The state of emergency medicine in Greece: at critical momentum.

Greece is a parliamentary republic in southeastern Europe populated by over 10 million permanent residents: 9 million reside on the mainland, with almost 4 million in the greater Athens area. The remaining 1 million populate the over 1200 Greek islands. In addition, more than 160,000 asylum-seekers reached Greece in 2022, and more than 25 million tourists have visited Greece in the last two years.

Detecting Stroke at the Emergency Department by a Point of Care Device: A Multicenter Feasibility Study.

Purpose: To evaluate if the Strokefinder MD 100 by Medfield Diagnostics AB can be used as a point of care device in overcrowded Emergency Departments (ED).

Patients And Methods: We used the strokefinder MD 100 by Medfield Diagnostics AB in two Greek National Health System (NHS) Hospitals Emergency Departments. Our research protocol was approved by local scientific and ethics committees.

Adipose tissue fatty acid composition in Greek patients with breast cancer versus those with benign breast tumors.

Background: Fatty acid composition of adipose tissue is a most reliable biomarker of long-term dietary fatty acid intake. Few studies have implemented biomarkers of fatty acid intake in relation to breast cancer. In this study the relation between adipose tissue composition and breast cancer was investigated.

Complications and toxicity after abdominal and pelvic hypoxic stop-flow perfusion chemotherapy: incidence and assessment of risk factors.

Background: Controversial results regarding the efficacy and toxicity of hypoxic abdominal and pelvic stop-flow perfusion chemotherapy (SFP) have been reported in relatively small series. Hence, because adequate assessment of its benefit in large homogenous cohorts is missing, acceptable morbidity should initially be assured in a series of adequate size. Additionally, risk factors should be assessed for eventual patient selection.

Immunohistochemical study of the angiogenetic network of VEGF, HIF1α, VEGFR-2 and endothelial nitric oxide synthase (eNOS) in human breast cancer.

Background: The role of Nitric Oxide (NO) in angiogenesis has not been fully clarified yet. A dual role for NO, either inductive or inhibitory, has been proposed on the basis of different effects that high or low concentrations of NO may exert on the angiogenic process. Additionally, it has been referred that NO may induce VEGF production, while VEGF may induce NO production via up-regulation of the endothelial nitric oxide synthase (eNOS), the two pathways being reverse.

Approaches to breast cancer screening among primary care physicians in rural areas of crete, Greece.

The aim of this study was to assess levels of knowledge regarding breast cancer screening among primary care physicians in rural areas of Crete. A cross-sectional survey of 106 general practitioners and internists and 83 trainee general practitioners (GPs) employed as of October 2004 and practicing at 14 primary health centers in Crete was performed. It was a self-administered survey with 27 items exploring knowledge, attitudes, and behaviors concerning delivery of general preventive and cancer screening services.

Significant differences in skin irritation by common suture materials assessed by a comparative computerized objective method.

Background: Erythema can be described only through subjective evaluation, except when it is quantified by digital image analysis software. Using such software, the authors performed comparisons of the erythema produced after skin closure of clean surgical wounds. Five suture materials were compared with respect to the local skin irritation that was caused.

The extent of lymph node dissection for gastric cancer: a critical appraisal.

The extent of lymphadenectomy during therapeutic gastrectomy for gastric cancer remains a protracted and controversial issue. While traditionally extended lymphadenectomy is performed in Eastern Asia, limited lymphadenectomy is advocated by most western surgeons. Two large western randomized trials, meta-analyses and a recent systematic review were unable to demonstrate overall benefit from extended lymphadenectomy.

Pilot implementation of a technologically advanced system for the optimization of pre-hospital, trauma patient care.

Background: Cooperation between medical informatics, wireless communication and pre-hospital emergency services is essential for the optimal pre-hospital patient treatment. The use of technological innovations improves medical care in the pre-hospital setting with regard to the organization of an integrated center, which coordinates all parties involved for the patient's best interest.

Methods: A dispatch center was developed in the city of Patras, in southwestern Greece, equipped with a Geographic Information System (GIS), which immediately points out the location of emergency vehicles (EVs) on a digital map depicting the city plan.

Super giant basal cell carcinoma of the abdominal wall: still possible in the 21st century.

Basal cell carcinoma (BCC) is very common and usually encountered when it is small in size. Giant BCC (i.e.

Gynaecomastia and scrotal rhacosis: two aesthetic surgical operations for men in Byzantine times.

Background: Nowadays, as in the past, much attention is paid to aesthetic operations in women, while only infrequently have such operations been referred to in males. Generally, male aesthetic surgery was introduced to surgical practise during the 19th century. In this study, we analysed the practise of such operations in Byzantine times and in other ancient cultures with surgical knowledge, i.

Pregnancy after breast cancer. A comprehensive review.

Pregnancy after breast cancer treatment has become an important issue since many young breast cancer patients have not completed their family. Generally, these patients should not be discouraged to become pregnant when they want to, since published data suggest no adverse effect of pregnancy on survival. As fertility may be impaired by chemotherapy, different fertility preserving strategies have been developed.

Preoperative decision making for rectal cancer.

Background: Rectal cancer treatment has become multimodal as a result of significant advances in imaging, staging, surgery, radiotherapy, and chemotherapy. Multidisciplinary teams can incorporate these developments into tailor-made treatment plans and offer state-of-the-art services for rectal cancer patients.

Methods: We searched the MEDLINE and PubMed databases using the following keywords: "rectal cancer," "total mesorectal excision," "multidisciplinary treatment/team," "radiotherapy," "chemotherapy," and their combinations.

Bone mass decreases in morbidly obese women after long limb-biliopancreatic diversion and marked weight loss without secondary hyperparathyroidism. A physiological adaptation to weight loss?

Objective: To investigate the effect of marked weight loss after long limb-biliopancreatic diversion (BPD-LL) on bone mass and serum calcium, 25-OH-vitamin D, and PTH levels in relation to calcium supplementation.

Background Data: BPD is the most effective type of bariatric surgery, but it is followed by bone mass loss, mainly attributed to calcium and vitamin D malabsorption leading to secondary hyperparathyroidism.

Methods: Two groups, each consisting of 26 healthy, morbidly obese, premenopausal women, underwent BPD-LL.

Adipose tissue fatty acids in breast cancer patients versus healthy control women from Crete.

Background: Few studies have implemented biomarkers of fatty acid intake in relation to breast cancer.

Aims: To examine possible differences in adipose tissue fatty acid composition between breast cancer patients and healthy control women. The relationship between tumor promotion and adipose tissue fatty acid synthesis was also investigated.

The effect of preoperative chemoradiotherapy on lymph node harvest after total mesorectal excision for rectal cancer.

Purpose: This study was designed to evaluate whether preoperative chemoradiotherapy reduces the number of lymph nodes harvested after total mesorectal excision of rectal cancer.

Methods: From January 1995 to December 2007, 168 consecutive patients with rectal cancer underwent total mesorectal excision in the Department of Surgical Oncology at the University of Crete. The patients were divided into three groups (Group A, no chemoradiotherapy; Group B, short course of chemoradiotherapy; Group C, long course of chemoradiotherapy).

Parathyroid carcinoma: clinical presentation and management.

Parathyroid carcinoma constitutes a rare cause of hyperparathyroidism. Five patients, presenting with symptoms and clinical signs of parathyroid hyperfunction, were diagnosed with parathyroid carcinoma in our department over a 12-year period. The experience we gained in the management of these tumors is presented.

Desmoid tumors: need for an individualized approach.

Desmoid tumor, also known as aggressive fibromatosis or desmoid-type fibromatosis, is a rare monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. Although histologically benign, desmoids are often locally invasive and associated with a high local recurrence rate after resection. Since it is a heterogeneous disease, in particular regarding clinical presentation, anatomic location and biological behavior, treatment should be individualized to reduce local tumor control failure with concurrently acceptable morbidity and preservation of quality of life.

Anastomotic leakage after low anterior resection for rectal cancer: facts, obscurity, and fiction.

The subject of anastomotic leakage after low anterior resection (LAR) for rectal cancer remains controversial. Risk factors have been discussed in several studies but the findings are often inconclusive. This review evaluates these studies and separates the known risk factors into those that are well documented, those that are obsolete, and those that require further research.

Melanoma of the vulva: a pigmented lesion is also significant in a non-sun-exposed area.

Purpose: The foremost important aetiological factor for malignant melanoma is considered to be sunlight exposure. However, primary lesions are also seen in non-sun-exposed areas. Vulvar melanoma is rare and associated with impaired outcome.

Sealants after axillary lymph node dissection for breast cancer: good intentions but bad results.

Background: This study was conducted to evaluate the effect of 2 surgical sealants on postsurgical drainage and lymphocele formation after axillary surgery for breast cancer.

Methods: This was a prospective, randomized study. Seventy-seven consecutive patients with breast cancer were included and randomized into a control group (18F vacuum drain) and 2 study groups (18F vacuum drain plus COSEAL or BioGlue).

Is there any benefit from sentinel lymph node biopsy using the combined radioisotope/dye technique in breast cancer patients with clinically negative axilla?

Objective: We evaluated the eventual benefits from sentinel lymph node biopsy (SLNB) in comparison with axillary lymph node dissection (ALND) using a combined radioisotope/dye technique versus dye alone in breast cancer patients.

Methods: SLNB was performed in 501 breast cancer patients (250 patients with dye alone and 251 with combined technique). Patients were divided in three groups: (A) clinical stage T1,2N0 (SLNB followed by ALND only in cases with positive histology), (B) clinical stage T1,2N0 (SLNB followed by ALND), and (C): advanced clinical stage (SLNB immediately followed by ALND).

Mammography screening: views from women and primary care physicians in Crete.

Background: Breast cancer is the most commonly diagnosed cancer among women and a leading cause of death from cancer in women in Europe. Although breast cancer incidence is on the rise worldwide, breast cancer mortality over the past 25 years has been stable or decreasing in some countries and a fall in breast cancer mortality rates in most European countries in the 1990s was reported by several studies, in contrast, in Greece have not reported these favourable trends. In Greece, the age-standardised incidence and mortality rate for breast cancer per 100.

Towards quality control in rectal cancer surgery: a preliminary Greek experience.

Background: The purpose of this study was to evaluate the effect of the introduction of a colorectal unit on provided services for patients with rectal cancer.

Methods: The colorectal unit in our department was initiated in January 2004. A dedicated database was used to retrieve data from 127 consecutive patients who were operated on electively from March 1995 to December 2005.

Effect of an ibuprofen-releasing foam dressing on wound pain: a real-life RCT.

Objective: To compare an ibuprofen-releasing foam dressing (Biatain Ibu, ColoplastA/S) with local best practice in the treatment of painful exuding wounds.

Method: In this large-scale randomised comparative study, 853 patients were randomised to either ibuprofen-releasing foam (test) dressing (n=467) or local best practice (n=386). Primary endpoint was wound pain relief from day 1-7, assessed by the patients twice daily using a five-point verbal rating scale.