Hospital In Athens Research Articles

657. Do personality traits affect the perceived severity of menopausal symptoms in postmenopausal women?

Introduction and aims of the study: To investigate the association of personality traits with the severity of vasomotor symptoms (VMS) in a predominantly Greek population. Methods: A questionnaire-based study of women from the Menopause Clinic of a University Hospital in Athens, Greece. Sociodemographic parameters were documented through a structured interview. All women were asked to complete the Menopause Rating Scale (MRS) for the assessment of severity of menopausal symptoms, the Hot Flush Belief (HFB) for the assessment of how women were coping with their symptoms and the Big Five Inventory questionnaires for the assessment of personality traits.

Study protocol of a randomised controlled trial for the effectiveness of a functional partial body weight support treadmill training (FPBWSTT) on motor and functional skills of children with ataxia

IntroductionA great heterogeneity characterises the paediatric population with ataxia, which has been studied poorly. The lack of postural control and coordination, in addition with features of the ‘ataxic’ gait are...

Action plan for the mitigation of greenhouse gas emissions in the hospital-based health care of the Hellenic Army.

Climate change is a growing threat for human health and well-being, one that will seriously impact and potentially disrupt all economic sectors and supply chains, such as trade, tourism, agriculture, forestry, and fisheries. The environmental impact of the delivery of medical and hospital care, which generates its own greenhouse gas emissions, needs to be examined and analyzed in detail in order to design and implement effective mitigation actions and measures. Hospital internal energy use processes include the energy consumed for hospital operation, such as lighting, heating, cooking, waste treatment, and other functions associated with the logistical and operational support of hospitals. The present research work, which follows the assessment undertaken in a previous study of the transport activities of the 401 Military General Hospital of Athens (401 MGHA), focuses on the carbon footprint of the stationary emission sources of the 401 MGHA; it serves as a second step in the development of an action plan for the mitigation of greenhouse gas emissions in the hospital-based health care of the Hellenic (Greek) Army. A portfolio of energy saving and emission reduction actions is proposed and mapped according to their abatement cost and greenhouse gas (GHG) reduction potential. The highest decrease of GHG emissions is expected to be materialized by the decarbonization of the Greek power sector due to the lignite phase-out and increased share of low carbon fuels and renewable energy sources. Significant emission reduction potential could also be achieved by the replacement of face-to-face hospital visits by telemedicine, primarily by reducing transport-associated emissions. Furthermore, a number of key performance indicators (KPI) are proposed as simple and easily monitored metrics of the hospital's performance towards its sustainable low carbon objectives. Specific KPIs per mitigation action are presented, as well as a general KPI that covers all mitigation actions and sources of emissions in the form of "tCO2eq per patient" or "tCO2eq per hospitalization day."

Health Professionals in a COVID-19 Reference Hospital: Post-traumatic Stress Disorder (PTSD) Levels and Their Associations With Psychological Resilience and Quality of Life.

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has affected the quality of life of both the general population and health professionals and has increased the levels of psychopathology among them. The present study aims to map the levels of post-traumatic stress disorder (PTSD), psychological resilience, and quality of life of healthcare professionals who work in a COVID-19 reference hospital in Athens, Greece, one year after the onset of the pandemic. Also, this study focuses on investigating the relationships among the study variables and demographics and examining possible mediating effects.MethodsThe sample consisted of 400 health professionals from Sotiria Hospital, of whom 102 were men. Participants were asked to complete the Post-Traumatic Stress Scale, Connor-Davidson Resilience Scale, and the WHO Quality of Life Questionnaire. The survey was conducted from May to July 2021.ResultsThe findings show statistical differences in resilience levels regarding marital status and employee education. Also, 13.5% of the staff reported significant PTSD levels, which relate to low levels of psychological resilience and every pillar of quality of life.ConclusionsThus, research findings indicate that resilience levels could have a protective effect on the development of PTSD symptoms. Therefore, the design of group interventions that aim at building health workers’ resilience will be discussed.

Depression, Adherence, and Functionality in Patients Undergoing Hemodialysis.

Background Patients undergoing hemodialysis face multiple problems such as difficulties in performing daily activities, low functional capacity, non-adherence to the hemodialysis regimen, and depressive symptoms that lead to poor health outcomes. The present study aimed to assess the levels of depression, adherence, and functionality in patients undergoing hemodialysis, as well as the association between the above variables.Materials and methodsIn this cross-sectional study, 100 patients undergoing hemodialysis from a private hospital in Athens participated. Data were collected via the Zung Self-Rating Depression Scale, the Barthel Scale/Index, and the Greek Simplified Medication Adherence Questionnaire-Hemodialysis for the evaluation of patients’ depression, functionality, and adherence to hemodialysis regimen, respectively. In addition, sociodemographic and clinical characteristics were recorded. The study was conducted during the period of December 2020 to February 2021. IBM SPSS Statistics for Windows, Version 25.0 (Released 2017. IBM Corp., Armonk, New York) was used for the statistical analysis of the data. The statistical significance level was set up at 0.05.ResultsOf the patients, 50% scored < 38 (possible range 20-80) in the scale pof depression, and 25% of patients scored < 34. Regarding adherence, the median value was 7 (IQR: 7-7) while 77% scored 7 (possible range of 0-8). Regarding functionality, mild dependence (score 91-99) was referred by 77% of the participants, moderate dependence (score 61-90) by 17%, and severe dependence (score 21-60) was referred by 6% of the patients. A statistically significant negative association emerged between depression and functionality (r= -0.342, p=0.001) while no significant association arised between depression and adherence (r= 0.021,p=0.836) as well as between adherence and functionality (r = 0.078, p = 0.439). Statistical significantly higher scores of depression were seen in women (β = 3.65, p = 0.001) and elderly >70 years old (β = 3.51, CI=0.09-6.93, p = 0.044). Statistically significantly lower functionality were referred by patients >70 years old (β = -13.58, CI: -21.68-5.49, p = 0.001) and by patients with high depression score (β= -0.62, 95% CI: -1.06-0.20, p = 0.005).ConclusionPatients experienced moderate to low levels of depression and high levels of adherence and functionality. The higher the functionality scores, the lower the depression scores. Demographic characteristics, such as age and gender, seem to be significant predictors of depression and functionality.

Assessment of nurses’ and assistants’ knowledge on the prevention and management of pressure ulcers

Background: The pressure ulcers constitute a major clinical problem with enormous socio-economic consequences worldwide. Nurses' knowledge on pressure ulcers’ management plays a crucial role in the prevalence of pressure ulcers.Aim: The investigation of nurses’ knowledge, working in a general hospital, regarding the prevention and management of pressure ulcers. Material and Method: It was a cross-sectional study using a structured questionnaire. The sample consisted of 54 nurses and assistants working in medical and surgical departments of a General Hospital in Athens, Greece. The collection of data took place from June 2019 until November 2019. The analysis of data conducted using the IBM SPSS® program, version 25 (IBM Corp. in Armonk, NY).Results: The mean age of the participants was 42,73 ±8,42 years, and 90,6% were women, with an average work experience of 19,05±9,84 years. The age of nurses of the sample was not associated with the knowledge regarding the prevention of pressure ulcers (p = 0,80). No significant differences were found between their knowledge and the department of work, or the years of work experience and the related seminars organized in the department (p &gt; 0,05). Nurses who had a postgraduate degree had statistically significant more correct answers (p = 0,01).Conclusions: Despite the development of nursing science in the treatment of pressure ulcers, nurses continue to present insufficient knowledge in the daily clinical practice. Τhe implementation of clinical guidelines and the continuing education courses may help nurses to enhance their knowledge.

Factors affecting breastfeeding in rural and urban population of Greece: Preliminary analysis of a prospective cohort study

Introduction: Breastfeeding is the unparalleled way to provide infants the ideal nutrients they need for their healthy growth. The World Health Organization (WHO) recommends exclusive breastfeeding until 6 months old, starting within 1 hour of birth. All infants should start receiving foods in addition to breast milk from 6 months onwards, while breastfeeding continues until 2 years old or more. Purpose: The purpose of this study is to investigate those factors that may influence the onset of breastfeeding in the first few days after birth and during the hospitalization in the maternity ward, as well as the establishment of breastfeeding 6 weeks after birth, along with studying the weight of the newborn. Material and Method: This was a prospective study with a convenience sample taking place in the General Hospital of Argolis and the Elena Venizelou maternity hospital in Athens. In the presented pilot study 75 women that delivered at full term completed the questionnaire. We chose to exclude women that delivered during the preterm period as well as those that delivered twins as these factors independently affect the possibility of discontinuing breastfeeding. A self-report questionnaire with closed and open-ended questions was used and was completed in two phases. Results: Overall, 75 women completed the questionnaire. Of those 3 women delivered within the early term period (37+0 – 38+6 weeks). The majority of women (74.67%) initiated breastfeeding within 2 hours from delivery. Rooming in was allowed within the first hour in a large proportion of participants (62.67%). Breastfeeding difficulties were encountered in approximately half of participants and the predominant reason was some form of breast pathology. Twenty-two mothers (29.3%) discontinued breastfeeding within the study period. Early rooming in significantly increased the possibility of continuing breastfeeding after the first month. Of all the factors that were investigated during the puerperal period only the amount of formula meals significantly affected the rates of continuous breastfeeding. Conclusion: Early rooming-in significantly increases breastfeeding practices. Unstructured educational activities from healthcare providers and accompanying brochures do not seem to enhance breastfeeding duration, indicating the need for adoption of specific programs that will be tested in forthcoming studies.

Early versus Late Tracheostomy Promotes Weaning in Intensive Care Unit Patients: a retrospective observational study.

Background and aim of the study:The time interval between the patients’ intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to intensive care unit (ICU) patients’ weaning from respiratory support.Methods:This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients’ medical records in order to estimate the duration of patient weaning and the number of days from the patients’ intubation until the time of tracheostomy. In the present study the term early tracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomy defines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission.Results:One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days.Conclusions:The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients’ outcomes, and specifically ICU patients’ weaning. (www.actabiomedica.it)

Health-Related Quality of Life and Social Support of Elderly Lung and Gastrointestinal Cancer Patients Undergoing Chemotherapy.

IntroductionIncreasing life expectancy has led to a higher incidence of cancer in the elderly, thus making them vulnerable and worsening their health-related quality of life (HRQoL) and their need for support.ObjectiveThe aim of this study was to examine the HRQoL and social support in elderly Greek lung and gastrointestinal cancer patients undergoing chemotherapy.MethodsThis was a descriptive, cross-sectional study of 104 elderly cancer patients, who were receiving chemotherapy in the outpatient department and inpatient ward of a General Hospital in Athens. The data were collected using purposive sampling between December 2019 and May 2020, and included demographic and clinical characteristics, the HRQoL questionnaire, Short Form 36 (SF36), and the Personal Resource Questionnaire (PRQ-2000).ResultsThe participants' median age was 72 years; the majority were male (62.5%) and had lung cancer (57.7%). The SF36 data revealed a relatively moderate (42.7–62.61) HRQoL in most subscales. The “Pain” subscale recorded the highest score (75.0), and the “social function” subscale the lowest (42.79). The PQR-2000 indicated a satisfactory level of social support (81.65), with values ranging between 48 and 105; married patients with higher education scored more highly (p < .05). Patients aged 65–75 years reported better HRQoL and greater social support than older patients. In addition, patients with their own family and a relatively high income reported better HRQoL and social support compared to single individuals, with low income, who were cared for by their children. Positive and statistically significant (p < .05) correlations were found between the SF36 subscales of role functioning/physical, vitality, general health, emotional well-being and the PRQ-2000.ConclusionThe HRQoL and social support of elderly cancer patients positively affect the course of their health. Healthcare systems and social services should address the multiplying needs of these patients with targeted interventions to support their well-being.

Chasing Hippos: Implications of YAP1 and TAZ Expression in Pregnancy-associated Breast Cancer Tumorigenesis.

The Hippo pathway is a molecular pathway recently associated with tumorigenesis, metastasis, and drug resistance. Pregnancy-associated breast cancer (PABC) is the most common malignancy diagnosed during gestation; however, the molecular mechanisms underlying PABC are largely unknown. The aim of the present study was to evaluate Hippo pathway transducers TAZ and YAP1 expression in PABC in relation to the clinicopathological characteristics of the disease. Formalin-fixed paraffin-embedded (FFPE) tissues from 21 PABC patients treated at Alexandra Hospital in Athens, Greece, were analyzed with immunohistochemistry. Strong nuclear TAZ/YAP1 stanning was found in 48% of the PABC patients analyzed. Hormone receptor negative patients had a statistically significant correlation with strong positive expression of TAZ/YAP1 co-transcription factors. No association was observed with overall and disease-free survival. The Hippo pathway is de-regulated in a subset of PABC patients, highlighting the complex molecular background of the disease, which certainly requires further investigation.

Diagnoses in the Psychiatric Hospital of Kerkyra (Corfu) (1838-2000).

The Psychiatric Hospital of Corfu was founded in 1838 by the (British) Ionian State and was joined in Greek territory in 1864. It was the unique psychiatric hospital in Greece, until the establishment of Dromokaition Hospital of Athens, in 1887. In its long history many of the patients' admissions had a local character, mainly from Corfu, the Ionian Islands, and later from Western Greece. Until the 1950s, we can follow efforts to improve buildings and patient care, but we note also long hospitalizations of men and women and high death rates. It had been an isolated institution until it joined the National Health System in 1983. It closed its doors in 2006, after a long reform process started in 1986. In its place today there is a network of community psychiatric care and rehabilitation units. Based on the medical and social hospital's books data, this paper focuses on the time of appearance and eventually withdrawal of the main diagnoses. 15844 admissions were recorded from 1838 to 2000. We note the time of first description of a diagnosis in European and Greek literature. In the 19th century, the wide diagnosis of dementia also included cases of chronic schizophrenia of our days. The diagnoses of lipomania (from 1855 to 1888), monomania (from 1845 to 1885), and degeneration insanity (from 1902 to 1952) depended on the scientific audience of these theories. Schizophrenia, as expected, was the leading one diagnosis, from 1915. Dementia praecox (πρωτογόνος άνοια in Greek) and precocious dementia were present from 1862 to 1945. Throughout the history of this institution, a large number of cases of mania and melancholia were also observed. Since 1859, the intermittent or cyclic nature of these two symptoms has been recorded, as well as since 1916, Kraepelin's manic-depressive insanity. From 1950, with the use of antibiotics, general paralysis (syphilis of the CNS) will disappear. The presence of many other diagnoses is discussed. From the end of the 19th century, the concept of widely used psychosis has gradually replaced insanity and phrenitis. From the 1940's, we also observe the use of "syndrome" in order also to describe clinical pictures of psychosis and affective disorders. This use of syndrome is probably related to the will of the medical directors of a freer use of diagnoses, compared to those included in the known nosography criteria. The homogenization of diagnoses in Greece was essentially accomplished by introducing ICD-10 in 1990s.

Early Occurrence of Adverse Events in Hospitalized Patients With COVID-19 and Beneficial Effect of Anticoagulation.

This study analyzed the characteristics of patients with COVID-19 with major events during the first days of hospitalization. This is a retrospective analysis of prospectively collected data from consecutive patients admitted to two hospitals in Athens, Greece. The characteristics of patients with COVID-19 who suffered the primary endpoint (venous thromboembolic events, intubation, and death) during the first days of hospitalization were analyzed. Among 95 patients included in the analysis, 21 presented with major adverse events during a median follow-up of 13 days. More than 50% of these patients presented with a major event during the first 3 days. Anticoagulation treatment was inversely associated with the cumulative incidence of the primary endpoint [hazard ratio=0.16 (95% confidence interval=0.06-0.47)]. Patients with major events were older, with lower baseline SatO2, and higher number of Wells' criteria and Charlson comorbidity index. Among these patients, those with hypertension were at higher risk for early occurrence of events (≤ first three days of hospitalization). Major adverse events may occur early in hospitalized patients with COVID-19 with a high-risk profile. Anticoagulation treatment appears to reduce this risk and thus prompt thromboprophylaxis should be employed in these patients.

PNPLA3 rs 738409 and Other Nongenetic Factors Associated with Hepatic Steatosis Estimated by Magnetic Resonance Imaging Proton Density Fat Fraction in Adult Greek Subjects with Type 2 Diabetes Mellitus.

Objectives: Nonalcoholic fatty liver disease is dramatically increasing in parallel with the pandemic of type 2 diabetes mellitus. We investigated factors associated with hepatic steatosis (HS) in adult Greek individuals with established type 2 diabetes mellitus. Materials and Methods: We investigated 120 consecutive people with type 2 diabetes attending the Diabetic Outpatient Clinic at an Academic Hospital in Athens, Greece. All of them had demographic, clinical, and biochemical data recorded. HS was estimated by magnetic resonance imaging determined by proton density fat fraction software and defined as the percentage of total liver fat divided by the liver volume. HS of >5% was considered abnormal. The PNPLA3 (I148M) variant was evaluated as a genetic factor by standard molecular techniques. FibroMax™ was also calculated. Results: Of the 120 participants, median age was 61.7, 46% were females, diabetes duration was 10 years, and HbA1c (glycated hemoglobin) was 6.7%. The median value of HS was 7.8. The PNPLA3 rs738409 CC/CG/GG genotype frequencies were 54.2%, 35%, and 10.8%, respectively. In multivariate analysis, PNPLA3 rs738409 (β = 0.425, P = 0.001), waist circumference (β = 2.448, P = 0.001), and female sex (β = 0.419, P = 0.002) had a direct association with HS, while duration of diabetes (β = -0.179, P = 0.011) had an inverse association with HS. Conclusions: HS in type 2 diabetes is the sum of interplay of various factors exerting a direct or an inverse association, the most prominent among them being abdominal obesity and PNPLA3 molecular variability.

The effect of hospital ethical climate on nurses' work-related quality of life: A cross-sectional study.

Hospital ethical climate (HEC) has been associated with nurses' interprofessional collaboration, moral decision-making and judgment, job satisfaction, and job burnout. This study aimed to examine the effect of hospitals' ethical climate on nurses' quality of working life. A cross-sectional study design was employed and 286 nurses from two hospitals in Athens participated in the study from January to February 2020. The data collected using a three-part self-administrated questionnaire were analyzed using the IBM Statistical Package for Social Sciences 25 (SPSS). According to the results, the staff nurses working on rotating shifts reported poorer Work-Related Quality of Life (WrQoL). Positive correlations were observed between age, control at work, and home-work interface, between the period of time the nurses were working in a specific department with the dimensions of the ethical climate scale, and between almost all the HEC aspects with WRQoL subscales. Only the domain of stress at work had fewer and less significant correlations. Health authorities and hospital managers should provide the necessary ground for the institutionalization of professional ethics by creating an appropriate ethical climate. A positive ethical climate may lead to a better working environment with less distress for health professionals and better quality of care for the patients.

Recurrent Wheeze Exacerbations Following Acute Bronchiolitis-A Machine Learning Approach.

Introduction: Acute bronchiolitis is one of the most common respiratory infections in infancy. Although most infants with bronchiolitis do not get hospitalized, infants with hospitalized bronchiolitis are more likely to develop wheeze exacerbations during the first years of life. The objective of this prospective cohort study was to develop machine learning models to predict incidence and persistence of wheeze exacerbations following the first hospitalized episode of acute bronchiolitis.Methods: One hundred thirty-one otherwise healthy term infants hospitalized with the first episode of bronchiolitis at a tertiary pediatric hospital in Athens, Greece, and 73 age-matched controls were recruited. All patients/controls were followed up for 3 years with 6-monthly telephone reviews. Through principal component analysis (PCA), a cluster model was used to describe main outcomes. Associations between virus type and the clusters and between virus type and other clinical characteristics and demographic data were identified. Through random forest classification, a prediction model with smallest classification error was identified. Primary outcomes included the incidence and the number of caregiver-reported wheeze exacerbations.Results: PCA identified 2 clusters of the outcome measures (Cluster 1 and Cluster 2) that were significantly associated with the number of recurrent wheeze episodes over 3-years of follow-up (Chi-Squared, p < 0.001). Cluster 1 included infants who presented higher number of wheeze exacerbations over follow-up time. Rhinovirus (RV) detection was more common in Cluster 1 and was more strongly associated with clinical severity on admission (p < 0.01). A prediction model based on virus type and clinical severity could predict Cluster 1 with an overall error 0.1145 (sensitivity 75.56% and specificity 91.86%).Conclusion: A prediction model based on virus type and clinical severity of first hospitalized episode of bronchiolitis could predict sensitively the incidence and persistence of wheeze exacerbations during a 3-year follow-up. Virus type (RV) was the strongest predictor.

Translation, Cultural Adaptation, Validity, and Internal Consistency of the Greek Version of the Individual Workload Perceptions Scale-Revised

Introduction: The working environment in hospitals has been characterized as very important for the improvement of the provided care and the nurses’ job satisfaction. The aim of the current study was translation and cultural adaptation of the Individual Workload Perceptions Scale-Revised (IWPS-R) as well as the investigation of the validity and internal consistency of the scale.Methods: This is a cross-sectional, descriptive study involving 365 Greek nurses from two large hospitals in Athens, Greece. Nurses completed the Individual Workload Perceptions Scale-Revised, which is a self-administered questionnaire consisting of 29 items on a five-point Likert-type scale. For the translation, the scale was first translated into the Greek language (forward translation) and then into the English language (backward translation) and culturally adapted. For the study of the construct validity, exploratory and confirmatory factor analyses were performed, while the criterion of the convergent validity was between the five factors of the scale. To study the reliability, the method of test-retest was performed while Cronbach’s alpha coefficient was used to study the internal consistency of the scale. Data analysis was performed via the Statistical Package for the Social Sciences (SPSS), version 21.0 (IBM Corp., Armonk, NY).Results: According to the exploratory factor analysis, the Greek version of the Individual Workload Perceptions Scale-Revised consists of five factors (Manager Support, Peer Support, Unit Support, Workload, and Intent to Stay) explaining 51.4% of the total variance. From the confirmatory factor analysis, the model was equivalent to the original factorial structure of the IWPS-R. Τhe convergent validity revealed a positive correlation between all the domains of the scale (p < 0.001). The test-retest method showed that there are no significant differences between the first and the second measurements (intraclass correlation coefficient [ICC] = 0.990, p < 0.001). The internal consistency was very good (Cronbach’s alpha coefficient = 0.878).Conclusions: The IWPS-R is a reliable and valid instrument for Greek nurses to measure the perceptions of the nursing working environment.

Effectiveness of atrial fibrillation on high-intensity transient signals to cerebral circulation during TAVI

Abstract Background Cerebral microemboliazations remain a major concern peri-operatively and following Transcatheter Aortic Valve Implantation (TAVI). We evaluated whether atrial fibrillation may predispose to an increased number of cerebrovascular emboli during the procedure. Purpose The aim of the study was to evaluate, using a transcranial doppler, the effect of atrial fibrillation on transient high-intensity signals to middle cerebral arteries during transcatheter aortic valve implantation. Methods Consecutive patients who underwent transfemoral TAVI with Evolut™ R bioprosthesis, were categorized into two groups. Group A patients with permanent atrial fibrillation (AF) on anticoagulation, Group B patients with sinus rhythm (SR). Dual antiplatelet therapy with aspirin and clopidogrel was administered to all patients 24 hours prior to the procedure at loading dose, with patients in Group A receiving in addition low-molecular-weight-heparin. The number of detected High Intensity Transient Signals (HITS) was assessed using Rimed Digi-Lite™ Transcranial Doppler on both cerebral arteries during the following phases of the procedure; Phase 0: 30 minutes prior to procedure initiation, Phase I: between access site puncture and introduction of the delivery system, Phase II: during the implantation of the bioprosthesis, until the removal of the delivery system. All implantations were performed without predilation. Furthermore, patients were evaluated by neurologist before TAVI and on discharge day. Safety was evaluated according to VARC-2 criteria. Results Twenty-eight patients were evaluated (81±6 years, 16 males (57.1%)). Group A had higher number of total (786±95 vs. 604±103, p=0.002) as well as Phase I HITS (393±94 vs. 285±86, p=0.002). One cerebrovascular event was recorded in Group A and one patient categorized to Group B developed major bleeding due to conversion to femoral surgical cut-down. The average number of received blood units, was higher in AF compared to SR Group (Group 1: 0.8±1.9 vs. Group 2: 0.5±0.7, p: 0.886), without however, reaching statistical significance. Conclusion Patients with atrial fibrillation had larger burden of embolic HITS during TAVI indicating high risk patients for embolic cerebrovascular events. This may has implications for future strategies for cerebral embolic protection. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Ippokrateio General Hospital of Athens

Hypertensive urgencies during the first wave of the COVID-19 pandemic in a tertiary hospital setting: a U-shaped alarming curve.

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic provoked unprecedented disturbance in hypertension care, while alarming concerns arose about its long-term consequences. We investigated the trends of emergency visits and admissions regarding uncontrolled hypertension in order to assess the impact of COVID-19 spread on population behavior towards hypertension urgencies during its first wave.Material and methodsData from daily unscheduled visits and admission counts in the Cardiology sector were collected from the Emergency Department database of a tertiary General Hospital in Athens, Greece for the period January 15th to July 15th 2020. These data were compared with those from the previous year. Cases of patients who presented with hypertensive urgency or who were admitted due to uncontrolled hypertension were separately analyzed.ResultsA total of 7,373 patient records were analyzed. Hypertension urgency cases demonstrated a U-shaped distribution in 2020, showing a declining trend during the rapid virus spread, an image that was reversed after the transmission rate’s decline. COVID-19 incidence in Greece was inversely associated with uncontrolled hypertension admissions during its declining phase (r = –0.64, p = 0.009), whereas total attendance exhibited a similar correlation during the first and the following months of the pandemic (r = 0.677, p = 0.031, r = –0.789, p = 0.001). Uncontrolled hypertension rate on admission was positively related to the national incidence of COVID-19 cases during the first months of 2020 (r = 0.82, p = 0.045).ConclusionsHypertensive urgency-related visits followed a U-shape distribution during the pandemic’s first wave with the attendance nadir coinciding with the virus spread peak. This is a complex phenomenon, closely related to increased levels of public stress, disruptions in health care services and to a lesser extent to the imposed restrictions in transportation. The initial relative increase in uncontrolled hypertension-related admissions rate, combined with the later increase of hypertensive urgencies may be indicative of blood pressure deregulation among the studied population, which is multifactorial and potentially detrimental.

CN33 Is there a relationship between missed nursing care and compassion fatigue of nursing staff at a Greek Oncology Hospital?

Missed nursing care is affected by the work environment and nurses’ personal characteristics. Aim: to explore the relationship between missed care and compassion fatigue in the nursing staff of an Oncology Hospital of Athens.

Are patients willing to be informed on the risks and complications associated with the proposed therapy? A survey on informed consent.

Informed consent is essential to the patient-physician relationship. The paternalistic old-time approach used by physicians to achieve the optimal management is changing today; detailed medical information must be disclosed to the patients regarding their health problem. The aim of this study was to highlight the value of informed consent in the context of medical practice as well as to emphasize its importance through the prism of human rights. A patient survey was conducted in two public and one private hospitals in Greece. Eighty-three inpatients from the Surgical Departments of Democritus University Hospital of Alexandroupolis (DUHA), Laikon University Hospital of Athens (LUHA) and a private hospital were included in the study. A questionnaire regarding patients' attitude towards informed consent was distributed to patients prior to surgery. The majority of the patients (63.86% in DUHA, 59.38% in LUHA, and 78.95% in the private hospital) opted for full disclosure regarding the course and development of their condition. Patients want to be informed about their treatment options and possible complications so that they can make decisions about their treatment after a comprehensive and understandable discussion.