfaction, treatment results, or both.

ABSTRACT The coronavirus pandemic had a tremendous impact on the hotel industry worldwide. The present study highlights strategic directions for quality improvements and customer satisfaction enhancement in Wuhan hotels by applying Multiple Criteria Satisfaction Analysis to online user-generated satisfaction ratings. In total, 21.247 guest satisfaction ratings on four aspects of hotel stay (location, cleanliness, value for money and service) as well as on overall satisfaction for the 406 hotels listed for Wuhan on TripAdvisor were retrieved. The analysis revealed that convenient location is the most important satisfaction criterion for hotel guests’ satisfaction and that hotels perform well regarding this criterion. Also, cleanliness, value for moneyand service can be potential threats for customer satisfaction.