Blood donation knowledge and attitudes among undergraduate health science students: A cross-sectional study.

Awareness towards blood donation can be empowered by health professionals' role-modelling. We aimed to assess knowledge and attitudes among Greek undergraduate medical laboratory students. A questionnaire was distributed to 330 students (response rate: 88.7%). Overall, 24% had donated blood at least once, with males 4.62 times more likely to be donors. Voluntary, non-remunerated blood donors were more likely to be repeaters. A quarter of all students were inclined to offer blood for monetary reward, with men more prone to accept payment. There is a need to campaign health science students during formal education through need-based as well as altruistic 'smart' messages.

Effect of religiosity/spirituality and sense of coherence on depression within a rural population in Greece: the Spili III project.

BACKGROUND: Recent research has addressed the hypothesis that religiosity/spirituality and sense of coherence buffer the negative effects of stress on numerous health issues. The aim of the current study was to further this work by exploring potential links between psycho-social factors such as religiosity/spirituality and sense of coherence with depression. METHODS: A total number of 220 subjects of the SPILI III cohort (1988-2012) attending a primary care setting in the town of Spili on rural Crete represented the target group. All participants underwent a standardized procedure. Validated questionnaires were used to evaluate sense of coherence, depression levels and religious and spiritual beliefs. A multiple linear regression analysis of the Beck Depression Inventory Scale (BDI) in relation to demographic characteristics, scores on the Royal Free Interview for Spiritual and Religious Beliefs scale (RFI-SRB) and Sense of Coherence scale (SOC) was performed. RESULTS: A significant inverse association was found between BDI and RFI-SRB scale (B-coef = -0.6999, p < 0.001), as well as among BDI and SOC scale (B-coef = -0.556, p < 0.001). CONCLUSIONS: The findings of the current observational study indicate that highly religious participants are less likely to score high in the depression scale. Furthermore, participants with high SOC scored significantly lower in the BDI scale. Further research is required in order to explore the potential effect of SOC and religiosity/spirituality on mental health.

A fatal case of seronegative, late-onset systemic lupus erythematosus presenting with motor sensory axonal polyneuropathy.

Systemic lupus erythematosus is a multisystemic, autoimmune, inflammatory disorder predominantly affecting young females. Its onset may be abrupt or insidious, presenting with a broad range of clinical and immunological features. We report an unusual case of elderly-onset systemic lupus erythematosus in a woman initially diagnosed with discoid lupus, and subsequently admitted to hospital due to a progressive psycho-motor deficit. Electrophysiological measurements suggested a diagnosis of acute motor sensory axonal neuropathy. Unusual clinical features and negative serology led to diagnostic uncertainty. This case report offers information on the course of the disease through the entire chain of the health care delivery (from primary to tertiary). Despite the efforts of the hospital staff, it was not possible to save the life of the woman.

Severe throat pain in patients with negative oropharyngeal examination: four case reports and overview of the literature.

Throat pain is one of the most frequent complaints prompting patient visits to healthcare professionals. Primary care physicians being the first contact point are frequently encountered with symptoms such as sore throat and odynophagia. However, high level of diagnostic uncertainty exists when the oropharyngeal examination is normal despite patients' complaints of severe pain. We present four Caucasian Greek patients, two males aged 47 and 57 years and two females aged 32 and 47 years respectively admitted to an Ear Nose and Throat department of a general hospital, with severe throat pain and initially normal oropharyngeal examination. This case series highlights the necessity for a high level of suspicion on the part of the primary care physicians when facing patients complaining of severe throat pain since their symptoms may indicate conditions such as supraglottitis, lingual tonsillitis or pemphigus vulgaris. A careful clinical examination, including an indirect laryngoscopy, is required especially when the initial oropharyngeal examination is normal.

Medical decision and patient's preference: 'much ethics' and more trust always needed.

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice.

Holly Sacrament: the medicine of spiritual immortality or a vehicle for contamination?

The Holy Communion is the oldest Christian practice, through which a gathered group of people partake bread and wine with a shared spoon. The pandemic of COVID-19 produced unexpected social instability and chaos. In Greece, a recent bishop's death from COVID-19 re-awaked the issue of infection transmission by using a common chalice and spoon. This review evaluates the available medical literature on this topic from the beginning of the pandemic until today.

Hypothyroidism Induced Rhabdomyolysis in a Young Male after a Single Intramuscular Injection: A Case Report.

Hypothyroidism is a common endocrine disorder resulting from the inability of the thyroid gland to produce sufficient thyroid hormone for the metabolic demands of the body. Clinical symptoms and signs are often non-specific and subtle. Muscular symptoms are frequently reported. Rhabdomyolysis is a life-threatening condition caused by necrosis of muscles and leakage of toxic intracellular components into the blood circulation. Hypothyroidism induced rhabdomyolysis, represents an unusual clinical occurrence. This is a case of a middle-aged man, who presented with severe myalgias, following an intramuscular injection. After laboratory work-up, he was diagnosed with rhabdomyolysis. Laboratory and ultrasound tests disclosed primary hypothyroidism of auto-immune etiology.

Primary care and the COVID-19 pandemic: Schrödinger's cat.

The #COVID19 pandemic crisis requires the collaboration of all healthcare providers. Every contribution is welcome to gain time during the phase of "system state" superposition. https://bit.ly/3m4SBxY.

COVID-19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review).

The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the World Health Organization to characterize the pandemic as a public health emergency of international concern. National health care systems in countries during the initial surge of the pandemic were unable to handle the sanitarian crisis that had emerged. Thus, the prevention and control of future global health emergencies must be a priority. The present scoping review aimed to retrieve articles that summarize the current experience on issues related to historical knowledge, and epidemiology, clinical features and overall burden of SARS-CoV-2 on health care services. In summary, a comprehensive overview of the information that has been learnt during this period is presented in the current review. Furthermore, taking into account the global experience, the need for planning cohesive and functional health services before similar pandemic events occur in the future is highlighted. The next public health issue should be prevented rather than treated. In spite of the vaccination benefits, a number of sporadic cases of SARS-CoV-2infections will persist. Information collected remains relevant for appraising how similar threats can be faced in the future. Overall, collaborative health care plans need to be rethought to increase preparedness.

Primary lower limb lymphedema: a focus on its functional, social and emotional impact.

Primary lymphedema is a rare, chronic and distressing condition with negative effects on physical, social and emotional level. The purpose of these reports was to present and discuss two different cases of primary lower limb lymphedema with a focus on its physical and mental impact and on some qualitative aspects of patients' self-reported experiences. The patients were recruited as they used occasional services within the University Hospital of Heraklion (Crete, Greece). The functional and mental impact of primary lymphedema was measured using the generic Medical Outcome Study short form-36 questionnaire and open-ended questions led to give more emphasis to patients' experiences. The analysis of short form-36 results in the first patient disclosed a significant functional impairment with a minor impact of the condition on emotional and social domains. For the second patient quality of life scores in the emotional and social domains were affected. Our findings support further the statement that physicians should pay full attention to appraise the patient's physical and emotional condition. General practitioners have the opportunity to monitor the long-term impact of chronic disorders. Posing simple open-ended questions and assessing the level of physical and mental deficits in terms of well-being through the use of specific metric tools can effectively follow-up rare conditions in the community.

Holy Communion and Infection Transmission: A Literature Review.

The Holy Communion originated in the Last Supper of Jesus Christ, nearly 2,000 years ago. According to the Bible, the night before his crucifixion, Jesus Christ shared with his 12 apostles a meal of bread and wine. During the meal, Christ instructed his disciplines to eat and drink in his memory, saying that bread is his body and wine is his blood. Today, faithful people worldwide share the consecrated bread and wine retracted from a chalice with a Holy Communion spoon. The novel coronavirus that emerged in December 2019 recorded a rapid exponential spread across space and time. The ongoing pandemic of coronavirus disease has affected people from all cultures and religions. In Greece, the pandemic concurred with the Easter celebration. Measures of social distancing have been implemented. Among others, churches have closed their doors to the public in order to avoid religious mass gatherings. The issue of the novel coronavirus transmission by partaking Holy Communion has received much criticism. In this review, we aimed to retrieve articles that summarize the current knowledge on the selected topic. In order to offer a balanced analysis of the subject, we have also assessed the theological framework of the Holy mystery.

A Young Male With Anorexia, Abdominal Complaints and Marked Blood Eosinophilia.

Peripheral blood eosinophilia represents a frequent finding in routine clinical practice when absolute eosinophil count is found to be greater than 0.5 x 109/L (500/µL). Common causes include parasitic infections, allergic reactions, and hyper-eosinophilic syndrome. Eosinophilia secondary to malignancy represents an uncommon presentation. Here we report an atypical case of a 47-year-old previously healthy male who presented to a primary care setting complaining of fatigue and anorexia for the last two weeks. The evaluation revealed leucocytosis and peripheral hypereosinophilia with an absolute eosinophil count of 14.13×109/L (37%). Following an extensive diagnostic work in a secondary care centre he was finally diagnosed with rectal carcinoma. This case highlights that solid malignancy should be considered in patients with marked peripheral eosinophilia.

Spontaneous Intra-Cerebral Haemorrhage Presenting with Chest Pain in a Healthy Young Man.

Spontaneous, non-traumatic intra-cerebral haemorrhage is the second most common type of stroke and is associated with significant morbidity and mortality. It is defined as the presence of blood within the cerebral parenchyma without prior injury or surgery. The purpose of this work is to describe an atypical presentation of spontaneous intra-cerebral haemorrhage in a healthy young adult. A literature review was also carried out. LEARNING POINTS: Spontaneous intra-cerebral haemorrhage is a challenge in daily practice due to the wide range of clinical symptoms on presentation.Chest pain mimicking acute myocardial infarction is an atypical presentation of intra-cerebral haemorrhage.In the primary care setting, misdiagnosis of a patient with spontaneous cerebral haemorrhage with chest discomfort suggesting cardiac aetiology and prompting antiplatelet/aspirin therapy could result in disaster.Taking a detailed history and conducting a thorough neurological examination is important in every clinical encounter and may trigger diagnostic suspicion.

An Elderly Woman with Pyrexia of Unknown Origin.

Pyrexia of unknown origin represents a diagnostic challenge in the daily practice. Clinical features are often subtle or inadequate to recognize the etiology of prolonged fever. Endocrine etiology of pyrexia of unknown origin is not common. Here we present a case of an elderly female seeking medical advice from her general practitioner due to a four-week history of moderate fever, malaise and loss of appetite. Initial outpatient diagnostic workup was negative. During repeated examination a slight enlargement of thyroid gland was noticed. Thyroid function tests revealed a very low level of thyroid stimulated hormone along with elevated free T4 suggesting subacute thyroiditis. Low dose administration of corticosteroids led to clinical improvement and fever remission. Physicians involved must be aware about this unusual presentation of thyroiditis and include the condition in the differential diagnosis of prolonged unexplained fever. In the absence of clinical signs and symptoms, an abnormal thyroid function test may prevent from unnecessary investigations and inefficient hospital admission.

Religiosity, Well-Being and 'Slowing Down' Ageing Damage: A Literature Review.

Telomere length (TL) represents an important marker of cellular aging. Its shortening affects human health and longevity by inducing senescence, apoptosis, and oncogenesis. Advanced ageing and negative behavioral and lifestyle factors decrease TL. The relationship between positive psycho-social factors and longer telomeres has given rise to a growing number of research efforts. Among these, religiosity poses a particular interest since it is associated with a wide range of favorable health outcomes. In this direction, recent literature reports, suggest a positive link between religiosity and TL. Underlying mechanisms for this association are not yet clarified. In this review, we would like to summarize the current knowledge on the link between religiosity and TL. Taking this opportunity, we recall findings from a cohort study in rural Crete, Greece that adds evidence on the discussion of potential psycho-social mediators which some may prevent shortening of TL.

Rectal Lipoma in an Elderly Male: A Case Report.

Lipomas of the gastrointestinal tract are uncommon, benign non-epithelial tumors detected incidentally during surgery or endoscopy. Rectal lipomas are extremely rare. Patients may be asymptomatic or present with rectal bleeding, constipation, tenesmus and signs of intestinal obstruction. Preoperative diagnosis is challenging. Management consists of simple observation, endoscopic or laparoscopic removal, and open surgery. We present a case of an elderly male admitted to the Department of Surgery of a general hospital in Crete, complaining of a protruding rectal mass during defecation. CT raised the diagnostic suspicion. The mass was removed by trans-anal excision. Histopathology of the resected specimen confirmed the diagnosis. The patient had an uneventful postoperative course and was discharged home at the second postoperative day.

Diabetic neuropathy and restless legs syndrome: can a known chronic condition slow down our diagnostic way of thinking? A case report and a short literature overview.

Restless legs syndrome is a common lifelong neurological disorder with a negative impact on the patients' sleep and quality of life. Despite its common occurrence in the general population, the condition usually remains undiagnosed. Patients with diabetes run at a higher risk to suffer from restless legs syndrome. Diabetic neuropathy, in particular, shares similar clinical characteristics with restless legs syndrome and reduces significantly the patients' quality of life. Our aim was to report on an interesting case of restless legs syndrome in a patient with diabetes seeking medical advice for a ten-year long insomnia. Sleep deprivation was falsely attributed to diabetic neuropathy. A literature overview of the up-to-date knowledge was performed in order to summarize available information and provide primary care physicians with a comprehensive way of clinical thinking to differentiate peripheral neuropathy and restless legs syndrome manifestations.

Burden of metabolic syndrome among primary care patients in Crete, Greece: A descriptive study.

BACKGROUND: Metabolic Syndrome (MetS) is a clustering of abdominal obesity, hypertriglyceridaemia, low HDL cholesterol, hyperglycaemia and hypertension. Early identification of MetS is important for preventing cardiovascular disease (CVD). MetS has not been systematically explored in Greek primary care. OBJECTIVES: To examine MetS frequency among primary care patients 40 years of age or older in Crete. METHODS: A descriptive study was conducted (July-December 2015). General practitioners, randomly selected from regional physician listings, recruited consecutive patients, 40 years of age or older, visiting their practice. Chart audits were completed for eligible patients using medical records, including demographics and cardiovascular risk factors (hypertension, dyslipidaemia, diabetes mellitus). MetS was defined using the revised NCEP ATP III criteria. Frequencies with 95% confidence intervals were calculated. Gender differences were explored using Chi-square and Mann-Whitney tests. RESULTS: Our sample consisted of 815 patients (55.7% female; mean age 65.2 years; range 40-98 years) from 44 GP practices. Overall, 73.6% (95% CI 70.4, 76.6) were identified with MetS, with a higher proportion of males (75.6%; 95% CI 71.0, 79.8) than females (72.0%; 95% CI 67.8, 76.0). Among the total sample, relatively high rates of hypertension (males: 64.5%; 95% CI 59.9, 70.0 and females: 61.1%; 95% CI 56.8, 65.8), dyslipidaemia (males: 69.3%; 95% CI 64.3, 74.1 and females: 63.5%; 95% CI 59.3, 68.0), diabetes mellitus (males: 46.9%; 95% CI 42.2, 52.4 and females: 36.5%; 95% CI 32.5, 41.6) and coronary heart disease (males: 21.2%; 95% CI 17.0, 25.2 and females: 6.2%; 95% CI 4.2, 8.6) were documented. CONCLUSION: MetS and CVD risk factors were encountered at high frequencies in the studied population of primary care patients in Crete.

R on T Phenomenon and Long QTc Syndrome due to Moxifloxacin in a Healthy Female.

Long QT syndrome is characterized by prolongation of the corrected QT interval and is associated with fatal arrhythmias. R on T phenomenon is the coincidence of a premature ventricular complex with a T wave and may result to syncope and sudden cardiac death. Here we present a case of a 59-year-old woman with no previous history of medication, receiving moxifloxacin for community-acquired pneumonia. She was admitted complaining for thoracic pain and shortness of breath. Electrocardiogram showed both R on T phenomenon and QT prolongation. After discontinuation of the antibiotic symptoms and electrocardiography features were resolved. Physicians should always be vigilant about this rare and potentially fatal adverse drug reaction especially in high risk patients. General practitioners in particular being the first point of access in care have to carefully assess and detect high risk patients before the administration of moxifloxacin.