The Hippocratic principle "to help or at least to do no harm".

Hippocrates' teaching on the ethical and moral values of medicine have captivated physicians, scholars, and historians for over twenty-five centuries, enduring despite the challenges of applying moral guidance across diverse cultures. At the core of Hippocratic ethics is the human relationship between the physician and the patient, with an emphasis on the physician's responsibility to assess potential harm involved in any attempt to heal. The Hippocratic principle "to help, or at least to do no harm" remains as relevant today as it was 2,500 years ago.

Hippocratic concepts of acute and urgent respiratory diseases still relevant to contemporary medical thinking and practice: a scoping review.

Background: The collected works of Hippocrates were searched for concepts on the diagnosis, prognosis, and treatment of acute and urgent respiratory diseases, with the objective to trace their origins in the Hippocratic Collection.

Methods: A scoping review was performed to map out key concepts of acute and severe respiratory diseases in the entire Hippocratic Collection. The digital library Thesaurus Lingua Graeca (TLG) was researched for references in the entire Hippocratic Collection regarding the epidemiology, pathophysiology, prognosis, diagnosis and treatment of acute respiratory diseases; then, the relevant texts were studied in their English translation by the Loeb Classical Library.

Preoperative Albuminuria and Intraoperative Chloride Load: Predictors of Acute Kidney Injury Following Major Abdominal Surgery.

Background: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery.

The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part II: interpretation of the Hippocratic Oath-today's perspective.

This is the second part of a paper on the relevance and significance of the Hippocratic Oath to modern medical ethical and moral values with the aim at answering questions on controversial issues related to the Oath. Part I argued that the general attributes and ethical values of the Oath are relevant to the modern world. Part II attempts to elucidate the interpretation of the specific injunctions of the Oath from today's perspective in relation to ethical values concerning the duties of physicians to patients and society.

The value of the Modified Early Warning Score for unplanned Intensive Care Unit admissions of patients treated in hospital general wards.

Aim: To determine the value of the Modified Early Warning Score (MEWS) for general ward patients and its potential use as an alarm tool for ward nurses.

Methods: A combined prospective-retrospective observational study was conducted with 153 patients in a university hospital (2013-2014). All patients were admitted to the intensive care unit (ICU) from general wards.

The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times.

The present paper discusses the relevance and significance of the Hippocratic Oath to contemporary medical ethical and moral values. It attempts to answer the questions about some controversial issues related to the Oath. The text is divided in two parts.

Gastrointestinal motility following thoracic surgery: the effect of thoracic epidural analgesia. A randomised controlled trial.

Backgrounds: Impairment of gastrointestinal (GI) motility is an undesirable but inevitable consequence of surgery. This prospective randomised controlled study tested the hypothesis that postoperative thoracic epidural analgesia (TEA) with ropivacaine or a combination of ropivacaine and morphine accelerates postoperative GI function and shortens the duration of postoperative ileus following major thoracic surgery compared to intravenous (IV) morphine.

Methods: Thirty patients scheduled for major thoracic surgery were randomised to three groups.

The origins of oral medicine in the Hippocratic collected works.

The collected works of Hippocrates describe for the first time in a systematic way a large number of oral diseases, such as ulcers, inflammations, abscesses and tumours from the epiglottis, mouth, tongue, palate, uvula and the sublingual area. Several of these case reports are remarkable for the accurate observation of clinical symptoms and signs, the aetiology, the pathogenesis and their therapeutic approach in relation to prognosis. The Hippocratic authors report cases of aphthae as part of a polysystemic disease, described many centuries later by Behçet and Adamantiades, while they associate features of splenomegaly from endemic malaria with gingivitis (ulitis).

Emergencies and acute diseases in the collected works of Hippocrates: observation, examination, prognosis, therapy.

The collected works οf Hippocrates include a wealth of references to emergencies and acute conditions; if the physician could treat these, he would be considered superior to his colleagues. Works most relevant to current Emergency Medicine are presented. They indicate Hippocrates' remarkable insight and attention to the value of close observation, meticulous clinical examination, and prognosis.

A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries.

Background: Europe is a patchwork of 47 countries with legal, cultural, religious, and economic differences. A prior study suggested variation in ethical resuscitation/end-of-life practices across Europe. This study aimed to determine whether this variation has evolved, and whether the application of ethical practices is associated with emergency care organisation.

Adding fentanyl to etomidate fails to reduce painful recall of external direct current cardioversion in adults: a randomised trial.

Introduction: External electrical cardioversion under hypnotics, even when combined with opioids, has been consistently described as distressing or painful. The main objective of the present study was to determine if adding an opioid to a hypnotic, in comparison to the same hypnotic alone, would decrease the incidence of unpleasant or painful recall during anaesthesia for external electrical cardioversion.

Methods: This was a single-centre, prospective, randomised, double-blinded clinical trial that took place from September 2011 to March 2012.

Molecular response of the human diaphragm on different modes of mechanical ventilation.

Background: The mechanical stress that the human diaphragm is exposed to during mechanical ventilation affects a variety of processes, including signal transduction, gene expression, and angiogenesis.

Objectives: The study aim was to assess the change in the production of major angiogenic regulators [vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF2), and transforming growth factor beta 1 (TGFB1)] on the human diaphragm before and after contraction/relaxation cycles during mechanical ventilation.

Methods: This observational study investigates the diaphragmatic mRNA expression of VEGF, FGF2, and TGFB1 in surgical patients receiving general anesthesia with controlled mechanical ventilation (CMV) with muscle relaxation (group A, n = 13), CMV without muscle relaxation (group B, n = 10), and pressure support of spontaneous breathing (group C, n = 9).

Anaesthesia for cardioversion: a prospective randomised comparison of propofol and etomidate combined with fentanyl.

Introduction: External electrical cardioversion is mostly performed solely under sedatives or hypnotics, although the procedure is painful. The aim of this prospective randomised study was to compare two anaesthetic protocols that included analgesia.

Methods: Patients with persistent atrial fibrillation were randomised to receive intravenously either fentanyl 50 μg and propofol 0.

Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents.

Purpose: The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-hydroxytryptamine type 3 antagonists in terms of the incidence and intensity of postoperative nausea and vomiting (PONV) in a homogenous group of female patients undergoing thyroidectomy.

Methods: The study cohort consisted of 203 American Society of Anesthesiologists PS I-II female patients randomized into four groups to receive at induction of anesthesia an intravenous (IV) bolus of 5 ml solution of one of the following: normal saline (placebo), granisetron 3 mg, ondansetron 4 mg, or tropisetron 5 mg. Nausea and vomiting were evaluated at five time points: during the first hour in the postanesthesia care unit (PACU) and 6, 12, 18, and 24 h postoperatively.

Basic life support skill retention by medical students: a comparison of two teaching curricula.

Aim: In December 2005 the new guidelines for resuscitation were released and a new curriculum for the teaching of basic life support (BLS) was adopted. The aim of the present study was to investigate the effectiveness of the new guidelines and teaching curriculum on the BLS skill retention of medical students 1 year following their initial training.

Methods: The study was conducted in two consecutive academic years and compared BLS skill retention of two groups of medical students in their fourth year of medicine.

Case report: subarachnoid anesthesia for kyphoplasty: is anesthesia adequate?

We performed a prospective pilot study of subarachnoid anesthesia for kyphoplasty in 11 nonrandomized patients. Subarachnoid anesthesia was administered at the level of the best palpable intervertebral space below L3. Patients received intrathecally either hyperbaric or plain bupivacaine with or without fentanyl.

Cranial trauma in ancient Greece: from Homer to classical authors.

This article presents literary evidence on traumatic cranio-cerebral injuries in ancient Greece from about 900 B.C. to 100 B.

References to anesthesia, pain, and analgesia in the Hippocratic Collection.

The Hippocratic Collection, containing 60 medical texts by Hippocrates and his pupils, was searched using the electronic database Thesaurus Lingua Graeca to identify the words "anaesthesia" and "analgesia," their derivatives and also words related to pain. Our purpose was to investigate the special use and meaning of these words and their significance in medical terms. The word "anaesthesia" appears 12 times in five Hippocratic texts to describe loss of sensation by a disease process.

Effect of epidural ropivacaine on somatosensory and motor evoked potentials.

The case of a 57-year-old man who underwent major spinal surgery as a result of a traumatic burst fracture of the T(12) vertebra, is presented. Changes in somatosensory evoked potentials and motor evoked potentials following the intraoperative epidural administration of ropivacaine, is described.

Airway management in cervical spinal cord injured patients: a survey of European emergency physicians' clinical practice.

No European airway management guidelines are currently specific to patients with cervical spinal cord injury (CSCI). The objectives of this study were to determine the clinical practice of European emergency physicians and anaesthesiologists regarding airway management in patients with CSCI. A questionnaire survey was completed by the participants of the fourth European Congress on Emergency Medicine regarding the preferred intubation techniques and the relevant skills, as well as airway management manoeuvres that, in the physician's opinion, caused the least and the greatest cervical spine movement.

Effect of the physical properties of isoflurane, sevoflurane, and desflurane on pulmonary resistance in a laboratory lung model.

Background: Airway resistance depends not only on an airway's geometry but also on flow rate, and gas density and viscosity. A recent study showed that at clinically relevant concentrations, the mixtures of volatile agents with air and oxygen and oxygen-nitrogen affected the density of the mixture. The goal of the current study was to investigate the effect of different minimum alveolar concentrations (MACs) of three commonly used volatile agents, isoflurane, sevoflurane, and desflurane, on the measurements of airway resistance.

Workload and case-mix in a Greek emergency department.

The objective of the present study was to evaluate the workload and case-mix of the Emergency Department of a referral hospital, with the aim of determining the causes of overcrowding. The study was of a descriptive prospective design and was carried out in a 700-bed university hospital covering a population of approximately 200,000 inhabitants. The total number of patient visits to the Emergency Department and hospital admissions were recorded during one year, whereas the case-mix of patients visiting the department was evaluated during 11 consecutive on-call days using a triage scale with four categories of patient severity.