General Hospital of Serres

Internet Gaming Disorder (IGD) has been associated with symptoms of Digital Eye Strain (DES) and poor academic performance among adolescent students. The purpose of this study is to assess whether a student's achievement of a specific academic goal within a short period of time can be directly predicted by symptoms of IGD and DES. This is a cross-sectional survey of 140 high school graduates who received an examination of visual acuity as a pre-requisite for entering the written admission examinations of law enforcement and military academies. The students completed the Digital Eye Strain Questionnaire (DESQ) and the Ten-Item Internet Gaming Disorder Test (IGDT-10) and stated their own evaluation of their chances for success. They were contacted following their admission examinations, and their success or failure to be admitted was recorded. The students with IGD symptomatology were more likely to present with symptoms of DES. They were also more pessimistic about their chances of success in the subsequent written admission examinations; none succeeded, while the rest of the students recorded an expected rate of success. A combination of IGD and complaints related to the prolonged fixation of the upper body in a specific viewing position was the best predictor variable set for future success in admission examinations. IGD is associated with a failure to achieve academic success. Combining a factor for physical discomfort during prolonged sessions of gaming with the typical criteria for IGD may expand the predictive validity of the construct of gaming disorder.

Our aim is to present an updated overview of the erythrocyte metabolism highlighting its richness and complexity. We have manually collected and connected the available biochemical pathways and integrated them into a functional metabolic map. The focus of this map is on the main biochemical pathways consisting of glycolysis, the pentose phosphate pathway, redox metabolism, oxygen metabolism, purine/nucleoside metabolism, and membrane transport. Other recently emerging pathways are also curated, like the methionine salvage pathway, the glyoxalase system, carnitine metabolism, and the lands cycle, as well as remnants of the carboxylic acid metabolism. An additional goal of this review is to present the dynamics of erythrocyte metabolism, providing key numbers used to perform basic quantitative analyses. By synthesizing experimental and computational data, we conclude that glycolysis, pentose phosphate pathway, and redox metabolism are the foundations of erythrocyte metabolism. Additionally, the erythrocyte can sense oxygen levels and oxidative stress adjusting its mechanics, metabolism, and function. In conclusion, fine-tuning of erythrocyte metabolism controls one of the most important biological processes, that is, oxygen loading, transport, and delivery.

Internet Gaming Disorder (IGD) is now an official diagnosis and significant public health challenges have been already identified regarding the provision of appropriate care to patients of all ages and the preparedness of mental health professionals to manage the disorder. Despite the existence of psychotherapeutic treatment modalities available for some time now, there is a paucity of any psychoanalytically driven treatments and the disorder is widely regarded and classified as being 'behavioral'. This has profound implications for patients with long-standing character pathology and psychiatric comorbidities, who are underserved by the provision of health services that could efficiently address their issues. This study presents a psychoanalytic perspective on IGD, based on Kohut's Self Psychology as applied in the treatment of other addictions. An outline of the theory, assessment and treatment modalities is presented with two case reports that illustrate its application. The presentation outlines the challenges in treating IGD, expanding on the concept of guided imagery, resistance to treatment, selfobject transference and comorbidity with marijuana use and bipolar disorder. A psychoanalytically driven protocol can be effective in treating IGD, especially in cases with marked character pathology and low motive to engage in other treatment modalities.

Although the impact of microbial infections on orthopedic clinical outcomes is well recognized, the influence of viral infections on the musculoskeletal system might have been underestimated. To systematically review the available evidence on risk factors and musculoskeletal manifestations following viral infections and to propose a pertinent classification scheme. We searched MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), the Reference Citation Analysis (RCA), and Scopus for completed studies published before January 30, 2021, to evaluate risk factors and bone and joint manifestations of viral infection in animal models and patient registries. Quality assessment was performed using SYRCLE's risk of bias tool for animal studies, Moga score for case series, Wylde score for registry studies, and Newcastle-Ottawa Scale for case-control studies. Six human and four animal studies were eligible for inclusion in the qualitative synthesis. Hepatitis C virus was implicated in several peri- and post-operative complications in patients without cirrhosis after major orthopedic surgery. Herpes virus may affect the integrity of lumbar discs, whereas Ross River and Chikungunya viruses provoke viral arthritis and bone loss. Evidence of moderate strength suggested that viruses can cause moderate to severe arthritis and osteitis. Risk factors such as pre-existing rheumatologic disease contributed to higher disease severity and duration of symptoms. Therefore, based on our literature search, the proposed clinical and pathogenetic classification scheme is as follows: (1) Viral infections of bone or joint; (2) Active bone and joint inflammatory diseases secondary to viral infections in other organs or tissues; and (3) Viral infection as a risk factor for post-surgical bacterial infection.

BackgroundCytomegalovirus can possibly cause multisystemic inflammation and is the second most common pathogen associated with Guillain-Barre syndrome. Complications from Cytomegalovirus infection are only rarely reported among immunocompetent patients. Case ReportWe report of an immunocompetent patient who presented with paraparesis and was found to have acute sensory ataxic neuropathy with concomitant hepatitis, periodontitis and rash associated with Cytomegalovirus infection. ConclusionsThis case report highly illustrates the clinical spectrum of Cytomegalovirus infection and describes the clinical characteristics of acute sensory ataxic neuropathy, a recently recognized, rare Guillain-Barre syndrome variant. Previous case reports are also reviewed and similarities with our patient are emphasized.

ABSTRACT The purpose of the study was to assess the influence of short, intermediate, and long muscle lengths on dorsiflexor force steadiness and the discharge characteristics of motor units in tibialis anterior during submaximal isometric contractions. Steady contractions were performed at 5 target forces (5, 10, 20, 40, and 60% maximal voluntary contraction, MVC) for 3 ankle angles (75°, 90°, and 105°). MVC force was less (p = 0.043) at the smallest joint angle compared with the other two angles. The absolute (standard deviation) and normalised amplitudes (coefficient of variation) of the force fluctuations were similar for all 3 ankle angles at each target force. The coefficient of variation for force decreased progressively from 5% to 20% MVC force and then it plateaued at 40% and 60% MVC force. At all target forces, the mean discharge rate (MDR) of the motor units at 75° was greater than at 90° (p = 0.006) and 105° (p = 0.034). Moreover, the MDR was similar for 5% and 10% MVC forces and then increased gradually until 60% MVC force (p < 0.005). The variability in discharge times (coefficient of variation for interspike interval) and variability in neural drive (coefficient of variation of filtered cumulative spike train) were similar at all ankle angles. Variability in neural drive had a greater influence on force steadiness than did the variability in discharge times. Changes in ankle-joint angle did not influence either the normalised amplitude force fluctuations during steady submaximal contractions or the underlying modulation of the discharge characteristics of motor units in tibialis anterior.

Objectives To examine the impact of endoscopy setting (hospital-based vs. office-based) on sedation/analgesia administration and to provide nationwide data on monitoring practices among Greek gastroenterologists in real-world settings. Material and Methods. A web-based survey regarding sedation/analgesia rates and monitoring practices during endoscopy either in a hospital-based or in an office-based setting was disseminated to the members of the Hellenic Society of Gastroenterology and Professional Association of Gastroenterologists. Participants were asked to complete a questionnaire, which consisted of 35 items, stratified into 4 sections: demographics, preprocedure (informed consent, initial patient evaluation), intraprocedure (monitoring practices, sedative agents' administration rate), and postprocedure practices (recovery). Results 211 individuals responded (response rate: 40.3%). Propofol use was significantly higher in the private hospital compared to the public hospital and the office-based setting for esophagogastroduodenoscopy (EGD) (85.8% vs. 19.5% vs. 10.5%, p < 0.0001) and colonoscopy (88.2% vs. 20.1% vs. 9.4%, p < 0.0001). This effect was not detected for midazolam, pethidine, and fentanyl use. Endoscopists themselves administered the medications in most cases. However, a significant contribution of anesthesiology sedation/analgesia provision was detected in private hospitals (14.7% vs. 2.8% vs. 2.4%, p < 0.001) compared to the other settings. Only 35.2% of the private offices have a separate recovery room, compared to 80.4% and 58.7% of the private hospital- and public hospital-based facilities, respectively, while the nursing personnel monitored patients' recovery in most of the cases. Participants were familiar with airway management techniques (83.9% with bag valve mask and 23.2% with endotracheal intubation), while 49.7% and 21.8% had received Basic Life Support (BLS) and Advanced Life Support (ALS) training, respectively. Conclusion The private hospital-based setting is associated with higher propofol sedation administration both for EGD and for colonoscopy. Greek endoscopists are adequately trained in airway management techniques.

Aims:We examined whether the use of a renin-angiotensin-aldosterone system (RAS)inhibitor plays a role in protecting against left atrial appendage thrombus(LAAT) in patients with hypertension complicated by atrial fibrillation(AF).Methods:Two observational studies were conducted on patients with diagnoses ofhypertension and AF, who were categorized into RAS inhibitor user or nonusergroups. Demographic characteristics, clinical characteristics,echocardiographic parameters and hemostatic markers were examined and theoccurrence of LAAT during follow-up were recorded.Results:In the first study (n = 131), LA peak systolic strain andLAA emptying flow velocity (LAA eV) were significantly increased in patientson RAS inhibitors compared with the nonuser group (p <0.05). Lower D-dimer and fibrinogen levels were observed in patients on RASinhibitors (p < 0.05). In the second study(n = 99), 25.9% (n = 11) of patientson RAS inhibitors developed LAAT, compared with 46.7% (n =21) in the nonuser group (p < 0.05). After controllingfor risk factors related to LAAT, use of RAS inhibitors remained associatedwith a significantly lower risk of developing LAAT (HR, 0.406; 95% CI,0.191–0.862; p = 0.019).Conclusions:RAS inhibitors use was associated with a significant reduction in the risk ofLAAT in patients with hypertension and AF.

Atrial structural remodeling in the form of fibrosis contributes to the arrhythmic substrate in atrial fibrillation (AF). The aim of this study was to investigate the effects of doxycycline on chronic intermittent hypoxia (CIH)-induced atrial fibrosis and the pathophysiological mechanisms underlying such changes. A total of 30 Sprague Dawley rats were randomized into three groups: control group, CIH group, and CIH with doxycycline treatment (CIH-D) group. CIH lasted 5hours per day for 4weeks. CIH-D rats were administrated doxycycline for 4weeks, while they received CIH. Masson's trichrome staining was used to determine collagen deposit in the atrial myocardium. Protein and mRNA levels of Matrix Metalloproteinase-2 (MMP-2) and -9 (MMP-9), microRNA-21 (miR-21) and its downstream target Sprouty1 (Spry1), and extracellular signal-regulated kinases 1/2 (ERK1/2) were measured using Western blotting or real-time qRT-PCR, respectively. Compared to the control group, the CIH group showed higher interstitial collagen fraction, increased MMP-9, miR-21, and p-ERK1/2 levels, and decreased MMP-2 and Spry1 levels. Doxycycline treatment attenuated CIH-induced atrial fibrosis, reduced MMP-2, MMP-9, miR-21, and p-ERK1/2, and increased Spry1. CIH treatment induced significant atrial fibrosis in our rat model, which was attenuated by doxycycline. These changes can be explained by alterations in the MMP and miR-21/ERK signaling pathways.