Auguste François Chomel (1788-1858) and his Work on Rheumatism: Introducing Rheumatic Heart.

In the early 19th century, Auguste François Chomel gathered the knowledge on rheumatism, systematised it, and published it in his majestic work Pathologie Générale. In his treatise, for the first time, rheumatic heart was discussed. Taking into account the opinions of the ancient Greek physicians, he had described the disease as an acute or chronic manifestation of the inflammation of the heart due to rheumatism. His publication rendered rheumatic heart an issue in vogue for his era, a disease being mentioned in all textbooks of the internal pathology.

Charles Boyd Kelsey (1850-1917). The pioneer of rectal surgery in USA.

Charles Boyd Kelsey (1850-1917) was a pioneer rectal surgeon. His surgical career was dedicated in the surgery of the rectum, anus, hemorrhoids, and pelvis. He invented also surgical instruments. He managed to be recognized as a pioneer of Rectal surgery not only in America but worldwide. He was a prolific writer and a famous teacher.

Intra-renal Arteries in Nephrectomy from a Historical Aspect, a Quest Originated by Medical Illustrations to Reach Modern Angiography.

The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the intra-renal arteries. The vasculature and especially the intra-renal arteries of the kidneys are an intriguing field which was first studied through art and then perfected by medicine. Angiography and microsurgery have resulted in partial nephrectomy techniques for surviving kidneys with adequate functional results. Graves' categorization dating from 1954 opened the way for innovative approaches that have resulted in modern topographical anatomy. CONCLUSION: Our understanding of the anatomy of intra-renal arteries has played a significant role in surgical anatomy and internal medicine.

Attitudes and Practices Related to COVID-19 Vaccination with the Second Booster Dose among Members of Athens Medical Association: Results from a Cross-Sectional Study.

BACKGROUND: There are limited data on the attitudes and acceptance of the second booster (fourth dose) of the COVID-19 vaccination among physicians. METHODS: A cross-sectional, questionnaire-based, online study was conducted among members of the Athens Medical Association (A.M.A.) who were invited to participate anonymously over the period from January to March 2023. RESULTS: From the 1224 members who participated in the survey, 53.9% did not receive the fourth dose of the COVID-19 vaccine. The main reasons for no vaccination were the lack of obligation to receive the fourth dose, the history of three doses of the COVID-19 vaccine and the lack of sufficient information about the effectiveness of the fourth dose. Over half of the three-dose-vaccinated participants were willing to receive the fourth dose in the near future. Interestingly, the vaccination coverage among participants who had been informed about the fourth dose through scientific sources was low. CONCLUSIONS: The low vaccination coverage with the fourth dose reported in this study can lead to broad and serious consequences, such as increase in COVID-19 infections, reduction of available healthcare staff and increased caseloads of COVID-19 in hospitals. Furthermore, hesitant physicians will adversely influence the vaccination uptake among the general population due to their key role in informing and recommending the vaccine. The healthcare system administration should acknowledge and address physician's concerns through effective communication and better support.

Clinical Considerations of First Extensor Wrist Compartment (FEWC) Variants and De Quervain's Disease: A Review Study.

The first extensor wrist compartment (FEWC) displays significant variants. This review highlights all possible variants that may be associated with the occurrence and pathophysiology of de Quervain's tenosynovitis. A thorough search of PubMed and MEDLINE databases, following the PRISMA guidelines, was conducted from 2002 to 2022 to evaluate all FEWC variants, including the following: 1) the presence of an inter-tendinous septum, 2) the number of tendinous slips of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) muscles, 3) their distal insertions and 4) the presence of a bony ridge within the FEWC. A total of 3878 wrists (1277 cadaveric and 1296 de Quervain patients) were included. Of the 1234 cadavers, a total of 701 (56.8%) were males and 533 (43.2%) were females. Regarding the 883 patients, 178 (20.2%) of them were males and 705 (79.8%) were females. An inter-tendinous septum was identified in 42.9% (47% of the patients' wrists compared to 39.3% of the cadaveric wrists, p<0.0001). Cadaveric wrists presented two or more slips for the APL in a significantly higher percentage (92.5%, p < 0.0001) compared to de Quervain patients' wrists (74.5%). Regarding the EPB muscle, de Quervain patients' wrists had a single slip in 93% (p=0.0007) and two or more slips in 3.6%, compared to cadaveric wrists (a single slip in 87%, and two or more slips in 11%, p< 0.0001). A bony ridge over the radial styloid process was recorded in 58.9% of the cadaveric wrists compared to 17.8% of the patients' wrists (p < 0.0001). Remarkable diversity concerning the structures within the FEWC was reported. The presence of an inter-tendinous septum dividing the FEWC and a single EPB muscle slip is more likely to be found in patients with de Quervain's disease.

The Facial Artery as a Branch of the External Carotid Artery in Thomas Turner's (1793-1873) Treatise on the Arterial System (1825) and a Comparison with Modern Anatomy.

The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the facial artery. The facial artery plays a fundamental role in the study of the anatomy of the face, and in maxillofacial and vascular surgery. The debate on the understating of this vessel is essential in the educational process, with special focus on the historical development of topographical and descriptive ideas about it. The comparison between the study of facial artery in the work of Thomas Turner (1793-1873) and modern anatomical concepts serves as an excellent educational paradigm. The documentary research method was used this short historical survey. CONCLUSION: Thomas Turner laid the scientific foundation for the accurate anatomical study of the facial artery.

Professor Lorenz Heister (1683-1758), His Discovery of Appendicitis and Other Innovations in Surgery.

BACKROUND: Professor Lorenz Heister (1683-1758) is considered as one of the most significant surgeons of the Deutschland area, named as the father of Surgical Anatomy in Germany. PURPORSE: He was a reputable Professor who taught a great number of Deutsch and foreign medical students. He was a prolific writer whose treatises received many editions being translated in the most important languages of his era. His texts books became reference works for the European Universities and Japanese physicians and surgeons. ANALYSIS/RESULTS: He had discovered and scientifically described the appendicitis, while he was coined with the term tracheotomy. CONCLUSIONS: He had made several surgical innovations and demonstrated novel techniques and anatomical entities of the human body in his atlases.

Cilostazol Effects after Lower Extremity Revascularization. Historical Background and Review of the Literature.

Introduction: Cilostazol is a selective cyclic inhibitor of the 3-phosphodiesterase type (PDE3) that is recommended to be administered in cases of symptomatic peripheral vascular disease (YEI). It was discovered as a chemical compound in the 1980s, in Takao Nishi laboratory in Japan. Objective: The purpose of the present review was to evaluate the efficacy of cilostazol administration in a YEI with intermittent claudication or moderate to severe lower extremity ischemia. Materials and methods:A systematic review of the literature was carried out where articles were searched in the international database PubMed. The year 2005 was set as a time limit for the publication date of the articles. The following keywords were used: cilostazol, peripheral arterial disease, revascularization and lower limb. A total of 95 articles were found, of which only 10 were selected for the present study. Results:According to the results of the current review, the use of cilostazol increases the ability to walk, improves the quality of life, reduces the rates of re-narrowing of vessels and stents, reduces the likelihood of amputation and is co-administered with other antiplatelet and anticoagulant agents. Conclusion:Cilostazol administration should be a possible treatment option for symptomatic YEI. Further research is necessary to determine its safety after three years.

The Hyoid Bone - the Anatomy of a Small Bone of the Neck in Hellenic and Greco-Roman Medical Literature.

OBJECTIVES: To understand the nomenclature of the hyoid bone. MATERIALS AND METHODS: Hyoid, a small bone of the neck, is a bony part that is rather difficult to unearth and discover among skeletal remains. RESULTS: The named was coined by the ancient Greeks, along with its anatomic description. Galen (2nd - 3rd c. AD) and Theophilus Protospatharius (7th century AD), facing religious and social barriers, succeeded in presenting its anatomy and suggesting its probable function in speech and swallowing, regarding the bone as a muscle pillar of the neck area. CONCLUSION: Authorities of Hellenic antiquity surprise us with their accuracy and the resilience of their anatomical descriptions.

Evaluation of the Perceptions, Attitudes and Practices among Greek Non-Professional Athletes Visiting a Public Hospital during March 2022, towards COVID-19 Vaccination and Its Consequences on Sports Training and Sports Activity.

Sports have been majorly impacted by the COVID-19 pandemic. After the lockdown period, vaccination and protocols were implemented to return to normality. We aimed to assess the attitudes and practices related to COVID-19 vaccination among athletes, and to record adverse effects of vaccination, if any. A questionnaire was distributed to 1012 male and female athletes, 15+ years old, within the region of Athens. Vaccination coverage with at least one dose was 93.5%, whereas 53.9% were fully vaccinated. More than half of the participants were infected with SARS-CoV-2 at the time of the study. More than 90% of the participants, considered the vaccines as safe, effective and important for public health. Concern about potential side-effects was raised especially by women athletes (59.1% of women compared to 42.2% of men, p < 0.001). The main reasons for avoiding vaccination were fear of vaccine safety, concern about the short time period for vaccine development and testing and doubt of risk of being exposed to SARS-CoV-2 infection. The main reported side-effects were pain at the injection site, fatigue, fever and headache. Approximately two thirds of the participants reported that vaccination did not affect their training, and none reported missing participation in scheduled athletic events. Participants reported high compliance to preventive measures by themselves and fellow athletes, but low satisfaction regarding the implementation of public protocols and the flow of information provided by the authorities. Athletes of older age and those less concerned about potential side-effects were more likely to get fully vaccinated. Nevertheless, the vast majority of the athletes in our study were vaccinated for COVID-19 despite any hesitation regarding effectiveness, safety, or potential side-effects from the vaccines.

Increased Influenza Vaccination Coverage among Members of the Athens Medical Association Amidst COVID-19 Pandemic.

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020-2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01-1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07-3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51-60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation.

Evaluation of Knowledge, Attitudes and Practices Related to Self-Testing Procedure against COVID-19 among Greek Students: A Pilot Study.

The COVID-19 pandemic has had a major impact on health, economy, society and education. In the effort to return to normalcy, according to the instructions of the Greek Government for the resumption of the operation of schools, a screening Rapid Antigen Detection Test with the method of self-testing is required for students twice per week, for the early identification and isolation of positive cases. We aimed to pivotally investigate the knowledge, attitudes and practices related to self-testing procedures against COVID-19 among Greek students. A questionnaire was distributed to a convenient sample of students in the region of Athens. Information about the vaccination coverage against SARS-CoV-2 was also obtained. Our study included 1000 students, with 70% of them having an average grade at school. Most of the participants were aware of coronavirus (98.6%) and the self-test (95.5%). The vast majority of students (97%) performed self-testing twice per week, with the 70% them being assisted by someone else. Nearly one sixth of the participants had been infected by COVID-19 (14%) while 36% of them have already been vaccinated against SARS-CoV-2. In conclusion, we report high compliance with the COVID-19 self-testing procedure among students in Attica, Greece. Older age adolescents are more likely to not comply with the regulations of self-testing. Consequently, tailored interventions targeted at older age adolescents are warranted in order to increase the acceptability of self-testing.

Remembering Karl Gustav Theodor Simon (1810-1857).

Karl Gustav Theodor Simon is considered as the founder of dermatopathology, because for the first time in modern times he beds the bases of the microscopical examination of the cutaneous diseases. He worked in Berlin as a private physician, general practitioner, especially for the poor patients, continuing his research in pathology and focusing on the cutaneous diseases, in which the use of the microscope had a central role. During his medical career, he achieved to be acknowledged as one of the most important figures in the treatment of cutaneous diseases and to be included among the best dermatologists and venerologists at the time worldwide.

Professor Paul Jules Tillaux (1834-1904): His Contribution to Surgery and His Unknown Pioneer Work in Ophthalmic Surgery.

Backround. Professor Paul Jules Tillaux (1834-1904) is considered to be a leading figure in the field of surgery during the 19th century. Methods. Although his work is mostly linked to orthopedic operations, he contributed a lot in ophthalmology and ophthalmic surgery too. Results. In addition, his masterpieces on topographical anatomy and clinical surgery became the gold standard treatises of the era.

Reported COVID-19 Vaccination Coverage and Associated Factors among Members of Athens Medical Association: Results from a Cross-Sectional Study.

There are limited data on the prevalence and determinants of COVID-19 vaccination coverage among physicians. A cross-sectional, questionnaire-based, online study was conducted among the members of the Athens Medical Association (I.S.A.) over the period 25 February to 13 March 2021. All members of I.S.A. were invited to participate in the anonymous online survey. A structured, anonymous questionnaire was used. Overall, 1993 physicians participated in the survey. The reported vaccination coverage was 85.3%. The main reasons of no vaccination were pending vaccination appointment followed by safety concerns. Participants being informed about the COVID-19 vaccines by social media resulted in lower COVID-19 vaccination coverage than health workers being informed by other sources. Logistic regression analysis demonstrated that no fear over COVID-19 vaccination-related side effects, history of influenza vaccination for flu season 2020-2021, and the perception that the information on COVID-19 vaccination from the national public health authorities is reliable, were independent factors of reported COVID-19 vaccination coverage. Our results demonstrate a considerable improvement of the COVID-19 vaccination uptake among Greek physicians. The finding that participants reported high reliability of the information related to COVID-19 vaccination provided by the Greek public health authorities is an opportunity which should be broadly exploited by policymakers in order to combat vaccination hesitancy, and further improve COVID-19 vaccination uptake and coverage among physicians/HCWs, and the general population.

Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: Α Cadaveric Study.

Background The suprascapular notch (SN) represents the point along the route of the suprascapular nerve (SSN) with the greatest potential risk for injury and compression. Thus, factors reducing the area of the notch have been postulated for suprascapular neuropathy development. Methods Thirty-one fresh-frozen shoulders were dissected. The contents of the SN were described according to four types as classified by Polguj et al and the middle-transverse diameter of the notch was measured. Also, the presence of an ossified superior transverse scapular ligament (STSL) was identified. Results The ligament was partially ossified in 8 specimens (25.8%), fully ossified in 6 (19.35%), and not ossified in the remaining 17 (54.85%). The mean middle-transverse diameter of the SN was 9.06 mm (standard deviation [SD] = 3.45). The corresponding for type-I notches was 8.64 mm (SD = 3.34), 8.86 mm (SD = 3.12) was for type-II, and 14.5 mm (SD = 1.02) was for type III. Middle-transverse diameter was shorter when an ossified ligament was present (mean = 5.10 mm, SD = 0.88 mm), comparing with a partially ossified ligament (mean =7.67 mm, SD = 2.24 mm) and a nonossified one (mean = 11.12 mm, SD = 2.92 mm). No statistically significant evidence was found that the middle-transverse diameter depends on the number of the elements, passing below the STSL. Conclusion Our results suggest that SSN compression could be more likely to occur when both suprascapular vessels pass through the notch. Compression of the nerve may also occur when an ossified transverse scapular ligament is present, resulting to significant reduction of the notch's area.

Anatomical Variation of a Communicating Branch between the Musculocutaneous and the Median Nerve: A Case Report.

OBJECTIVE: The aim of our paper is to depict an anatomical variation of the brachial plexus, concerning a communicating branch between the median and the musculocutaneous nerve and its clinical significance. Anatomical variations of the brachial plexus and especially those of the musculocutaneous nerve are quite common. Awareness of these variations is of paramount importance in clinical practice, mainly in achieving best results in minimal invasive or surgical procedures. CASE REPORT: After dissection in upper extremities in a 89-year-old male cadaver, a communicating branch between the median and the musculocutaneous nerve was found. This communicating branch was formed before the musculocutaneous nerve perforated the coracobrachialis muscle. It also derived from the level of the ansa medianis and its course was of an approximately 2cm length. CONCLUSION: The clinical significance of our study is the entrapment of the musculocutaneous nerve that may cause clinical findings similar to those of the carpal tunnel syndrome.

Cardiovascular Disease in Juvenile Idiopathic Arthritis.

Juvenile idiopathic arthritis (JIA), is a term used to describe a group of inflammatory disorders beginning before the age of 16 years. Although for the majority of children remission is achieved early, those with systemic or polyarticular form of the disease may present persistent symptoms in adulthood. Considering that there is overlap in the pathogenesis of JIA with adult rheumatic diseases, concerns have been raised as to whether JIA patients could be at increased cardiovascular (CV) risk in the long-term. In this review, we summarize evidence for CV involvement in JIA and present data on CV risk factors and surrogate markers of arterial disease. We also provide information on beneficial and harmful CV effects of anti-inflammatory medications in the context of JIA and suggest strategies for CV screening. Overall, patients with systemic forms of JIA demonstrate an adverse lipid profile and early arterial changes relevant to accelerated arterial disease progression. Although there is paucity of data on CV outcomes, we recommend a holistic approach in the management of JIA patients, which includes CV risk factor monitoring and lifestyle modification as well as use, when necessary, of antiinflammatory therapies with documented CV safety.

The impact of Platelet Rich Plasma (PRP) in osseointegration of oral implants in dental panoramic radiography: texture based evaluation.

PURPOSE: In this study the temporal texture differentiation associated with the bone formation properties, around loaded oral implants after Platelet Rich Plasma (PRP) employment, was investigated in Panoramic Radiographs. MATERIALS AND METHODS: Thirty eligible patients are randomly assigned to two groups. The test group received PRP application around new implants, while in the control group no PRP treatment was made. The bone-to-implant contact region was analyzed in a clinical sample of 60 Digitized Panoramic Radiographs, 30 corresponding to immediate implant loading (Class-I) and 30 after an 8 month follow-up period (Class-II). This region was sampled by 1146 circular Regions-of-Interest (ROIs), resulting from a specifically designed segmentation scheme based on Markov-Random-Fields (MRF). From each ROI, 41 textural features were extracted, then reduced to a subset of 4 features due to redundancy and employed as input to Receiver-Operating-Characteristic (ROC) analysis, to assess the textural differentiation between two classes. RESULTS: The selected subset, achieved Area-Under-Curve (AUC) values ranging from 0.77-0.81 in the PRP group, indicating the significant temporal textural differentiation has been made. In the control group, the AUC values ranged from 0.56-0.68 demonstrating lesser osseo integration activity. CONCLUSION: This study provides evidences that PRP application may favor bone formation around loaded dental implants that could modify the dental treatment planning.