Introduction: Intensive care may prolong the dying process in patients who have been unresponsive to the treatment already provided. Limitation of life-sustaining therapy, by either withholding or withdrawing support, is an ethically acceptable and common worldwide practice. The purpose of the present study was to examine the frequency, types, and rationale of limiting life support in Greek intensive care units (ICUs), the clinical and demographic parameters associated with it, and the participation of relatives in decision making. Methods: This was a prospective observational study conducted in eight Greek multidisciplinary ICUs. We studied all consecutive ICU patients who died, excluding those who stayed in the ICU less than 48 hours or were brain dead. Results: Three hundred six patients composed the study population, with a mean age of 64 years and a mean APACHE II score on admission of 21. Of study patients, 41% received full support, including unsuccessful cardiopulmonary resuscitation (CPR); 48% died after withholding of CPR; 8%, after withholding of other treatment modalities besides CPR; and 3%, after withdrawal of treatment. Patients in whom therapy was limited had a longer ICU (P < 0.01) and hospital (P = 0.01) length of stay, a lower Glasgow Coma Scale score (GCS) on admission (P < 0.01), a higher APACHE II score 24 hours before death (P < 0.01), and were more likely to be admitted with a neurologic diagnosis (P < 0.01). Patients who received full support were more likely to be admitted with either a cardiovascular (P = 0.02) or trauma diagnosis (P = 0.05) and to be surgical rather than medical (P = 0.05). The main factors that influenced the physician's decision were, when providing full support, reversibility of illness and prognostic uncertainty, whereas, when limiting therapy, unresponsiveness to treatment already offered, prognosis of underlying chronic disease, and prognosis of acute disorder. Relatives' participation in decision making occurred in 20% of cases and was more frequent when a decision to provide full support was made (P < 0.01). Advance directives were rare (1%). Conclusions: Limitation of life-sustaining treatment is a common phenomenon in the Greek ICUs studied. However, in a large majority of cases, it is equivalent to the withholding of CPR alone. Withholding of other therapies besides CPR and withdrawal of support are infrequent. Medical paternalism predominates in decision making.

The aim of this study is to determine the prevalence of burnout in Greek medical residents, investigate its relationship with training satisfaction during residency and survey Greek medical residents' opinion towards the European Work Time Directive (EWTD).

The rapid expansion of digital technologies and artificial intelligence (AI) has profoundly transformed cardiovascular imaging, enabling more precise, efficient, and reproducible assessment of cardiac structure and function. This narrative review summarizes recent advances in AI-driven methods across echocardiography, cardiac computed tomography, cardiac magnetic resonance, and nuclear imaging, with emphasis on image acquisition, automated quantification, and diagnostic and prognostic interpretation. We reviewed contemporary literature describing machine-learning and deep-learning applications for image reconstruction, segmentation, radiomics, and multimodal data integration. Current evidence demonstrates that AI improves image quality, reduces acquisition and analysis time, and enables automated, highly reproducible measurements of chamber volumes, function, tissue characterization, coronary anatomy, and myocardial perfusion, while facilitating advanced pattern recognition for differential diagnosis and risk stratification. Furthermore, digital platforms support remote acquisition, tele-echocardiography, and AI-assisted training of non-expert operators. Despite these advances, challenges remain regarding external validation, generalizability across vendors and populations, explainability, data governance, and regulatory compliance. In conclusion, AI and digital technologies are reshaping cardiovascular imaging by enhancing accuracy, efficiency, and accessibility, but their safe and effective clinical integration requires robust multicenter validation, transparent reporting, and ethical-legal frameworks that ensure trust, equity, and accountability.