Pammakaristos Hospital

Euthanasia has been a research subject among scientists for several decades. The aim of the present study was to examine the attitudes of health professionals toward the bioethical issue of euthanasia. The sample consisted of 465 health and social care professionals working in Health Services in Greece. Participants completed an online sociodemographic questionnaire as well as a set of short-form open-ended questions about euthanasia. Although the majority of health professionals (61.9%) agreed with the legalization of euthanasia in Greece, a lower percentage of participants reported that they have desired or asked for euthanasia (28.8%) or they have experienced a euthanasia case (9.0%). Similarly, fewer participants stated they had wished for the possibility of euthanasia for one of their patients (47.5%), while the majority (71.4%) reported that they had never attended a specific course or received training about euthanasia at any educational level. Incurable, irreversible diseases and cancer end-stage patients were the two main categories for which health professionals would suggest the performing of euthanasia. The most consistent sociodemographic variables associated with the majority of the study questionnaire items were age, gender and religiosity, while the most consistent working characteristics were hospitalization of end-stage patients and profession. The findings of this study point out the shortcomings of the educational system as well as the impact of religious beliefs on health professionals' attitudes toward euthanasia.

ObjectiveThe aim of this study is to record and analyze socioeconomic, demographic and health profiles of adult patients referred to the Social Service of a tertiary Hospital, as well as to present additional hospitalization conditions.MethodsA retrospective hospital archive study containing all patients referred to the Social Service during a four-year period was conducted.ResultsThe study consisted of 350 patients (168 males) with mean age 70.1 years. Most of the patients were of Greek origin and singles or divorced. 184 patients (52.6%) were retired. The participants’ average income ranged between 500 and 1000 euro/month. Most of the patients were insured by the Government (public health insurance) and were hospitalized in Pathology and Covid Clinics, with a mean hospitalization level of 17.6 days. The main reasons for referral were admission to an Aged Care Unit and the need to investigate network support. The most frequently recorded diagnosis was Covid-19, while 103 (29.4%) patients had a mental illness problem. The analysis of associations between demographic characteristics with health dimensions showed significant differences.ConclusionsChanges in socioeconomic conditions have an impact on outpatient and inpatient care as well as on Greek social work practice and pose enormous challenges to social work professionals.

The link between type 2 diabetes (T2D) and the severe outcomes of COVID-19 has raised concerns about the optimal management of patients with T2D. This study aimed to investigate the clinical characteristics and outcomes of T2D patients hospitalized with COVID-19 and explore the potential associations between chronic T2D treatments and adverse outcomes. This was a multicenter prospective cohort study of T2D patients hospitalized with COVID-19 in Greece during the third wave of the pandemic (February-June 2021). Among the 354 T2D patients included in this study, 63 (18.6%) died during hospitalization, and 16.4% required ICU admission. The use of DPP4 inhibitors for the chronic management of T2D was associated with an increased risk of in-hospital death (adjusted odds ratio (adj. OR) 2.639, 95% confidence interval (CI) 1.148-6.068, p = 0.022), ICU admission (adj. OR = 2.524, 95% CI: 1.217-5.232, p = 0.013), and progression to ARDS (adj. OR = 2.507, 95% CI: 1.278-4.916, p = 0.007). Furthermore, the use of DPP4 inhibitors was significantly associated with an increased risk of thromboembolic events (adjusted OR of 2.249, 95% CI: 1.073-4.713, p = 0.032) during hospitalization. These findings highlight the importance of considering the potential impact of chronic T2D treatment regiments on COVID-19 and the need for further studies to elucidate the underlying mechanisms.

The COVID-19 pandemic has the potential to adversely affect the mental health of healthcare workers (HCWs). The public healthcare system in Greece was already facing serious challenges at the outset of the outbreak following years of austerity and an escalating refugee crisis. This multi-center, cross-sectional study aims to assess the levels and associated risk factors of anxiety, depression, traumatic stress and burnout of frontline staff in Greece. A total of 464 self-selected HCWs in six reference hospitals completed a questionnaire comprising sociodemographic and work-related information and validated psychometric scales. The proportion of HCWs with symptoms of moderate/severe depression, anxiety and traumatic stress were 30%, 25% and 33%, respectively. Burnout levels were particularly high with 65% of respondents scoring moderate/severe in emotional exhaustion, 92% severe in depersonalization and 51% low/moderate in personal accomplishment. Predictive factors of adverse psychological outcomes included fear, perceived stress, risk of infection, lack of protective equipment and low social support. The psychological burden associated with COVID-19 in healthcare professionals in Greece is considerable, with more than half experiencing at least mild mental health difficulties. Findings signal the need for immediate organizational and individually tailored interventions to enhance resilience and support wellbeing under pandemic conditions.

The globalization of the Western lifestyle has resulted in increase of diabetes mellitus, a complex, multifactorial disease. Diabetes mellitus is a condition often related to the disorders of the cardiovascular system. It is well established that three quarters of diabetics, aged over 40, will die from cardiovascular disease and are more likely than non-diabetics to die from their first cardiovascular event. Therefore, it is of paramount importance to individualize treatment via risk stratification. Conditions that increase cardiovascular risk in people with diabetes include age more than 40 years, male gender, history of relative suffering from premature CHD, blood pressure and high LDL levels, presence of microalbuminuria, obstructive sleepapnea, erectile dysfunction and other conditions.Several models have been developed in order to assess cardiovascular risk in people with and without diabetes. Some of them have been proven to be inadequate while others are widely used for years. An emerging way of risk assessment in patients with diabetes mellitus is the use of biomarkers but a lot of research needs to be done in this field in order to have solid conclusions.

BackgroundCurrently, the implementation of dosimetry in molecular radiotherapy (MRT) is not well investigated, and in view of the Council Directive (2013/59/Euratom), there is a need to understand the current availability of dosimetry-based MRT in clinical practice and research studies. The aim of this study was to assess the current practice of MRT and dosimetry across European countries.MethodsAn electronic questionnaire was distributed to European countries. This addressed 18 explicitly considered therapies, and for each therapy, a similar set of questions were included. Questions covered the number of patients and treatments during 2015, involvement of medical specialties and medical physicists, implementation of absorbed dose planning, post-therapy imaging and dosimetry, and the basis of therapy prescription.ResultsResponses were obtained from 26 countries and 208 hospitals, administering in total 42,853 treatments. The most common therapies were 131I-NaI for benign thyroid diseases and thyroid ablation of adults. The involvement of a medical physicist (mean over all 18 therapies) was reported to be either minority or never by 32% of the responders. The percentage of responders that reported that dosimetry was included on an always/majority basis differed between the therapies and showed a median value of 36%. The highest percentages were obtained for 177Lu-PSMA therapy (100%), 90Y microspheres of glass (84%) and resin (82%), 131I-mIBG for neuroblastoma (59%), and 131I-NaI for benign thyroid diseases (54%). The majority of therapies were prescribed based on fixed-activity protocols. The highest number of absorbed-dose based prescriptions were reported for 90Y microsphere treatments in the liver (64% and 96% of responses for resin and glass, respectively), 131I-NaI treatment of benign thyroid diseases (38% of responses), and for 131I-mIBG treatment of neuroblastoma (18% of responses).ConclusionsThere is a wide variation in MRT practice across Europe and for different therapies, including the extent of medical-physicist involvement and the implementation of dosimetry-guided treatments.

Myoepitheliomas of the salivary glands are rare neoplasms accounting for less than 1.5% of all salivary gland tumours. They are classified into four cell types: spindle, clear, epithelioid and plasmacytoid. The plasmacytoid cell type appears to have a predilection for the oral cavity, especially the palate. A 56-year-old man was admitted to the ENT department complaining of a painless soft palate mass that had shown progressive growth over the past 9 months. At oral examination, a firm, nodular, ovoid-shaped lesion measuring 2.5cm in diameter with a well-delimited border, was palpated at the posterior midline portion of the soft palate. The overlying mucosa was intact. Computed tomography (CT) showed a hypodense tumour image. The clinical picture was suggestive of a tumour of the small salivary glands. The patient underwent a complete surgical resection of the tumour. The latter was located in the submucosa. It consisted of polygonal cells with round, eccentric nuclei and eosinophilic cytoplasm. Focal necrosis was not observed. The mitotic index was 2/10 high-power fields. Immunohistochemically, the tumour cells showed positivity for S-100 protein, vimentin, GFAP and negativity for CK 14 and SMA. The immunoreactivity of Ki-67 was sporadic, confirming the diagnosis of benign myoepithelioma. Myoepithelioma composed predominantly of plasmacytoid myoepithelial cells is a rare neoplasm that occurs in the soft palate. Wide excision with tumour-free margins is the treatment of choice.

Reports of inflammatory pseudotumour (IPT) of the spleen with Epstein-Barr virus (EBV) infection complicated by idiopathic thrombocytopenic purpura (ITP) are very rare. The pathogenesis of this tumour has remained obscure, with most authors agreeing that IPT of the spleen is a non-neoplastic, reactive condition. IPT of the spleen often poses diagnostic difficulty because it forms an infiltrative mass which has clinical, radiological and gross pathologic features that suggest a malignant lymphoma, vascular malformations, but also inflammatory myofibroblastic tumour (IMT) and inflammatory pseudotumour-like follicular dendritic cell tumour (IPT-FDC). Herein, we report a case of IPT of the spleen with EBV infection in a 51-year-old woman who presented with symptoms of ITP. The results of abdominal ultrasonography and computed tomography (CT) showed the presence of a splenic mass. She had been observed for 12 months with the diagnosis of a possibly benign neoplasm such as haemangioma or granulomatous disease; the tumour grew, necessitating an open splenectomy for diagnostic and curative goals. Histopathologic examination showed an inflammatory pseudotumour with spindle cells positive for EBV by in situ hybridization. When examined immunohistochemically, the spindle cells were focally positive for SMA, vimentin and CD68, and negative for CD21, CD23, CD35 and ALK, thus excluding IMT and IPT-FDC tumour. No evidence of recurrence of thrombocytopenia or subsequent development of other neoplasm was noted 18 months after splenectomy. Splenic IPT can be considered as a benign reactive tumoral lesion. It is important to distinguish it from other conditions using a combination of clinical, histologic, and immunophenotyping findings. We believe that EBV infection may have played a role in the pathogenesis of splenic IPT and the development of thrombocytopenic purpura.

Aim The development of synchronous cancers of the colon and the stomach is particularly rare. An unusual case of advanced synchronous colon and gastric carcinoma is described and the literature reviewed.

The aim of this study was to evaluate in a double-blind, randomized, placebo-controlled study the safety and efficacy of venlafaxine extended release (XR) in the prophylactic treatment of out-patients with tension-type headache (TTH) and no current depression or anxiety disorders. Sixty neurology and headache clinic out-patients meeting the International Headache Society diagnostic criteria for TTH were treated with venlafaxine XR (150 mg/day, n = 34) or placebo (n = 26) for 12 weeks. The primary efficacy variable was the decline in number of days with headache. At end-point, the venlafaxine XR group had a significantly greater decrease in the number of days with headache compared with placebo (P = 0.05). Differences with regard to secondary efficacy variables where not significant. The number needed to treat for responders (>or=50% reduction in days with headache) was 3.48. Six patients in the venlafaxine XR group interrupted therapy due to adverse events, while no patients in the placebo group did so for the same reason. The number needed to harm was 5.58. This study provides preliminary evidence for the efficacy and safety of venlafaxine XR 150 mg/day in reducing the number of days with TTH.