Statins and colchicine co-administration consists of a potentially catastrophic drug-drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined myotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals regarding LDL levels with minimal myopathy risk. Therefore, once colchicine's use is commenced, a hydrophilic statin selection, such as rosuvastatin, seems favorable regarding the risk of myotoxicity. Herein, we aim to describe a patient with chronic kidney disease stage III and nephrotic syndrome that developed acute rhabdomyolysis soon after the administration of rosuvastatin while receiving colchicine. To the best of our knowledge, this is the first report of the combined effect of rosuvastatin and colchicine in the setting of chronic kidney disease leading to myotoxicity.

Rectus sheath hematoma (RSH), an exceptionally rare clinical entity, results from the rupture of epigastric arteries or tear of the rectus abdominis muscle itself. Spontaneous RSH represents a potentially life-threatening bleeding complication in anticoagulated patients with distinct characteristics. The non-specific nature of RSH clinical manifestations renders RSH a kaleidoscopic disease that may be misdiagnosed. The widespread use of anticoagulants for deep vein thrombosis (DVT) prophylaxis or therapy is among the most commonly documented risk factors. To the best of our knowledge, this is the first report of a fondaparinux-associated giant RSH in a 58-year-old Caucasian man who presented with severe pain at the right abdominal quadrant accompanied with a large ecchymosis secondary to violent cough due to a respiratory infection. The aim of our study is to broaden current knowledge regarding the predisposing factors, the pathophysiological mechanisms, and the management of this bleeding disorder.

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Background: It is well known that health management on board is a major challenge for maritime authorities, shipping companies, and seafarers. This paper presents the outcomes of the pilot use of an e-learning platform for dealing with mariners’ health issues aboard.Methods: The survey took place in the Piraeus port (Attica, Greece) during November 2021-February 2022. Data were gathered from merchant ship mariners (n=41) by questionnaires at the Piraeus port, Athens, Greece. A descriptive statistical analysis was performed by the SPSS v23.0® and Microsoft excel© 365.Results: Twenty-one seafarers (51.21%) were at the age group 31-40 years old, fifteen (36.58%) were at the age group 41-50 years old, four (9.75%) were at the age group 51-60 years old and 1 participant (2.43%) was over 60 years old. Twenty-six (63.41%) of the participants were occupied on deck department while fifteen (36.58%) in the engine room. A statistically significant higher score on web-test after the use of SeaHealth platform was confirmed by paired t test (p<0.001) (Figure 3).Conclusions: The participants who used the e-learning platform improved their knowledge on first aid, increased their basic skills on medical care, and achieved more confidence in handling emergencies effectively aboard.