Background: Triage refers to the process of patient prioritisation in the emergency department (ED). This is based on the severity of the patient’s illness and is performed by emergency nurses (ENs). This has a pivotal role in ensuring patient safety and in ensuring that the ED operates smoothly – so continuous and accurate training are essential. As Emergency Nursing has been formally established in Greece since 2019, it is of the uppermost importance that all Greek ENs should be trained in the use of a standardised triage system. The present study aimed to evaluate the effect of triage training of ENs in the use of the Swiss Triage System (STS) after an intervention of one week. Methods: The effect of triage training was studied experimentally by comparing performance before and one week after training. A sample of thirty-six ENs from the University Department of Emergency Medicine at AHEPA University Hospital took part. The role of training in triage by the STS was assessed by completing the same self-administered questionnaire before and after a 45-minute e-learning program (presentation video of STS but with simulation scenarios) which was available during the period of a week. The post-training test was taken 2 weeks later, after the training process. Results: The most promising finding was that there was a significant improvement in the number of correct answers after the training in triage (p<0.001). A significant improvement was also detected (p<0.001) in the questions that tested vigilance in providing safe health services by ENs, whereas there was no significant association between the number of correct answers and years of emergency experience or level of education, - either before or after the intervention. Conclusions: Triage training seems to successfully improve effective and efficient triage. To the best of our knowledge, this is the first study that has demonstrated that triage training has a significant positive impact on triage performance by ENs in Greece. It is planned to support these findings by real time studies in an ED.

The relationship between psoriasis and onychomycosis is controversial, and the exact nature of this association remains to be clearly elucidated. In healthy nails, the compact nail plate acts as a barrier, preventing any infection. In psoriatic nails, the nail plate involvement, together with abnormalities in the blood capillaries, may lead to decreased natural defenses against microorganisms. Moreover, onycholysis (detachment of the nail plate) induces a humid environment that may favor fungal proliferation. Treatment with immunosuppressive drugs may additionally enhance onychomycosis. In this comprehensive review, we present data regarding the incidence and pathogenic action of dermatophytes and other fungi in the development of fungal infection in psoriatic nails.

Background: Large language models (LLMs) are increasingly proposed as clinical decision support tools. However, their reliability in the emergency department (ED) triage remains insufficiently validated. This study aimed to evaluate the performance and limitations of multiple LLMs in triage using a large retrospective dataset. Methods: We conducted a retrospective analysis of 39,375 anonymized patient cases from the ED of AHEPA University General Hospital, Thessaloniki, Greece (June 2024–July 2025), extracted from the hospital’s electronic medical record system. All cases were triaged in real time according to the Emergency Severity Index (ESI) by 25 emergency physicians. In cases of uncertainty, a senior emergency physician was consulted. Seven LLMs (ChatGPT-5 Thinking, ChatGPT-5 Instant, Gemini 2.5, Qwen 3, Grok 4.0, Deep Seek v3.1, and Claude Sonnet 4) were evaluated against the physician-assigned ESI level (reference standard). Outcomes included triage score agreement (quadratic weighted kappa, κw), clinic referral accuracy and admission prediction. Subgroup analyses were performed by referral clinic and admission outcome. The study was conducted in accordance with TRIPOD-AI reporting guidelines. Results: Model performance varied substantially. DeepSeek and Claude Sonnet 4 achieved the highest agreement with physician-assigned ESI (κw ≈ 0.467; raw accuracy: 61.7%). In contrast, GPT-5 Instant performed poorly across all evaluation metrics (κw = 0.176; 95% CI: 0.167–0.186). Claude Sonnet 4 demonstrated the best performance in clinic referral (67.1%; κ = 0.619) and admission prediction (κw ≈ 0.46). Subgroup analyses indicated higher performance in pediatric cases and organ-specific complaints, such as ophthalmology (up to 81% accuracy). LLMs also showed tendencies toward over- or under-triage. Conclusions: Current LLMs demonstrate promising but inconsistent capability in triage. While selected models achieved moderate alignment with physician ESI decisions, none achieved strong agreement (κ > 0.80). LLMs are most suitable as supervised decision support tools, particularly in anatomically well-defined clinical scenarios, rather than as autonomous systems.

Postoperative pain is the unpleasant sensory and emotional experience after surgery, its origin being both the inflammatory reaction induced by the surgical trauma on the abdominal wall and the splanchnic pain induced by the activation of nociceptors of the viscera, which are highly sensitive to distension, ischemia, and inflammation. Nowadays, it is well recognized that there is a close relationship between the gut microbiome and pain perception, and that microbiome is highly affected by both anesthesia and surgical manipulation. Thus, efforts to restore the disturbed microbiome via supplementation with beneficial bacteria, namely probiotics, seem to be effective. In this article, the knowledge gained mainly from experimental research on this topic is analyzed, the concluding message being that each probiotic strain works in its own way towards pain relief.

Background: Accurate decision-making in triage largely determines the amount of time required for a patient to be evaluated and treated while in the emergency department. Nursing staff worldwide have similar learning characteristics with similar working hours and common goals, despite the fact that different triage scales are used globally. The aim of this mini review is to present the different educational methods and identify the most effective for triage training of triage nurses. Materials and Methods: We screened studies concerning triage education for nurses in Emergency Department, in databases including PubMed, CENTRAL and CINAHL. From November 12, 2023 to February 15, 2024, databases were searched for relevant literature. “Triage education” OR “triage training” AND “emergency nurses” OR “triage nurses” were the MeSH terms. Results: There are various educational methods, including traditional, web-based, audiovisual, simulation-based, blended learning, and other specialized approaches. Almost all of the studies that are currently available demonstrate how effectively an educational intervention might improve nurses’ comprehension of triage. Except for one, every study concluded that the educational intervention significantly improved nurses’ triage knowledge. Comparing the included studies is challenging due to their heterogeneity, and applying the results in practice requires caution. Conclusion: The majority of studies reported that educational interventions effectively increased nurses’ triage knowledge. Blended learning in conjunction with refresher courses enhanced triage-related knowledge and decision-making; however, additional research is required to ascertain whether this approach is superior to the others and whether these improvements will last.

Scleredema diabeticorum is an uncommon skin disorder which is characterized by stiffness and hardening of the subcutaneous tissues located on the upper back and posterior neck. Patients with this skin disease typically experience pain and stiffness on the neck. Scleredema associated with diabetes mellitus may often go unrecognized. We report a case of a 55-year-old female patient with diabetes mellitus type 1, who presented with skin tightness on her upper back and decreased range of motion. Scleredema diabeticorum is rare and its treatment is difficult and tricky, as no specific regimen has been instituted to treat this skin disease.