Background: Surgical site infections are a major cause of postoperative morbidity and mortality, but data regarding their prevalence in Greece are scarce. In this study, we report the rates of surgical site infections after major abdominal surgery in a large sample of patients in Greece.

Methods: This was a prospective multicentre trial (NCT 05393752) including 11 tertiary hospitals from Greece and Cyprus. Patients undergoing major/major+ abdominal surgery during 2022-2023 were included. Surgical site infections were classified according to the definitions of the CDC, and for sepsis, the SEPSIS-3 criteria were used. Demographics, type/site/magnitude of the operation, American Society of Anesthesiologists class, and the presence/stage of malignancy, as well as comorbidities, were recorded.

Results: There were 1649 patients (41,8% females) with a mean age of 66.3 years (SD: 13.8). The most common site of operation was the lower GI tract (58,9%), followed by the upper GI tract (20.2%) and the hepatobiliary system (13.6%). A total of 30.6% of the operations were performed on an emergency basis, and 3% of the patients had sepsis/shock. The rates of smoking, COPD, diabetes, corticosteroid use, and chronic renal failure were 23.5%, 9.7%, 22%, 6.5%, and 0,8%, respectively. Cancer diagnosis was present in 68.2% of patients and distant metastases in 9.7%. Postoperatively, 7.5% of patients developed sepsis and 3.3% developed septic shock. A total of 322 SSIs were recorded (19.8%), of which 13.3% were superficial, 2.7% deep, and 3.5% were in the organ space. SSIs were significantly more common in emergency operations, in hepatobiliary sites, and in patients with cancer (p<0.01).

Conclusion: SSIs are common after major abdominal surgery, even though most of them are superficial. At relatively high risk are hepatobiliary, oncological, and urgent operations.

Introduction:

In Europe, in recent years, we have been facing numerous migration crises, which have resulted in significant health, social, and economic consequences for host countries, particularly in terms of the transmission and control of infectious diseases, including vaccine-preventable diseases. Vaccinations serve as the primary tool for preventing the spread of communicable diseases, safeguarding the health of newly arrived migrants (NAMs) and the health of the communities they become a part of. Reaching under-vaccinated groups (i.e., NAMs) requires understanding the barriers to immunization they face and developing tailored strategies to improve access and uptake.

Since vaccination coverage among migrants in European countries remains low and immunization is not a priority for them, this study aimed to identify the barriers to vaccination and develop systemic solutions to increase the vaccination uptake of NAMs in Poland.

Methods:

This qualitative research study was conducted in April 2024. Two online focus group discussions involved 19 stakeholders working with NAMs in the field of immunization or the healthcare/social care sector as part of the project “Access To Vaccination for Newly Arrived Migrants” (AcToVax4NAM).

Results:

We identified a range of factors driving under-immunization in migrant populations in each of the following five steps on the pathway in the immunization process: (1) entitlement to vaccination, (2) reachability of people to be vaccinated, (3) adherence to vaccination, (4) achievement of vaccination, and (5) evaluation of the intervention. To improve the access to vaccination of NAMs, country-specific, action-oriented flowcharts with relevant solutions to overcome system barriers to effective vaccination and a repository of useful tools were developed.

Conclusions:

We recommend working closely with migrant communities to understand their health and vaccination needs in the host countries, as well as implementing co-designed tailored interventions, data collection, and good practice sharing as effective strategies to enhance vaccination outcomes for NAMs and to reduce population health inequities.

Titanium is considered a biocompatible biomaterial of dental titanium alloys (Ti-6Al-4V). However, patients with certain dental metals (Hg++, Al, Ti, etc.), including dental Ti implants, can provoke a chronic silent inflammatory state.

On the other hand, periodontitis favours the adherence of biofilms on the surface of teeth, increasing the local recruitment of innate immune cells (neutrophils, macrophages, and dendritic cells). Thus, a chornic proinflammaotry cytokine release of cytokine/chemokines, including CX3CL1, can amplify the local inflammatory resposnes and also promote oral disbiosis. In fact, recent studies link Alzheimer's disease (AD) with periodontitis. However, systemic CX3CL1 and MCP-1 elevations can be also detected in patients with long-term dental Ti implants without periodontisis. The periodontisis favours the teeth destruction and also enhances the accumulation of oral biofilm. In fact, porphyromonas gingivalis has been associated with AD, and high systemic CX3CL1 levels have been found to contribute to p-Tau accumulation in the brain of AD transgenic mices.

Thus, this CX3CR1 overexpression as a chronic silent proinflammatory response can predispose patients with periodontal disease and poor bucal higiene to AD. Collectivelly, CX3CR1 overproduction affects the normal control of the inhate inmune system and favours the destruction of the supporting tissues of the teeth in patients with periodontal disease. Thus, the link between AD and periodontitis via CX3CL1 opens up a new therapeutic role of delta chemokine blockers against periodontitis and AD pathology.

The influence of genetic variations on drug efficacy has become an area of growing interest in the treatment of gastrointestinal (GI) disorders, particularly gastroesophageal reflux disease (GERD). Proton pump inhibitors (PPIs), the cornerstone of GERD management, are metabolized by the cytochrome P450 enzyme CYP2C19, whose activity is highly variable due to genetic polymorphisms. Patients with CYP2C19 loss-of-function alleles (poor metabolizers) exhibit prolonged PPI exposure, leading to enhanced acid suppression, while those with gain-of-function alleles (ultra-rapid metabolizers) may experience suboptimal therapeutic effects. This variability in drug metabolism highlights the importance of personalized treatment approaches in GERD. Pharmacogenomic testing provides a novel and clinically relevant tool for identifying these genetic variants, allowing for tailored PPI dosing to maximize efficacy and minimize adverse effects, such as increased risks of Clostridium difficile infection or nutrient malabsorption associated with long-term PPI use. Recent clinical trials and observational studies underscore the benefits of incorporating pharmacogenomic testing into routine practice, where it has shown improved patient outcomes and medication adherence. Future research should focus on expanding pharmacogenomic testing to include other GI disorders and medications while addressing implementation barriers, including cost-effectiveness and clinician education. Integrating pharmacogenomics into clinical practice offers a promising pathway to personalized GI care, optimizing drug response, and enhancing therapeutic outcomes for patients with GERD.

Introduction: Among the issues related to the use of medical care in intensive care units (ICUs), the leading place is occupied by hospital or ventilator-associated pneumonia. One of the promising methods of preventing respiratory infectious diseases in ICU may be adaptive phage therapy.

Methods: The study included patients (n=41) with an average age of 54 years (28% men) and a control group (n=38) with an average age 59 of years (19% men). Adaptive phage therapy was administered by inhalation (5.0 ml, 3 times a day) from the first day of stay of patients of the main group (n=41) for at least 21 days in the intensive care unit of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology. The control group (n=38) consisted of patients who received standard therapy in accordance with current recommendations for pneumonia. The taxonomic composition and resistance genes of endotracheal aspirate were assessed via PCR testing using Amplisens reagents (Russia) on CFX 96 (BioRad; USA).

Results: Over the entire study period, 24 (58.5%) patients in the main group (n=41) had no recurrence of nosocomial pneumonia and did not require antibiotics, while in the control group (n=38), only 11 (26.3%) patients did not need antibiotic therapy. A statistically significant decrease in the number of pathogens in the study group compared to the control (p=0.008) suggests the possibility of the effective use of a complex preparation of bacteriophages.

Conclusions: In the long term, the use of bacteriophages helps to improve the quality of treatment, reduce the number of recurrent infections, and reduce the use of antibiotics.

Condyloma acuminata is a cutaneous manifestation of human papillomavirus (HPV), with lesions varying in clinical presentation, ranging from small, sessile, or pedunculated growths to flat papules or large cauliflower-like plaques. Condyloma acuminata are categorized into high-risk and low-risk genotypes based on their association with carcinomas. High-risk HPV genotypes, HPV 16, 18, 31, 33, and 35, are more commonly associated with malignant transformation into squamous cell carcinoma (SCC). In contrast, low-risk subtypes, including HPV 6 and 11, are typically not associated with SCC. The development of SCC in this context is exceptionally rare, with malignant transformation likely being secondary to chronic infection and persistent inflammation. A thorough clinical evaluation of all HPV-associated cutaneous lesions is sometimes necessary in order to assess malignant potential, including physical examination, biopsy, and gene testing. Treatment methods including topical agents and surgical debridement are utilized on a case-by-case basis, guided by clinical features and histopathology. Similarly, SCC arising from pre-existing HPV lesions is systematically evaluated, with consideration of tumor stage, depth, and patient comorbidities guiding treatment decisions. Here, we present a unique SCC case arising out of a large and long-standing condylomatous plaque on the thigh, expressing low-risk HPV subtype in a 71-year-old male. The diagnosis and management are discussed.

Recent advancements in 3D bioprinting technology have shown significant promise in developing innovative treatments for pediatric burn victims. This systematic literature analysis examines the progress in isolating and expanding autologous skin cells, specifically keratinocytes and fibroblasts, from pediatric patients for use in bioprinting applications. Key studies demonstrate the ability to effectively culture these cells, which are crucial for generating viable skin grafts. The systematic review also explores the evolution of bio-inks and the optimization of 3D bioprinting protocols aimed at creating multi-layered skin constructs that closely mimic natural skin architecture. Preclinical studies have been analyzed to evaluate the integration, functionality, and cosmetic outcomes of bioprinted skin grafts in animal models, highlighting their potential to improve healing and reduce scarring. Additionally, the review addresses the challenges of translating these promising preclinical findings into clinical trials, considering factors such as biocompatibility, immune response, and the scalability of bioprinting techniques. This comprehensive review underscores the transformative potential of 3D bioprinting in pediatric burn treatment, while also identifying the critical areas where further research and development are needed to bring these advancements to clinical practice. To fully realize the clinical application of 3D bioprinting for pediatric burn victims, interdisciplinary collaboration and long-term studies are essential in addressing the complex ethical, regulatory, and technical challenges associated with this cutting-edge technology.

Behavioural addictions caused by contemporary developing technologies and technological devices, such as internet addiction, gaming disorder, and problematic smartphone and social media use, pose a threat to the mental health and well-being of people from all age groups. Through a systematic literature review, we wish to synthesise the existing literature on the relationship between technology-related behavioural disorders and Emotional Intelligence (EI), a psychological construct known to play a protective role in many indicators of subjective and psychological well-being. Due to the importance of distinguishing between different EI theories and their measures, the current review focuses on uncovering the potentially different roles of ability EI and trait EI. A search was conducted in PubMed, Scopus, Web of Science, APA PsychArticles, and PsychINFO in May 2024. The data extraction process identified 43 articles and the transparency of this review was maximised by following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Key findings revealed the predictive role of EI for several behavioural addictions in samples from different developmental groups (i.e., children, adolescents, adults). Other results will be discussed in detail with a focus on the divergent roles of the two main EI models. Conclusions from the current literature and directions for future studies will be provided by highlighting the critical issues to consider in EI research conducted to explore its role in technology-related behavioural addictions.

Background: Suicide is one of the leading causes of death worldwide, and in the perinatal period, this trend is increasing, even up to 100 times in the US. In the postpartum period, 36% of maternal deaths are due to suicide. In different European countries, suicide is one of the leading causes of maternal mortality, along with cardiovascular pathologies. The perinatal phase is a critical period where mental health challenges can arise. Understanding risk factors and protective elements is essential for improving maternal well-being.

Objective: To identify key risk factors associated with enhanced suicidal ideation during the perinatal period and to highlight potential protective factors.

Methods: An analysis of various psychosocial variables was conducted, yielding the following risk associations and protective factors:

Results: Risk factors:

Anxiety: Adjusted Odds Ratio (aOR) of 1.08 (95% Confidence Interval: 1.04-1.31);
Intimate partner violence during perinatal period: aOR of 1.59 (95% CI: 1.04-2.43);
Postpartum Depression (PPD): aOR of 3.00 (95% CI: 1.86-4.81);

Protective Factors:

Perceived social support during perinatal period: aOR of 0.97 (95% CI: 0.95-0.99);
Skin-to-skin contact during delivery: aOR of 0.50 (95% CI: 0.28-0.88);

Conclusion: Anxiety, depression, insufficient social support, and exposure to intimate partner violence are significantly linked to an elevated risk of suicidal thoughts in the perinatal phase. Conversely, perceived social support and skin-to-skin contact with the infant serve as critical protective factors. Addressing these elements may enhance maternal mental health outcomes during this vulnerable period.

Implications for practice: Enhancing social support systems and promoting skin-to-skin practices could significantly reduce mental health risks among perinatal women. Further research is warranted to explore intervention strategies targeting these factors.

This study presents a systematic review of the transformative impact of telemedicine on modern healthcare, with a focus on its potential to enhance patient outcomes, reduce costs, and improve access to care. The methodology involved selecting and analyzing 29 key papers published exclusively in South Korea over the last 20 years, which explore the role of advanced telemedicine technologies in facilitating remote patient monitoring and managing chronic diseases.

A significant area of focus is the advancement of "On-Device AI" technology, enabling real-time health monitoring and proactive healthcare interventions. This technology represents a substantial leap forward in telemedicine, allowing for more personalized and timely healthcare delivery. The integration of such telemedicine solutions into existing healthcare infrastructures helps overcome traditional barriers, such as limited service availability in remote areas and the challenges posed by the need for continuous connectivity.

This study also highlights the economic benefits of telemedicine, including reducing the need for in-person visits and lowering hospital readmission rates, which contribute to significant cost savings. The findings emphasize the urgent need for healthcare systems to adopt telemedicine technologies to address the evolving challenges of contemporary healthcare, particularly in the post-pandemic era.

The research concludes that integrating telemedicine offers a promising pathway toward more resilient, accessible, and efficient healthcare services. It calls for increased collaboration among policymakers, healthcare providers, and technology developers to promote the widespread adoption of telemedicine, ensuring its benefits are equitably distributed across diverse patient populations.