Leadless pacing: First experience and outcomes in an isolated area in the setting of the Greek financial crisis.

BACKGROUND: Leadless pacing (LP) is a novel permanent pacing modality without transvenous leads that is increasingly applied in certain circumstances. We aimed to report our preliminary experience in LP implementation. CASE SERIES: This observational study represents a simple registry of LP systems implanted in our tertiary center from April 2018 until November 2019 in the setting of the Greek financial crisis. Consecutive patients from the isolated area of Northwestern Greece referred to our center for LP were included. Patients' clinical and procedural data, as well as follow-up events, were carefully recorded. Nine patients (mean age: 75 years; six men) were included and were followed for a median period of 20 months. The commonest indication for LP implantation was increased patient infection risk (n: seven), while in the remaining patients (n: two), the indication was problematic vein access along with concomitant comorbidities that increase infection risk. Most of the patients (6/9) were in sinus rhythm, while the rest had slow atrial fibrillation. During the follow-up period, two patients with end-stage renal disease suffered sudden cardiac death, two patients died due to pneumonia, and one patient died due to metastatic cancer. However, no device-related death occurred during the follow-up. CONCLUSIONS: Our data indicate that LP's long-term cost-effectiveness is limited in patients with several comorbidities due to increased mortality. Indeed, considering its increased financial cost, well-defined patients' selection criteria should be developed and applied, especially in medium/low-income countries. HIPPOKRATIA 2021, 25 (2):75-78.

Environmental measurements and inspections on imported foods and feedstuffs in Greece after the Fukushima accident.

The radionuclides released during the accident at the Fukushima Daichii nuclear power plant following the Tohoku earthquake and tsunami on 11 March 2011 were dispersed in the whole north hemisphere. Traces of (131)I, (134)Cs and (137)Cs reached Greece and were detected in air, grass, sheep milk, ground deposition, rainwater and drainage water. Members of Six Greek laboratories of the national network for environmental radioactivity monitoring have collaborated with the Greek Atomic Energy Commission (GAEC) and carried out measurements during the time period between 11 March 2011 and 10 May 2011 and reported their results to GAEC. These laboratories are sited in three Greek cities, Athens, Thessaloniki and Ioannina, covering a large part of the Greek territory. The concentrations of the radionuclides were studied as a function of time. The first indication for the arrival of the radionuclides in Greece originating from Fukushima accident took place on 24 March 2011. After 28 April 2011', concentrations of all the radionuclides were below the minimum detectable activities (<10 µBq m(-3) for (131)I). The range of concentration values in aerosol particles was 10-520 µBq m(-3) for (131)I, 10-200 µBq m(-3) for (134)Cs and 10-200 µBq m(-3) for (137)Cs and was 10-2200 µBq m(-3) for (131)I in gaseous phase. The ratios of (131)I/(137)Cs and (134)Cs/(137)Cs concentrations are also presented. For (131)I, the maximum concentration detected in grass was 2.2 Bq kg(-1). In the case of sheep milk, the maximum concentration detected for (131)I was 2 Bq l(-1). Furthermore, more than 200 samples of imported foodstuff have been measured in Greece, following the EC directives on the inspection of food and feeding stuffs.

Small bowel obstruction caused by inflammatory cytomegalovirus tumor in a renal transplant recipient: report of a rare case and review of the literature.

Cytomegalovirus (CMV) infection in renal transplant recipients can present as asymptomatic viremia or CMV syndrome or, in more severe cases, as tissue-invasive disease. CMV enteritis, a common manifestation of CMV invasive disease, usually presents with fever, abdominal pain, anorexia, nausea, and diarrhea, and can be rarely complicated by colon perforation, hemorrhage, or megacolon. CMV infection occurs primarily in the first 6 months post transplantation, when immunosuppression is more intense. We describe the case of a female renal transplant recipient with small bowel obstruction caused by CMV disease 7 years post renal transplantation. The patient presented with diarrhea and abdominal pain. Because of elevated CMV viral load, she was initially treated with antiviral therapy with transient response. Endoscopy and imaging tests showed obstruction of the terminal ileum and, subsequently, the patient underwent exploratory laparotomy when a right hemicolectomy was performed. Biopsy results confirmed the diagnosis of CMV enteritis. Epidemiologic characteristics, clinical presentation, diagnostic workup, therapeutic options, and morbidity-mortality rates of CMV infection/disease, in renal transplant recipients, are reviewed.