Changes in Smoking Habits in Greece During the Lockdown Measures Due to COVID-19.

INTRODUCTION: During lockdown, people are experiencing higher than usual levels of stress related to social isolation, employment, and finances that may result in lifestyle changes. Here, we aim to assess whether smoking habits changed during the lockdown measures due to coronavirus disease 2019 (COVID-19). METHODS: For the purpose of the survey, an online questionnaire was distributed from the tenth of April to the second of May 2020, among a Greek population, by using an online platform. RESULTS: Two hundred smokers/vapers participated in the present survey (62.5% women, 44% of 36-45 years, 29% of 16-55 years, 15.5% 26-35 years). The daily number of cigarettes smoked before the onset of the COVID-19 pandemic is 15.06 ± 9.84, while during the restrictive measures due to COVID-19, the daily number of cigarettes smoked is 14.52 ± 10.13 (p > 0.05). Vapers consumed an average of 0.54 ± 2.43 mL vapor per day before the COVID-19 pandemic and 0.61 ± 2.81 mL during lockdown. Males smoked more cigarettes per day before (16.31 ± 11.87) and during the lockdown (15.33 ± 12.17) versus females (14.30 ± 8.36) and 14.04 ± 8.70, respectively) (p > 0.05 for both genders). Before versus during the restrictive measures, subjects that were primary school graduates smoked more cigarettes per day (28.00 ± 9.09 and 27.50 ± 9.57, respectively), followed by subjects that were high school graduates (16.90 ± 9.33 and 15.97 ± 9.50, respectively), university graduates (14.17 ± 10.14 and 13.93 ± 10.66, respectively), postgraduates (12.96 ± 9.52 and 12.25 ± 9.90, respectively) and middle school graduates (12.89 ± 8.22 and 14.22 ± 7.93, respectively).The self-reported reason for the change in the mL vaporized and the cigarettes smoked are confinement at home (36.3%), stress about COVID-19 (34.09%), free time (20.45%), boredom (4.54%), stress about the work status (2.27%), and participation in online lucky games (2.27%). DISCUSSION: We did not observe significant differences in the daily consumption of smoke/vaping during the lockdown measures. More studies are needed to assess the long-term effects of the pandemic in smoking habits.

Investigation of the Level of Burnout in Health Care Professionals in COVID-19 Pandemic Conditions.

The coronavirus disease 2019 (COVID-19) pandemic has led to high levels of stress and anxiety for health care professionals. The purpose of this study was to investigate the burnout of health care professionals in COVID-19 pandemic conditions. Quantitative research was performed, and the Copenhagen Burnout Inventory was used to study burnout. The research sample consisted of 360 health care professionals. Health professionals have been found to have fairly high levels of personal burnout, work burnout, and burnout associated with patient interactions. It has also been found that women and health professionals working in department for patients with COVID-19 have significantly greater burnout. However, it was found that age, marital status, years of service, specialty, non-basic degree, and whether they or a first-degree relative had COVID-19 were not correlated to burnout. Given the very high level of burnout among health professionals, it is necessary to develop appropriate strategies to reduce burnout.

Nursing Students' Computer Anxiety and Attitudes Before and During the COVID-19 Pandemic.

Purpose of this research was to investigate how the COVID-19 pandemic affected the level of computer anxiety of nursing students and also their attitude related to computer use. A cross-sectional study was conducted in two periods, one before the COVID-19 pandemic (1st period) and the second during the COVID-19 pandemic (2nd period). The research instrument consisted of three parts, a questionnaire with questions about demographic and educational characteristics such as gender and semester of study, the Computer Anxiety Rating Scale (CARS), that used to assess the nursing students' levels of computer anxiety and the Computer Attitude Scale (CAS) that used to measure nursing students' positive and negative attitudes towards computers. Data from 957 undergraduate nursing students were obtained. Specifically, in the 1st period, 370 nursing students participated (38.66%), while in the 2nd period 587 (61.34%) undergraduates participated. The anxiety of participants during COVID-19 pandemic period was reduced compared to that of participants before the COVID-19 period. Respondents during the COVID-19 pandemic have fewer negative feelings towards computers, based on their answers in contrast to the participants in the study before the COVID-19 pandemic. Computer anxiety and attitudes have change among nursing students among COVID-19 pandemic. Nursing students after the implementation of online training are reporting positive feeling towards computer use and are more confident for their ICT skills.

Multifocal Tuberculosis Verrucosa Cutis: Case Report and Review of the Literature.

Cutaneous tuberculosis (TB) is still a major public health problem worldwide. Tuberculosis verrucosa cutis (TBVC) is a cutaneous form of exogenous TB caused by exogenous reinfection in previously sensitized individuals. TBVC typically presents as a unifocal condition. Multifocal cutaneous lesions without any other tubercular foci are extremely rare in exogenous TB and few cases are reported in the literature. We describe the first case of multifocal TBVC in an 81-year-old Greek man. In total, 14 cases of multifocal TBVC have been reported in the literature (8 males and 6 females), with mean age 47.64 years (SD = 20.75) and mean time to diagnosis of 9.69 years (SD = 15.31). Most cases (11/12) responded rapidly to treatment, implying the accuracy of diagnosis, while no one was reported to be immunocompromised. Finally, in 10 cases (71.4%), history of skin microtrauma was reported (related either to daily life habits or to professional praxis), confirming it as the main risk factor. The tuberculin skin test was positive in 10 cases and tissue culture for mycobacteria was negative in all cases. TBVC can present with multiple lesions, even in countries where TB prevalence is not high, especially in patients with history of skin abrasions. Prompt specialist assessment can expedite the establishment of diagnosis.

Pathophysiological Aspects of Aging in Venous Thromboembolism: An Update.

The aim of this review is to highlight all the factors that associate venous thromboembolism (VTE) with aging. Elderly people are characterized by a higher incidence of thrombosis taking into account the co-existing comorbidities, complications and fatality that arise. Based on the Virchow triad, pathophysiological aspects of venous stasis, endothelium injury and hypercoagulability in elderly people (≥65 years) are described in detail. More precisely, venous wall structure, nitric oxide (NO) and endothelin-1 expression are impaired in this age group. Furthermore, an increase in high-molecular-weight kininogen (HMWK), prekallikrein, factors V, VII, VIII, IX and XI, clot lysis time (CLT) and von Willebrand factor (vWF) is observed. Age-dependent platelet dysfunction and changes in anticoagulant factors are also illustrated. A "low-grade inflammation stage" is delineated as a possible risk factor for thrombosis in the elderly. Consequently, clinical implications for frail elderly people related to diagnosis, treatment, bleeding danger and VTE recurrence emerge. We conclude that aging is an acquired thrombotic factor closely related to pathophysiological changes.

Bilateral Deep Vein Thrombosis and Pulmonary Embolism Due to Right Common Iliac Artery Aneurysm with a Contained Rupture.

Venous thromboembolism (comprising deep venous thrombosis and/or pulmonary embolism) is a common disease, often of multifactorial cause. Focal iliac artery aneurysms are relatively rare, and only a few reports exist in the literature describing patients with venous thromboembolism resulting from venous floe disruption due to iliac artery aneurysm. Thus, we report a case of a 65-year-old male presenting with pulmonary embolism and bilateral deep vein thrombosis associated with a contained rupture of the right common iliac artery aneurysm.

Obesity as a Risk Factor for Venous Thromboembolism Recurrence: A Systematic Review.

Background and Objectives: Venous thromboembolism (VTE) encompasses Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE). The duration of anticoagulant therapy following a VTE event partly relies on the risk of recurrent VTE which depends on the clinical setting where VTE occurred and the VTE risk factors present. Obesity is considered a minor risk factor and studies in the literature have provided conflicting results on whether obesity influences the development of recurrences. The aim of the present study is to assess the effect of obesity on VTE recurrence in patients that suffered from a previous VTE event. Materials and Methods: We conducted systematic research for English language studies in Medline, Scopus and ProQuest databases in order to identify publications that assess the risk of VTE recurrence in obesity. Inclusion criteria were: 1. Diagnosis of VTE, 2. Definition of obesity as a body mass index ≥30 kg/m2, 3. Report of the risk of obesity on VTE recurrence, 4. Adult human population. We did not include case reports, review studies or studies that assessed other forms of thrombosis and/or used other definitions of obesity. We used the Newcastle-Ottawa scale to address the quality of the studies. Results: Twenty studies were included in the analysis, of which 11 where prospective cohort studies, 6 were retrospective cohort studies, 1 was a cross-sectional study, and 2 were post-hoc analysis of randomized clinical trials. Obesity was significantly associated with recurrences in 9 studies and in 3 of them the association was significant only in females. Conclusions: There is heterogeneity between the studies both in their design and results, therefore the effect of obesity on VTE recurrence cannot be adequately estimated. Future randomized clinical studies with appropriately selected population are needed in order to streamline the effect of obesity on VTE recurrence.

THE INVESTIGATION OF THE PSYCHOLOGICAL BURDEN OF PATIENTS AFTER HOSPITALIZATION FOR COVID 19.

OBJECTIVE: The aim: The current Cross-Sectional study investigated the psychosocial effects on recovered Covid 19 patients in a General Hospital in Greece. It was investigated the impact of Covid 19 on levels of social support, loneliness, resilience & PTSD. Furthermore, the correlation between all the above factors was studied. PATIENTS AND METHODS: Materials and methods: 107 adult patients participated. The questionnaire was fulfilled after signature of consensus form. This happened after their discharge from the hospital, without exclusion of infected on previous time. The questionnaire included 5 particular sections: a) Socio-demographic characteristics, b) social support scale, c) IES Covid 19 scale, d) UCLA scale e) CD-Risc scale. In terms of statistical analysis, the comparison between two groups of quantitative variables was conducted through Student's t-test. Related to examination of relationship between two quantitative variables was used Pearson's correlation coefficient (r). The Statistical analysis package used was SPSS 22. RESULTS: Results: The 55,1% of sample were women, married (57,9 %) and (39,3%) university graduates. Moreover, the rate of overweight was significant (39,3%). Related to psychosocial factors, observed high level of resilience (70,6), moderate level of loneliness (39,1) and 57,9% of participants showed moderate social support. At last, PTSD level as a result of Covid 19 was moderate (33,5). A strong correlation was observed between higher mental resilience and lower feelings of loneliness. CONCLUSION: Conclusions: The levels of determining factors of negative psychological effects, reveal the need for a preparation of political improvement policies in relation to mental health of rehabilitated persons, as well as the promotion of actions that would contribute to the development of a more effective supportive framework.

Temporal trends in pulmonary embolism prevalence in Greece during 2013-2017.

BACKGROUND: Pulmonary embolism (PE) epidemiological data about the disease prevalence in the general population are unclear. The present study aims to investigate the prevalence of PE in Greece and the associated temporal trends for the years 2013-2017. METHODS: Data on medical prescriptions for PE in the years 2013-2017 were provided by the Greek National Health Service Organization (EOPYY). Data on age, gender, specialty of the prescribing physician and prescription unit were provided as well. RESULTS: The total number of medical prescriptions for PE for the study period was 101,426. Of the total prescriptions, 51% were issued by the Public Sector and 48% by the Private Sector. In 2013 the prevalence of PE was 5.43 cases per 100,000 citizens and increased constantly until 2017 with 23.79 cases per 100,000 population. Prevalence was higher in all years studied in the age group of 70-80 years. For the year 2017, we observed 69.35 cases per 100,000 population for subjects 70-80 years, followed by the ages 80-90 (60.58/100,000) and 60-70 years (56.47 /100,000). Females displayed higher PE prevalence than males and higher increasing trend. CONCLUSION: PE prevalence has an increasing trend throughout the years 2013-2017 while prevalence in females is higher than males and displays a higher increasing trend. Our results may be used to appropriately organize nationwide health care campaigns aiming at the diagnosis, treatment and prevention of PE.

Level of Knowledge About COPD Among Patients and Caregivers.

Chronic obstructive pulmonary disease (COPD) represents a major health burden worldwide. COPD-specific education may positively affect the emotional distress associated with the disease and may contribute to the patients' poor health-related quality of life. Studies have shown that education regarding COPD is lacking among disease sufferers. The aim of our study was to evaluate the knowledge of COPD among patients and caregivers. We used the Bristol COPD Knowledge Questionnaire in hospitalized and nonhospitalized patients with COPD and other pulmonary diseases, their caregivers, and healthy volunteers. Mean total knowledge score of patients with COPD was 24.27 ± 8.44, of patients with other respiratory diseases 25.53 ± 7.93, of caregivers of patients with COPD 21.80 ± 5.32, of caregivers of patients with other pulmonary diseases 23.50 ± 8.79, and of healthy subjects 25.85 ± 9.27 (p = 0.071). Our data further indicate the lack of knowledge of COPD among patients and their carers and emphasize the need of education programs.

Exhaled Nitric Oxide (FeNO) in Patients Hospitalized for an Exacerbation of Bronchiectasis and/or COPD : FeNO Levels in COPD and Bronchiectasis.

Exhaled nitric oxide (FeNO) represents an important marker of airway inflammation, yet its role in chronic obstructive pulmonary disease (COPD) and/or bronchiectasis is not well studied. We aimed to measure FeNO in patients with COPD, bronchiectasis, and combination of COPD/bronchiectasis during an acute exacerbation (AE) of the underlying disease as well as to describe the characteristics of patients with COPD/bronchiectasis overlap in patients hospitalized for an acute exacerbation (AE). Seventy-nine patients were enrolled in the study as follows: COPD n = 45, bronchiectasis n = 18, and COPD and bronchiectasis n = 16. FeNO was measured with a commercially available analyzer within 24 hours of admission and at discharge. FeNO differed significantly on admission when compared at discharge in the whole group (16.91 ± 16.14 vs 12.48 ± 10.67, p = 0.008, respectively). On admission, FeNO was 17.80 ± 18.77 ppb in COPD patients, 17.12 ± 6.59 in bronchiectasis patients, and 11.55 ± 2.42 in patients with COPD/bronchiectasis overlap. At discharge, FeNO was 12.40 ± 12.11 ppb in COPD patients, 15.50 ± 6.39 in bronchiectasis patients, and 9.00 ± 3.22 in patients with combination. FeNO differed significantly in bronchiectasis patients versus patients with COPD/bronchiectasis overlap at admission (p = 0.043) and at discharge (p = 0.020) and versus COPD patients at discharge (p = 0.043). FeNO decreased significantly during the AE in all groups (p = 0.001 for COPD, p = 0.021 for bronchiectasis, and p = 0.026 for combination). FeNO levels in patients with COPD and/or bronchiectasis exacerbation are possibly increased at admission and decrease at discharge. The differences in FeNO levels between groups may reflect different underlying inflammatory mechanisms.

Compliance of Bronchial Asthma Patients' with the Mediterranean Diet : Compliance with the Mediterranean Diet in Asthma Patients.

INTRODUCTION: Asthma is considered the most common chronic disease that affects survival and quality of life. An astringent regulatory factor of asthma is the Mediterranean diet. Nutrition, however, seems to be of great importance in the onset and outcome of the disease as many ingredients and eating habits that may improve or exacerbate the condition of the patient. PURPOSE: The present study aimed to investigate dietary habits in patients with bronchial asthma and their compliance with the Mediterranean diet. MATERIAL AND METHODS: The study included 60 patients with bronchial asthma, 47 women (71% of the total) and 17 men (28.3%). All patients completed a questionnaire with sociodemographic questions, a medical history (years of diagnosis, exacerbations, hospitalizations, medication), and spirometry results (FEV1, FVC, FEV1/FVC, PEF, FEF25-75). Asthma control was evaluated with the Asthma Control Test (ACT). Conformity to the Mediterranean diet was assessed using the MEDLIFE index (Mediterranean lifestyle) questionnaire. Statistical analysis of the data was done using the SPSS 23.0 statistical package by applying the Inductive Analysis, which included the Pearson correlation coefficient (r), the t-test for independent samples, and the variance analysis (one-way ANOVA). RESULTS: There was a significant negative correlation of last year hospitalizations with the MEDLIFE questionnaire scale (r = -0.522, p = 0.009) and a significant negative correlation of last year's exacerbations with the ACT scale. We observed a significant negative correlation of hospitalizations in the last year with the ACT scale (r = -0.505, p = 0.012) and a significant statistical relationship of long acting ß2 agonist + steroid with the MEDLIFE scale (p = 0.046). CONCLUSION: The level of compliance with the principles of the Mediterranean diet leads to a reduction in hospitalization. The optimal asthma control is associated with a reduction of exacerbations and asthma control is associated with reduced hospitalizations. Those receiving beta2 + steroid show higher levels of compliance with the principles of the Mediterranean diet.

The Effect of Emotional Intelligence on Caring Behaviors Among Psychiatric Nurses in Greece : Emotional Intelligence and Caring Behaviors in Mental Healthcare.

The effect of emotional intelligence in the field of mental health is of particular interest, as it is an intensely emotional field. The nursing staff has as an object the healthcare of people with mental problems, where emotions and their management are key factors. The purpose of this study was to investigate the levels of emotional intelligence and caring behaviors among mental health nurses as well as the correlation between these variables. In this cross-sectional study, 191 nurses completed the tools Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) and the Caring Behaviors Inventory-24 scale (CBI-24) for assessing the degree of emotional intelligence and caring behaviors, respectively. Demographic and job characteristics were recorded. Results: The results showed that the majority of participants were female and the average age was 44.69 years. According to the total but also the individual scoring of the TEIQue-SF, emotional intelligence was found to be at a relatively high level (total mean: 4.92) and was associated directly (r = 0.448, p < 0.001) with the frequency of caring behaviors of the CBI-24 which was found to be at a fairly high level (total mean 5.08). The study findings showed that as the overall emotional intelligence increased, the frequency of occurrence and the importance of behavioral behaviors increased.

Attitudes and Smoking Prevalence Among Undergraduate Students in Central Greece.

Tobacco smoking is a major public health problem globally. The vast majority of smokers start smoking early. The hazards of smoking depend on a plethora of factors such as the age one starts to smoke, number of cigarettes smoked per day, nicotine, and filter type of the cigarette among other factors. According to the World Health Organization, most tobacco-related deaths occur in low- and middle-income countries. Undergraduate students are an important part of the general population, and their life conditions, smoking rates, and the knowledge, attitudes, and exposure to smoking (including secondhand smoke) are an interesting topic for investigation. The aim of the present study is to investigate undergraduate university students' smoking attitudes as well as the prevalence of smoking and their exposure to secondary smoke. A cross-sectional study was conducted in 600 undergraduate students in Central Greece. Anonymous self-report-adjusted questionnaires were distributed in students of the Technological Educational Institute of Thessaly. The total prevalence of tobacco smoking was 35%, while the majority of the smokers were females (65%). Fifty-three of the participants reported daily exposure to secondary smoke inside their houses, and 45% of them reported daily exposure to secondary smoke in their work.

The Effect of Whole-Body Cryostimulation in Healthy Adults : Whole-Body Cryostimulation According to Gender and Smoking Status.

INTRODUCTION: Whole-body cryostimulation (WBC) refers to the therapeutic application of extremely cold dry air for a short period of time. The method has beneficial results in various diseases as well as the recovery of athletes. The effects of WBC in healthy individuals have not been extensively investigated. PURPOSE: We aim to explore differences in the effects of WBC on blood pressure (BP), oxygen saturation (SpO2), and heart rate (HR) in healthy adults (not athletes) as well as differences according to gender and smoking status. MATERIALS AND METHODS: Fifty adults (male/female: 32/18) smokers/nonsmokers: 26/24) were included in the study. WBC was performed in a cryochamber at -85 °C for 3 min. Systolic BP (SBP) and diastolic BP (DBP), HR, and SpO2 were measured before and immediately after WBC. RESULTS: Males and females differed significantly in SBP after WBC (138.1 ± 13.0 vs 128.5 ± 17.0 mmHg, respectively, p = 0.029), SpO2 after WBC (96.6 ± 1.8 vs 98.3 ± 1.5%, respectively, p = 0.001) and HR after WBC (60.1 ± 9.6 vs 70.2 ± 7.7 bpm, respectively, p < 0.001). In males, SpO2 remained unchanged before and after WBC, whereas in women SpO2 increased by 1.0 ± 1.4% (p = 0.038) (Table 2). HR after WBC displayed a downward trend by -9.8 ± 5.9% in males compared to an upward trend by 3.6 ± 15.1 in females (p < 0.001). Nonsmokers displayed higher increase in SBP after WBC (4.3 ± 9.0% in smokers compared to 13.3 ± 13.2% in nonsmokers, p = 0.007). Smokers presented an increase by 1.0 ± 1.6% in SpO2, while in nonsmokers, SpO2 decreased by 0.8 ± 2.1% following WBC (p = 0.001). CONCLUSIONS: Our results suggest that WBC affects the cardiovascular and the respiratory system differently in males versus females and smokers versus nonsmokers. More studies are needed in order to fully explore the effects of WBC in these population groups in order to design individualized treatment protocols.

Increased Body Mass Index (BMI) and Sunscreen Use Are Associated with Inadequate Vitamin D Status in Greek Adults in Winter : BMI, Sunscreen Use and Vitamin D Status in Greek Adults.

Vitamin D deficiency is common even in sunny countries like Greece, especially during winter and is associated with skeletal disorders and additionally with increased risk for chronic diseases and adipose metabolic diseases such as obesity and diabetes. The purpose of this pilot study was the determination of vitamin D status in Greek adults and the investigation of possible correlation with lifestyles and somatometric characteristics. The study was conducted during winter and included 36 members (20 women and 16 men) of a university community in central Greece (latitude 39.6° North). Their age was 36.2 ± 16.3 years, body mass index (BMI) 26.4 ± 4.8 (women 26.6 ± 5.6, men 26.3 ± 3.8), and waist circumference 85.7 ± 13.3 cm (women 81.5 ± 13.0, men 90.7 ± 12.4) (mean ± SD). Mean serum 25(OH)D concentration was 20.1 ± 7.3 ng/mL (women 19.7 ± 7.6, men 20.7 ± 7.1). More than half of the participants had 25(OH)D levels below the 20 ng/mL (50 nmol/L) threshold of deficiency. There was a significant negative association between the use of sunscreen during summer and serum 25(OH)D concentrations during winter and a significant positive association between physical exercise and serum 25(OH)D. Levels of 25(OH)D tended to decrease with increasing BMI in persons with a BMI over 25.0. There is a high prevalence of vitamin D insufficiency in Greek adults during winter. Serum 25(OH)D levels in winter are positively associated with exercise and negatively associated with high BMI and the use of sunscreen during summer.

A SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES ASSESSING THE IMPACT OF OXIDATIVE STRESS IN COGNITIVE DECLINE.

OBJECTIVE: Introduction: Cognitive functions are defined as the mental processes through which information is received, processed, stored, and retrieved. Oxidation is considered as an important factor that affects negatively the brain function. The aim: To assess the impact of oxidative stress, as it is measured by oxidative markers or by the presence of anti-oxidants, on cognitive decline. PATIENTS AND METHODS: Materials and methods: A systematic review of published observational studies in PubMed and in Scopus was performed. During the review process the keywords were used as follows: ("oxidative stress") AND ("cognitive decline" OR "cognitive dysfunction" OR "cognitive impairment" OR "cognitive deficiency") AND ("observational study" OR "cross sectional study" OR "prospective study" OR "retrospective study" OR "cohort study"). The search was conducted for the years from 2016 to 2020. CONCLUSION: Conclusions: Seventy-four eligible studies were identified. Thirteen studies met the inclusion and quality criteria and were included in the systematic review. The studies conducted in ten different countries. Information about oxidative stress biomarkers is available in eight studies, while information about antioxidant factors is in ten studies. In all the thirteen studies the cognitive function was assessed with specific tools - scales. In the majority of studies, the presence of high scores in oxidative markers was positively associated with cognitive decline, while higher levels of antioxidant markers were associated with better cognitive function. Our results indicate that oxidative stress may be significantly associated with cognitive decline. The presence of the antioxidants glutathione, uric acid, melatonin, cysteine and peroxide dismutase has a positive effect on cognitive function.

Time trends for pulmonary embolism incidence in Greece.

BACKGROUND: Pulmonary embolism (PE) is a disease with a significant impact on public health. However, international epidemiological data are unclear and show considerable heterogeneity. The present study aims to investigate the incidence of PE at the Greek population and the associated demographic characteristics of patients with PE. METHODS: Data on hospital admissions for PE between 1999 and 2012 were provided by the Hellenic Statistical Authority of Greece. Data on age, gender and days of hospitalization from 1999 to 2007 were provided as well. The total population in each region was derived from the 1991, 2001, 2011 Census of the national statistical service of Greece. RESULTS: The mean annual incidence of PE during the study period was 18.5 per 100.000 population. The annual incidence of PE showed an upward trend ranging from 14 (1999) to 30 (2012) per 100.000 population. In the years before and after the economic crisis faced by Greece we observed statistically significant differences of PE incidence for the two different periods (1999-2008 versus 2009-2012, 14.49 versus 23.06 respectively, p = 0.002). The available data revealed a female predominance (16.48 cases for females per 100.000 population versus 13.69 cases for males per 100.000 population, p = 0.031). Incidence rate increased with age with a higher incidence in the "80-89" age group. CONCLUSIONS: The incidence of PE appeared to increase in Greece, while it remains below the expected trend in an international context that may be attributed to Computed Tomography Pulmonary Angiography availability and/or PE awareness among clinicians.

Concurrent cardiac sarcoidosis and obstructive sleep apnea presenting as arrhythmias.

BACKGROUND: Cardiac involvement is a rare and potentially fatal presentation of sarcoidosis. Obstructive sleep apnea may complicate sarcoidosis. CASE PRESENTATION: We report a case of a sarcoidosis patient with cardiac involvement presenting with ventricular arrhythmias. Besides medical and invasive measures of therapy, the patient failed to respond fully. The patient was subjected to overnight polysomnography and diagnosed with concurrent obstructive sleep apnea syndrome. Following continuous positive airway pressure therapy, we observed a significant improvement of ventricular arrhythmias while methylprednisolone was further tapered. CONCLUSIONS: To our knowledge, this is the first report of cardiac sarcoidosis further implicated by OSAHS and presenting as ventricular arrhythmias that underlies the need for extensive testing in cardiac sarcoidosis in patients not responding to immunosuppressive therapy.

Mesothelioma Mortality Rates in Greece for the Period 2005-2015 Is Increased Compared to Previous Decades.

Background and Objective: To present summary statistics regarding malignant mesothelioma (MM) mortality in Greece during the period 2005-2015 and compare it with previous decades, along with gender, age and geographical area analysis. Materials and Methods: The Hellenic Statistical Authority provided the data, which included all deaths for the period 1983 to 2015 that mentioned MM as the death cause in the corresponding death certificate. MM mortality rates have been calculated with respect to gender, age, and geographical location in Greece. Furthermore, a comparison analysis was made among three eleven consecutive year periods, in order to assess potential changes in the mortality rates. Results: The MM mortality rate has significantly increased during the period 2005-2015 both in males and females compared to earlier decades. The maximum number of MM deaths has shifted to an older age group of 70-80 years during the 2005-2015 period as compared to that of 1983-2004 in both genders. Additionally, MM mortality rates have significantly increased in all geographical areas except for the Epirus Prefecture. Conclusions: Our results demonstrate an increased MM mortality rate in Greece for the decade 2005-2015 as compared to the two previous decades. This increase is possibly due to the fact that the peak in asbestos production and use in Greece was in mid 1990s, while the asbestos ban came in effect in 2005. Based on these findings the MM epidemic in Greece has not yet peaked, therefore it is important to implement screening strategies for early MM detection.