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Objectives: The aim of this study was to assess nutrient intake among individuals adhering to the Christian Orthodox Church (COC) fasting and to investigate potential differences in dietary intake according to Body Mass Index (BMI) classification. Methods: This cross-sectional study enrolled participants through announcements at public universities, churches, and monasteries, targeting both urban and religious adult populations. A total of 228 adults with a BMI exceeding 25 kg/m2 were enrolled. Of these, 121 had followed COC fasting practices for at least 10 years or since childhood, while 107 non-fasters were age-matched. Exclusion criteria included age under 18 years, refusal to provide consent, absence from measurements, non-communicable diseases, food allergies, pregnancy, or lactation. Results: Overweight and obesity rates were similar in both groups. Furthermore, there were no statistically significant differences in body composition measurements [body fat %, fat mass (kg), fat free mass (kg), waist circumference]. Diastolic and systolic blood pressure was significantly higher in non-fasters. Non-fasters reported higher intake of sugar, dietary protein, fats (saturated and polyunsaturated), and cholesterol. Fasters consumed lower amounts of vitamin A, vitamins B (B2, B3, B6, B12, folate, pantothenic acid), iron, phosphorus, sodium, zinc, and calcium. Serum folic acid levels were higher, and fasting glucose and phosphorus levels were lower in fasters. Distinct dietary patterns were observed between groups, with fasters consuming more fish and traditional plant-based foods, while non-fasters consumed higher amounts of meat, dairy products, and alcohol. Conclusions: COC fasting is associated with favorable dietary and metabolic profiles, including improved glucose regulation. However, its impact on weight status appears limited.

Cardiac arrhythmias are prevalent complications in pregnancy, yet their precise association with acute maternal cardiovascular morbidity and mortality remains unclear due to heterogeneous evidence. This systematic review and meta-analysis evaluated the impact of maternal arrhythmias on acute cardiovascular outcomes. We searched Medline, Scopus, and Cochrane databases for observational studies comparing pregnant women with arrhythmias to those without. Random-effects meta-analyses were used to calculate pooled risk ratios (RR) for maternal mortality and major adverse cardiovascular events (MACE). Eleven studies comprising 76,028 pregnancies with arrhythmias and over 82 million controls were included. Analysis of data, primarily derived from large administrative cohorts with low absolute event rates, indicated that arrhythmias were significantly associated with increased all-cause maternal mortality (0.78% vs. 0.01%; RR 31.94; adjusted RR 8.91) and a composite of MACE (2.90% vs. 0.03%; RR 6.48). Supraventricular tachycardia and atrial fibrillation were associated with an increased likelihood of adverse outcomes. Notably, the relative risk of mortality and heart failure in women with arrhythmias versus controls was significantly higher in the general obstetric population around delivery than in women with known structural heart disease, suggesting a “sentinel event” phenomenon. Thromboembolic events were also 15 times more likely in the arrhythmia group. Cardiac arrhythmias during pregnancy are associated with substantial maternal morbidity and mortality. New-onset arrhythmias may warrant comprehensive cardiac evaluation, as they may unmask underlying pathology and precipitate severe hemodynamic compromise, particularly in women without prior cardiac history.

Burnout and occupational stress are common problems in the modern society. The aim of the study was to investigate the association of burnout and occupational stress with sexual dysfunction. The study enrolled 251 residents, 143 males and 108 females. The personal medical history, demographics, and professional data of the participants were recorded. The Copenhagen Burnout Inventory (CBI) and the job stress measure were used for the evaluation of burnout and occupational stress, correspondingly. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were used for the assessment of sexual function. The majority of the respondents were males (57%), with a mean age of 31 years. From the analysis concerning males, personal burnout, hypertension, and alcohol consumption correlated independently with erectile dysfunction (p = 0.001) and reduced total satisfaction (p < 0.001). With respect to the female participants, the number of children was found to be related to easier arousal (p = 0.009), better lubrication (p = 0.006), and orgasm (p = 0.016). Contrariwise, job stress related negatively with lubrication (p = 0.031) and orgasm (p = 0.012). This is the first study examining the effect of burnout on sexual function. Personal burnout was observed to be associated with sexual dysfunction in men whereas job stress correlated with female sexual problems. Further examination in different occupational groups and a greater number of patients is required.

Background/Objectives: Pre-conception health behaviors may influence the risk of gestational diabetes mellitus (GDM), but evidence on the joint effects of physical activity (PA) and dietary patterns remains limited. This study investigated the associations between pre-conception PA and GDM risk and explored their interaction with adherence to a Mediterranean diet (MD). Methods: This analysis used data from the BORN2020 cohort, which included pregnant women in Greece (2020–2022). Pre-conception PA was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), expressed as the metabolic equivalent of task (MET)-min/week and categorized into quartiles. Adherence to the MD was assessed via the Trichopoulou score and then grouped into tertiles. Multivariable logistic regression models were computed, accounting for sociodemographic and clinical covariates, including sedentary time and post-lunch nap frequency. Results: In total, 524 women were included and 13.9% (n = 73) were diagnosed with GDM. Women who developed GDM were significantly older (mean age 34.41 vs. 31.98 years, p < 0.0001), were more likely to be >35 years old (46.6% vs. 26.6%, p < 0.001), had higher pre-pregnancy BMI (median 24.6 vs. 22.7 kg/m2, p = 0.014), and were more likely to be obese (23.3% vs. 11.8%, p = 0.012). No significant association was observed between total pre-conception PA and GDM risk. Compared to the lowest PA quartile, women in the medium (aOR = 0.80, 95% CI: 0.45–1.40), high (aOR = 1.12, 95% CI: 0.52–2.39), and very high (aOR = 1.10, 95% CI: 0.50–2.38) PA quartiles showed no significant differences in GDM risk. PA, when modeled as a continuous variable, showed no significant trend (aOR = 0.99, 95% CI: 0.99–1.00; p-trend = 0.61). A joint analysis of PA and MD adherence also yielded no significant associations overall. However, in very small BMI-stratified subgroups, a low level of PA combined with very high MD adherence in normal-weight women was associated with increased GDM risk (aOR = 14.06, 95% CI: 1.55–165.54, p = 0.022), while in obese women, very high levels of PA and medium MD adherence showed a potentially protective effect (aOR = 0.006, 95% CI: 8.43 × 10−6–0.42, p = 0.048). These subgroup findings require cautious interpretation, due to the limited size of the sample set and wide confidence intervals. Conclusions: In this cohort, pre-conception PA, either alone or in combination with MD adherence, was not a reliable predictor of GDM. While our subgroup signals are hypothesis-generating, they do not yet support changes to clinical risk stratification. Future large-scale and interventional studies should investigate combined lifestyle interventions before conception to clarify the potential synergistic effects on GDM prevention.

Background/Objectives: Gestational diabetes mellitus (GDM) is a common pregnancy complication, and maternal diet before conception may be an important modifiable risk factor. This study aimed to investigate the association between maternal pre-pregnancy energy and macronutrient intake and the risk of GDM. Methods: Data from the BORN2020 cohort in Northern Greece were used. Women were recruited at their first trimester prenatal visit (11–13 weeks of gestation) and provided detailed dietary data via a validated food frequency questionnaire (FFQ), reflecting intake in the six months prior to conception. Weighted Quantile Sum (WQS) regression models were applied to assess the joint effects of food-derived macronutrient mixtures on GDM risk. Analyses were adjusted for parity, maternal age, pre-pregnancy BMI, thyroid disorders, smoking, energy intake, and physical activity. Results: In total, 797 women were included in the analyses. In normal-BMI women, higher pre-pregnancy intake of energy (aOR = 81.16, 95% CI: 4.55–1447.46), total carbohydrates (aOR = 50.66, 95% CI: 3.59–715.04), total fat (aOR = 9.35, 95% CI: 1.17–74.54), and total protein (aOR = 11.06, 95% CI: 1.14–107.09) were significantly associated with increased odds of GDM. The main contributing foods were energy-dense and processed items such as puff pastry, processed meats, potatoes, refined grains, and dairy products. In contrast, dietary fiber, vegetable protein, and animal protein were not significantly associated with GDM risk. Among overweight and obese women, none of the macronutrient or energy mixtures showed significant associations. Conclusions: For women of normal weight, a pre-conception diet high in energy and macronutrients from processed foods is a significant predictor of GDM risk. This association was not found in overweight or obese women, highlighting a critical window for targeted nutritional intervention for normal-weight individuals before pregnancy.

Background/Objectives: Gestational diabetes mellitus (GDM) is a major pregnancy complication with rising global prevalence. The Mediterranean Diet (MD) has shown metabolic benefits, but total adherence scores may obscure meaningful variation in dietary quality. This study aimed to investigate whether specific dietary patterns, identified within the MD framework, and their glycemic load (GL) are associated with GDM risk. Methods: This prospective cohort is part of the BORN2020 longitudinal study on pregnant women in Greece; dietary intake was assessed using a validated food frequency questionnaire (FFQ) at two time points (pre-pregnancy and during pregnancy). MD adherence was categorized by Trichopoulou score tertiles. GL was calculated for food groups using glycemic index (GI) reference values and carbohydrate content. Dietary patterns were identified using factor analysis. Logistic regression models estimated adjusted odds ratios (aORs) for GDM risk, stratified by MD adherence and time period, controlling for maternal, lifestyle, and clinical confounders. Results: In total, 797 pregnant women were included. Total MD adherence was not significantly associated with GDM risk. However, both food-specific GLs and dietary patterns with distinct dominant foods were predictive. GL from boiled greens/salads was consistently protective (aOR range: 0.09–0.19, p < 0.05). Patterns high in tea, coffee, and herbal infusions before pregnancy were linked to increased GDM risk (aOR = 1.96, 95% CI: 1.31–3.02, p = 0.001), as were patterns rich in fresh juice, vegetables, fruits, legumes, and olive oil during pregnancy (aOR = 2.91, 95% CI: 1.50–6.24, p = 0.003). A pattern dominated by sugary sweets, cold cuts, animal fats, and refined products was inversely associated with GDM (aOR = 0.34, 95% CI: 0.17–0.64, p = 0.001). A pattern characterized by sugar alternatives was associated with higher risk for GDM (aOR = 4.94, 95% CI: 1.48–19.36, p = 0.014). These associations were supported by high statistical power (power = 1). Conclusions: Within the context of the MD, evaluating both the glycemic impact of specific food groups and identifying risk-associated dietary patterns provides greater insight into GDM risk than overall MD adherence scores alone.

Background/Objectives: To assess the association between early pregnancy carbohydrate quality, as measured by the Carbohydrate Quality Index (CQI), and the risk of delivering a large-for-gestational-age (LGA) infant in a Mediterranean pregnant cohort of northern Greece. Methods: We analyzed singleton pregnancies from the BORN 2020 prospective cohort in Greece. Dietary intake was assessed via a validated food frequency questionnaire, and CQI was computed from glycemic index, fiber density, whole-to-refined grain ratio, and solid-to-liquid carbohydrate ratio. Multivariable logistic regression was used to estimate the association between CQI (in tertiles) and LGA risk, defined as birthweight >90th percentile. Results: Among the 797 participants, 152 (19.1%) delivered LGA infants, and 117 (14.7%) were diagnosed with GDM. Of those with GDM, 23 (19.7%) delivered LGA infants. In the total population, higher maternal weight (p < 0.001), height (p = 0.006), and pre-pregnancy BMI (p = 0.004) were significantly associated with LGA. A greater proportion of women with LGA had a BMI > 25 (p = 0.007). In the GDM subgroup, maternal height remained significantly higher in those who delivered LGA infants (p = 0.017). In multivariable models, moderate CQI was consistently associated with increased odds of LGA across all models (Model 1: aOR = 1.60 (95% CI: 1.03–2.50), p = 0.037, Model 2: aOR = 1.57 (95% CI: 1.01–2.46), p = 0.046, Model 3: aOR = 1.58 (95% CI: 1.01–2.47), p = 0.044, Model 4 aOR: 1.70; 95% CI: 1.08–2.72; p = 0.023), whereas high CQI was not. In the GDM subgroup, a significant association between high CQI and increased LGA risk was observed in less adjusted models (Model 1 aOR: 6.74; 95% CI: 1.32–56.66; p = 0.039, Model 2 aOR: 6.64; 95% CI: 1.27–57.48; p = 0.044), but this was attenuated and became non-significant in the fully adjusted model (aOR: 3.05; 95% CI: 0.47–30.22; p = 0.28). When examining CQI components individually, no consistent associations were observed. Notably, a higher intake of low-quality carbohydrates (≥50% of energy intake) was significantly associated with increased LGA risk in the total population (aOR: 4.25; 95% CI: 1.53–11.67; p = 0.005). Conclusions: Higher early pregnancy intake of low-quality carbohydrates was associated with an elevated risk of LGA in the general population. However, CQI itself showed a non-linear and inconsistent relationship with LGA, with moderate, but not high, CQI linked to increased risk, particularly in GDM pregnancies, where associations were lost after adjustment. Both carbohydrate quality and quantity evaluations are essential, particularly in high-risk groups, to inform dietary guidance in pregnancy.

IntroductionHealthcare systems suffered a significant hit by the COVID-19 pandemic since the spring of 2020, and a need for major reorganization emerged. Along with the constant increase in COVID-19 cases, a significant drop in emergency attendances for non-COVID-19-related conditions was noted worldwide. We decided to document attendances in our hospital's emergency department during the first lockdown period in order to monitor this trend, compare it to data from other countries, and start monitoring the effects of this reduction in the years to come.Materials and methodsEmergency department attendances at AHEPA University Hospital, Thessaloniki, Greece, from March 10, 2020, to May 31, 2020, were documented and compared to the corresponding period in 2019. The data collected included the number of patients per specialty, severity upon admission, as well as the need for admission.ResultsWe found a 58% reduction in emergency department attendance during the studied period compared to the corresponding period in 2019 (p<0.0001). The reduction was more noticeable in ears, nose, throat (ENT), and ophthalmology attendances (75.7% and 78.1% reductions, respectively, p<0.001), but other specialties, such as cardiology and general surgery, were also significantly affected (60% and 63% reductions, respectively, p<0.001). However, the percentage of attendances that required admission increased significantly by 25-33% (p<0.001) during the lockdown, reflecting the higher severity of cases reaching the hospital.ConclusionDespite the obvious reduction in attendances during the COVID-19 pandemic, patients still suffer from serious conditions that require hospital admission. Therefore, hospitals need to be supported to also care for these patients. The long-term effects of avoiding hospital attendance need to be closely monitored.

In the present work, the interaction between temperature, relative humidity, wind speed, and wind direction was studied in the atmosphere of Patras port, and the following were found: The interaction between temperature and air particle concentration was synergistic in the absence of wind direction, this result being however false. The actual effect of temperature in the presence of wind direction was antagonistic in line with most of the authors of the international bibliography; i.e., increase of the temperature level resulted in a decrease of particle concentration per unit volume (cm3). On the other hand, increase of the relative humidity increased the particle concentration per cm3, while the interaction between temperature and relative humidity was also antagonistic; i.e., increase of temperature decreased accordingly the relative humidity, and vice versa. Similarly, the interaction between wind speed and relative humidity was also antagonistic and statistically significant. It is emphasized that the wind direction played an important role in determining the antagonistic or synergistic nature of the interactions between the meteorological factors, and especially, in controlling quantitatively the results (or outcomes), of the above interactions.

Background: Novel and accessible biomarkers may add to the existing risk stratification schemes in patients with acute coronary syndrome (ACS). The platelet-to-lymphocyte ratio (PLR) and glucose-to-lymphocyte ratio (GLR) have emerged as potential indicators of systemic inflammation and metabolic stress, both of which are pivotal in ACS pathophysiology. The aim of this study was to investigate the prognostic significance of the PLR and GLR in patients with ACS. Methods: We performed a retrospective cohort study of patients hospitalized with ACS between 2017 and 2023 at Hippokration Hospital of Thessaloniki, Greece. PLR and GLR were calculated from admission blood samples. The primary endpoint was all-cause mortality. Logistic and Cox regression models were used to investigate the associations of PLR and GLR with all-cause mortality. Receiver operating characteristic (ROC) analysis, Kaplan–Meier survival curves, and restricted cubic spline (RCS) modeling were also applied. Results: In total, 853 patients (median age: 65 years, 72.3% males) were included. Higher PLR and GLR were independently associated with increased risk of long-term mortality [adjusted Odds Ratio (aOR) for PLR: 1.007, 95% CI: 1.005–1.008; and for GLR: aOR = 1.006, 95% CI: 1.003–1.008]. The optimal cut-off values were 191.92 for PLR and 66.80 for GLR. Kaplan–Meier and Cox regression analyses confirmed significantly reduced survival in patients with GLR and PLR values exceeding these thresholds. RCS analysis revealed non-linear relationships, with mortality risk rising sharply at higher levels of both markers. PLR showed superior prognostic performance (AUC: 0.673, 95% CI: 0.614–0.723) compared to GLR (AUC: 0.602, 95% CI: 0.551–0.653). Conclusions: While PLR demonstrated greater predictive accuracy, both PLR and GLR were consistently associated with mortality and may provide complementary prognostic information. Incorporating those ratios into routine clinical assessment may improve risk stratification, particularly in resource-limited settings or for patients without traditional risk factors.