Hospital In Athens Research Articles

Perioperative neutrophil to lymphocyte ratio as a predictor of poor cardiac surgery patient outcomes.

PurposeThe purpose of the present study was to investigate the association between the perioperative neutrophil to lymphocyte ratio (NLR) and cardiac surgery patient outcomes.Patients and methodsA retrospective cohort study of 145 patients who underwent cardiac surgery in a tertiary hospital of Athens, Greece, from January to March 2015, was conducted. By using a structured short questionnaire, this study reviewed the electronic hospital database and the medical and nursing patient records for data collection purposes. The statistical significance was two-tailed, and p-values <0.05 were considered significant. The statistical analysis was performed with Mann–Whitney U test and Spearman’s correlation coefficient, by using the Statistical Package for Social Sciences software (IBM SPSS 21.0 for Windows).ResultsThe increased preoperative levels of NLR were associated with significantly higher mortality, both in-hospital (p=0.001) and 30-day (p=0.002), prolonged postoperative hospital length of stay (LOS), both in the cardiac intensive care unit (ICU) (p=0.002), and in-hospital (p=0.018), and likewise with delayed tracheal extubation (p≤0.001). Furthermore, patients with elevated NLR during the second postoperative day had significantly higher in-hospital mortality (p=0.018), increased incidence of pneumonia (p=0.022), higher probability of readmission to the ICU (p=0.002), prolonged ICU LOS (p≤0.001), and delayed tracheal extubation (p≤0.001).ConclusionIncreased perioperative NLR seems to be associated with significantly higher mortality and morbidity in cardiac surgery patients. At the same time, NLR is a significant and inexpensive biomarker for the early identification of patients at high risk for complications. In addition, NLR levels could lead clinicians to perform measures for the optimal therapeutic patient approach.

ABC and VED Analysis of Medical Materials of a General Military Hospital in Greece

ABC and VED analysis of a General Military Hospital of Athens was conducted in order to highlight expensive medical products, as a management tool. The annual consumption and expenditure incurred on each product for the year 2012 was analyzed and inventory control techniques were applied. ABC analysis revealed 5, 15 and 80 per cent products as A, B and C category products, respectively, accounting for 52, 28 and 20 per cent of annual expenditure. VED analysis showed 420, 689 and 2,101 products as V, E and D category products out of 3,210 products.

Preoperative Biliary Drainage of Jaundiced Patients with Pancreatic Head Cancer: A Routine or Selective Strategy

Most patients with pancreatic head cancer (85%) are jaundiced at presentation. Obstructive jaundice is believed to increase postoperative complications. According to some experimental and clinical studies, preoperative biliary drainage (PBD) improves postoperative outcomes. However, numerous randomized studies found that PBD might increase postoperative complications rate. Thus, PBD or not is controversial. Objective: To confirm if PBD can be a routine or selective strategy in these patients. Material and methods: A retrospective study comparing PBD with surgery alone in 200 jaundiced patients with pancreatic head cancer from 2nd Department of Surgery-Hellenic Red Cross Hospital of Athens (1996-2011). Data from patient’s files including: Age, gender, smoking, diabetes history, Laboratory parameters, procedures, post-operative course. Results: The majority of patients (62.5% ) were males, with adenocarcinoma (93.5% ), smokers (65.0% ), and half of them were diabetics. The median age was 70 years, median tumor size was 5 cm ,while PBD was performed in 74 patients ( 37.0%) with higher laboratory parameters (Direct bilirubin 18 mg/dl vs 13 mg/dl. Total bilirubin 24 mg/dl vs 20 mg/dl) and in this group was marked: higher postoperative complications rate, higher ICU admission rate, higher postoperative mortality (17.6% vs 5.6%). Conclusion: We believe that PBD should be a selective strategy in jaundiced patients with pancreatic head cancer in case of fever, non- operability of patients, and in case of more advanced disease as a palliative alternative since, this method increases postoperative complications rate.

Moderating Nutritious Habits in Psychiatric Patients Using Transtheoretical Model of Change and Counseling.

This study was aimed to change nutritious behavior of psychiatric patients using a specific Model of Change and Counseling implementing a health education program. A quasi-experimental design was adopted on a random sample of 60 psychiatric patients at Military Hospital of Athens. Patients were divided into two groups as follows; (a) Intervention Group (four sessions of counseling and encouraging motivation for modification of their nutritious habits), and (b) Control Group (simple information sessions about the principles of healthy alimentation). The mean age of Intervention Group (IG) was 43.9±9.5 and Control Group (CG) 46.1±9.1, ranging from 40 to 55years old. Also, 26.7% of the participants were female, 23.3% were married and, 10% divorced. Our analyses showed that IG patients were significantly loss weight post-intervention compared to CG patients. Specifically, IG patients were significantly moderated the intake of starchy foods in every meal (p<0.001) and the intake of fruits and vegetables (p<0.001). Similarly, IG patients were moderated the intake of low fat dairy foods while they changed the full fat dairy foods with low fat (p<0.001). Also important, IG patients showed significant enhance (80%) regarding drugs compliance, suggesting that 34% of the CG patients often forgot to take their medication. Finally, IG patients reported a positive attitude towards moderating unhealthy nutritious behaviors (p=0.032). Our results confirms that health educational and promotional Interventions may change behavior of psychiatric patients and thus may positively influence their nutritious habits.

Prevalence of Pandemic Influenza a (H1N1) Virus and Cytomegalovirus Co- Existence at an Early Stage in Evangelismos Hospital-ICU Patients

Objective: Cytomegalovirus (CMV) infections in immunocompetent ICU patients have been associated with poor outcomes. We determined the distribution of cytomegalovirus coinfection among patients admitted in the ICU1 of Evangelismos Hospital of Athens with or diagnosed with pandemic influenza A (H1N1) respiratory infection. Patients: We examined retrospectively 33 ICU consequently patients with community or hospital-acquired pulmonary infection. Investigation of viral-viral coinfection rate was determined at the first 48 h after ICU admission. Results: A total of 13 patients that received a diagnosis of influenza A (H1N1) had their diagnosis confirmed by influenza A rapid antigen testing and/or by influenza A (H1N1) polymerase chain reaction (PCR). Only three out of the 13 H1N1 positive patients were cytomegalovirus bronchoalveolar lavage (BAL)-PCR positive and 10 were negative. Additionally 2 out of the 20 H1N1 negative patients were CMV-BAL-PCR positive. Conclusion: We did not find significant CMV distribution in our H1N1 positive patients at least at the early 4-5 days period after H1N1 infection. However, the study is interesting because patients with a combination of H1N1 and CMV infections have been described only rarely. The scarce presence of CMV in H1N1 patients may suggest that endogenous reactivation of CMV infection within the lungs does occur and that these patients may profit from antiviral therapy. The interplay between host and viruses is very complex and therefore the triggering for the CMV disease activation following H1N1 pneumonia is possible to require more than the absolute presents of the H1N1 virus especially in the ICU patients.

Measurement of Patient Satisfaction as a Quality Indicator of Hospital Health Services: The Case of Outpatient Clinics in General Hospital

Purpose: The measurement of patient satisfaction by the provided health services in outpatient clinic of the General Hospital of Athens. Material-Method: To measure the satisfaction of health service users was chosen a sample of 400 people using the method of stratified random sampling. The data were collected using a weighted structured questionnaire in those who had an appointment with the hospital doctors (period from 1st to June 30th 2012). The evaluation of patient satisfaction for services imprinted in two ways: (a) assessment of total services in ten-point scale, where 1 represents dissatisfied and 10 very satisfied and (B) assessment of individual medical, nursing and administrative services with the five-point scale. The five-point scale was established as follows: value 1: very bad 2: rather bad 3: neither good nor bad, 4: rather good 5: very good. For the statistical analysis was used descriptive statistics, t test and ANONA test. Results: The response percentage of interviewees reached 83.25%. In assessing the overall satisfaction was found that in the ten-point scale, the Hospital is evaluated positively. The average total score of evaluation is quite high (8.3). Important parameters of satisfaction for the majority of patients were courtesy, specialized knowledge and the professionalism of the staff of outpatient clinic. 85.29% of the sample declared absolutely satisfied by the behavior of the reception staff, 72.37% by the behavior of doctors, 69.67% by the quality of nursing care. However, the problematic aspects of the visit were identified to the responsiveness, the access, the outpatient clinics and the accommodations infrastructure. The lowest percentage of completely satisfied corresponds to the replies on the notice boards and on the information at the hospital entrance (5.41% and 5.71% respectively). Dissatisfaction was expressed for the long waiting time between the desired date for visit and the scheduled date (percentage of fully satisfied 14.71%), as well as for waiting time in order to be respect the scheduled time (percentage of fully satisfied 12.01%). Noteworthy is that the majority of interviewees would recommend the hospital to friends and family environment (percentages: definitely yes 58, 86%, rather yes 36.94%). Conclusions: The overall assessment of the services provided by the outpatient clinic of Hospital was positive. However, it appeared to have problems in the organization, delays and infrastructure of clinics, for which must be taken corrective measures to ensure that the services that patients benefit are characterized by high quality.

Efficacy of Hexaminolevulinate Photodynamic Diagnosis of Non-Muscle Invasive Bladder Cancer

Objective: This study evaluated the efficacy of hexaminolevulinate fluorescence cystoscopy as a diagnostic tool for bladder cancer. The study was a case series in the Department of Urology in Hippokratio General Hospital of Athens between October 2008 and May 2012. Methods: Fifty patients (43 males and 7 females) who were investigated for hematuria were included in the study. White light cystoscopy (WLC) was first performed in all patients and after was performed a fluorescence cystoscopy (BLC-blue light cystoscopy). Biopsies were collected from any suspicious area and resection of the tumors identified (TUR).Whenever no suspicious areas could be seen, a standard random mapping including 8 biopsies overall was completed. Results: Patients demographic data and clinical history are presented in Table 1. Two-hundred twenty specimens were extracted and bladder cancer was diagnosed in 137. There were 17 CIS lesions all diagnosed with BLC whereas only 11 with WLC. WLC correctly diagnosed 109/140 specimens and the positive and negative predictive values were 77.9% and 65% respectively. The sensitivity and specificity were 79.6% and 62.6% respectively. BLC diagnosed 125/169 specimens and the positive and negative predictive values were 73.9% and 76.5% respectively. The sensitivity of BLC was 91.2% and the specificity 46.9%. Conclusion: Hexaminolevulinate-guided cystoscopy is a valuable diagnostic method, with considerably improved accuracy and improvement in diagnosis of non-muscle-invasive bladder cancer and especially CIS.

Benchmarkıng ındıcators nursing workload ın Intensıve Care Unıts

Introduction: The high and continues increasing nursing workload in the Intensive Care Unit (ICU) is a remarkable increase in mortality factor of heavy ill patients.Aim: The aim of this study was a comparison evaluation between the score of Nursing Workload (NW), Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS) in nurses who treat critically ill patients in Intensive Care Unit (ICU).Material and Methods: The studied population was 100 patients who were hospitalized in Intensive Care Units (ICU) hospitals in Athens and private clinic of Piraeus. It was used a special designed questionnaire by the researchers based on Nursing Activity Score (NAS) score and Comprehensive Nursing Intervention Score (CNIS) score. Data analysis was performed with the statistical package SPSS 17.0.Results: The 56% of study were men. The average age of the sample was 74 ± 15 years. The average Nursing Activity Score (NAS) for the first 10 days of hospitalization was 55, 4 ± 4, 9 and Comprehensive Nursing Intervention Score (CNIS) was 129, 5 ± 15, 4. Compared with indicators gravity nursing workload, with prognostic score APACHE II, SAPS II, the Glasgow scale and with laboratory markers creatinine and white blood showed that the Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS) indicators a statistically significant difference (p = 0.005 and p &lt;0.001, respectively) compared with patient outcome.Conclusions: The nursing workload (NW) as measured on scales Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS). Both scales are equality and validity. Similarly, the outcome of these patients was associated with disease severity as measured by the score APACHE II and SAPS II.

Predictive Value of HRT Stereometric Parameters and Blue-on-Yellow Perimetry Global Indices in Glaucoma-suspected Subjects.

To determine subtle changes of Heidelberg retina tomography (HRT) stereometric parameters and blue-on-yellow (B/Y) perimetry global indices for the early diagnosis of glaucoma in suspected subjects. Cross-sectional data on 174 eyes of 87 subjects from a larger cohort, attending the Glaucoma Department of the "G. Gennimatas" General Hospital of Athens from January 2004 to February 2014, were used in the study. Subjects were assigned to 3 groups: (a) "normals" not requiring treatment throughout the study (group 1), (b) suspects who developed glaucoma and required treatment during the study (group 2), and (c) patients with incipient glaucoma (group 3). Specific HRT and B/Y perimetry variables were compared among the 3 groups. Significant differences were established for the following HRT parameters: "reference height" differed significantly between groups 1 and 2 and groups 1 and 3; "cup shape measure" differed significantly between groups 1 and 2 and groups 2 and 3. B/Y perimetry global index "mean deviation" significantly distinguished group 2 from groups 1 and 3. The results of the present study suggest the predictive value of the HRT stereometric parameters "reference height" and "cup shape measure" and of the B/Y perimetry global index "mean deviation" in glaucoma-suspected subjects; further corroboration through longitudinal studies is warranted.

Recovery and Return to Work After a Pelvic Fracture.

BackgroundPelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF.MethodsDuring the years 2003–2012, 282 injured individuals aged 20–55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment.ResultsAlmost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626–25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092–6.720) were identified as independent predictive factors of full RTW.ConclusionPRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study.

Bacterial vaginosis (BV), candidiasis, and trichomoniasis were the three established types of vaginal conditions until aerobic vaginitis (AV) was defined in the early 2000s. We sought to study the prevalence of abnormal vaginal flora (AVF) with inflammation in our hospital and to correlate it with AV. We prospectively collected vaginal smear specimens originated from symptomatic women who were examined at Iaso Obstetrics, Gynecology and Children's Hospital of Athens from April 2014 until September 2015. Amsel's criteria were used for the diagnosis of BV. The presence of leukocytes and lactobacillary grade were evaluated to classify a condition as AVF with inflammation; subsequently, bacterial cultures were performed. A total of 761 women were included. Five hundred and seventy-nine women were diagnosed with candidiasis, BV, trichomoniasis, or other types of vaginitis in which no pathogenic bacterial growth occurred in cultures. One hundred and eighty-two women (23.9%) were diagnosed with AVF with inflammation (116 non-pregnant, 66 pregnant). Escherichia coli was the most common pathogen among these women (non-pregnant: 45.7%, pregnant: 34.8%). Other common pathogens were Group-B-Streptococcus (non-pregnant: 20.7%, pregnant: 22.7% respectively), Enterococcus faecalis (14.7%, 18.2%), and Klebsiella pneumoniae (6.9%, 12.1%). The prevalence of AVF with inflammation may be high. Since inflammation criteria were applied, most cases of BV were eliminated and the majority of cases of AVF are AV. Therefore, clinicians should include AV in the differential diagnosis of vaginitis, while microbiologists should take into account the growth of aerobic bacteria in vaginal cultures originating from women with microscopic findings of AV.

Knowledge of nursing stuff on radiation protection in a public hospital

Introduction: The ever-evolving applications of radiology-radiotherapy, apart from the solutions offered in daily diagnostic and therapeutic problems, expose healthcare workers to the risk of irradiation and its consequences.Aim: The aim of the present study was to evaluate nurses’ knowledge on the risk of radiation during the daily work and radiation protection instructions to be followed during their participation in diagnostic and therapeutic procedures involving radiation use.Method and Material: The studied sample consisted of 110 nurses working in Public General Hospital of Athens in clinical departments and units so as in laboratories using mainly radiation such as the CT scanner and the catheterization laboratory. For data collection, a special designed questionnaire with questions that reach key areas of the applied radiation protection policy of this hospital was used. Data analysis was performed with the statistical package Statistical Package for Social Sciences (SPSS).Results: The majority (87.3%) of the participants were women, with an average age of 39.66 years (± 7.33 years). The best part of the nurses who participated in the study (82.7%) has not attended any training program concerning radiation protection. Forty percent (40%) of the participants say they do not know the policy of their hospital on issues of radiation protection, while 45.5% did not know whether their working section met the prescribed radiation safety criteria. Participants working in radiology sector had significantly higher degree of agreement with the proposals concerning the applied radiation protection policy compared with participants who worked either in pathological and surgical field or in the operating room and the ICU (p = 0.002).Conclusion: All health professionals (doctors, nurses, technicians), should be constantly informed of all the rules related to both personal protective equipment and protective measures of the patient and the environment against radiation, and the rules applied for the proper use of the appropriate equipment.

In vivo dosimetry for head ct examinations in paediatric patients

Introduction Serious concerns about children exposure to ionizing radiation have been raised due to the widespread use of computed tomography (CT) in paediatrics. The increased radiosensitivity of children and the radiation-associated cancer risk call for immediate action in the field of patient-specific dosimetry and optimization of existing CT protocols. Purpose The main objective of our study is to present in vivo radiation dose measurements during paediatric head CT examinations using thermoluminescent dosimeters (TLDs). To our knowledge, there are limited literature data concerning in vivo dosimetry in paediatric patients. Materials and methods The ongoing study includes paediatric patients ranging from neonates to 15 years old who underwent head CT examinations on a 16-slice CT scanner in ‘’Agia Sofia” Children’s Hospital in Athens using iterative reconstruction algorithm. LiF:Cu,P TLDs, properly calibrated, were placed in eyes, forehead, behind ears and thyroid glands. Surface doses to the lens of the eye, the brain and the thyroid were calculated for each patient. Results For patients ⩽5 years old, surface doses in eye lens, brain and thyroids were 38.45 ± 5 mGy, 33.69 ± 14.05 mGy and 1.84 ± 0.48 mGy respectively, while for patients >5 years old, the surface doses were 35.56 ± 11.16 mGy, 40.04 ± 7.67 mGy and 2.05 ± 0.32 mGy respectively. Conclusion Although there are many challenges, patient-specific dosimetry is of great importance in paediatric patients. In vivo dosimetry is a powerful tool which provides an accurate and effective method for skin dose measurements. Furthermore, since the eyes and the thyroid are superficial organs, the calculated surface dose can give a good estimation of the organ dose to ocular lens and thyroid gland. Disclosure None.

Patient effective dose during pacemaker implantation at a flat panel and image intensifier angiography system

Introduction Pacemaker implantation is a minimally invasive technique performed under fluoroscopic guidance. Purpose This study aims to compare effective dose (ED) delivered to patients at pacemaker implantation procedures by two angiographic systems of different image capture technology; one with flat panel detector (FPD) and one with image intensifier (II). Materials and methods A retrospective analysis of 62 procedures performed at Attikon University Hospital of Athens has been conducted. Data concerning dose area product (DAP), fluoroscopy time and patient’s weight and height have been collected. The ED has been calculated, multiplying DAP with a conversion factor of 0.2 mSv/(Gy ∗ cm 2 ) and the results have been divided in categories accordingly to patients’ BMI and fluoroscopy time. Results ED, presented as median and range values, for normal, over weighted and obese patients that have been operated under a FPD X-ray system, in a fluoro time less than five minutes was 0.49 mSv (0.09–1.1 mSv), 0.67 mSv (0.4–1.2 mSv) and 1.18 mSv (1–1.3 mSv) respectively. The corresponding values for an II system were 0.50 mSv (0.5–0.8 mSv), 2.49 mSv (1.86–3.58 mSv) and 1.70 mSv (0.8–3.3 mSv). For fluoro time greater than five minutes in FPD imaging, ED for the three BMI categories was 1.57 mSv (0.7–3.7 mSv), 0.74 mSv (0.45–1.26 mSv) and 2.93 mSv (1.78–3.45 mSv), while for the II angiography system ED was 12.29 mSv (1.88–49.27 mSv), 28.36 mSv (6.27–15.43 mSv) and 35.27 mSv (5.84–158,73 mSv). Conclusion Obtained results indicate statistically significant higher radiation burden associated with II system compared to FPD system used for pacemaker’s implantations ( p Disclosure All authors confirm that none relationship may bias this presentation.

A comparison of dose area product from different angiography procedures

Introduction The increased use of Interventional Radiology (IR) techniques the last decade and the extend fluoroscopy time during IR procedures deliver high radiation dose to patients and raised serious concerns about exposure to ionizing radiation. Purpose The purpose of this study is to evaluate the radiation exposure to patients during different IR procedures. The measurement of Dose Area Product (DAP) values and fluoroscopy time, allows a relative estimation of patients’ effective dose in interventional operations. Materials and methods A retrospective analysis of 333 procedures performed during last year at KAT General Hospital of Athens, the biggest trauma hospital of Greece in Athens has been conducted. All the procedures were performed on an image intensifier angiography system (Siemens Axiom Artis). Data concerning dose area product (DAP) and fluoroscopy time have been collected and divided in categories according to the type of procedure – technique. Results DAP, presented as median and range values, for 210 coronary angiographies (CA), 75 coronary angioplasty procedures (PCI), 19 cerebral Digital Subtraction Angiography (DSA) and 29 lower limbs DSA was 3.10 mGy∗m2 (0.26–25.39 mGy∗m2), 6.58 mGy∗m2 (1.33–18.28 mGy∗m2), 5.43 mGy∗m2 (0.65–14.80 mGy∗m2) and 30.03 mGy∗m2 (0.02–137.87 mGy∗m2) respectively. The corresponding values for fluoroscopy duration were 5.99 min (1.4–32 min), 12.98 min (4.3–32.2 min), 17.82 min (6–103 min) and 10.1 min (1–63.7 min). Conclusion Obtained results indicate that PCI procedures deliver statistically higher doses compared to CA procedures. Furthermore, radiation exposure was significantly greater for lower limbs DSA compared to cerebral DSA technique. Disclosure All authors confirm that none relationship may bias this presentation.

Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?

The effect of preoperative education on anxiety and postoperative outcomes of cardiac surgery patients remains unclear. The aim of the study was to estimate the effectiveness of a nurse-led preoperative education on anxiety and postoperative outcomes. A randomised controlled study was designed. All the patients who were admitted for elective cardiac surgery in a general hospital in Athens with knowledge of the Greek language were eligible to take part in the study. Patients in the intervention group received preoperative education by specially trained nurses. The control group received the standard information by the ward personnel. Measurements of anxiety were conducted on admission-A, before surgery-B and before discharge-C by the state-trait anxiety inventory. The sample consisted of 395 patients (intervention group: 205, control group: 190). The state anxiety on the day before surgery decreased only in the intervention group (34.0 (8.4) versus 36.9 (10.7); P=0.001). The mean decrease in state score during the follow-up period was greater in the intervention group (P=0.001). No significant difference was found in the length of stay or readmission. Lower proportions of chest infection were found in the intervention group (10 (5.3) versus 1 (0.5); P=0.004). Multivariate linear regression revealed that education and score in trait anxiety scale on admission are independent predictors of a reduction in state anxiety. Preoperative education delivered by nurses reduced anxiety and postoperative complications of patients undergoing cardiac surgery, but it was not effective in reducing readmissions or length of stay.

A Case-Control Study on the Risk Factors for Meningococcal Disease among Children in Greece.

PurposeThe aim of this study was to identify environmental or genetic risk factors that are associated with invasive meningococcal disease (IMD) in children in Greece.MethodsA case-control study was performed in 133 children (44 cases and 89 controls) aged between 0–14 years, who were hospitalized in a children's hospital in Athens. Demographics and possible risk factors were collected by the use of a structured questionnaire. To investigate the association of mannose binding lectin (MBL) with IMD, a frequency analysis of the haplotypes of the MBL2 gene and quantitative measurement of MBL serum protein levels were performed using Nanogen NanoChipR 400 technology and immuno-enzyme techniques, respectively.ResultsThe multivariate analysis revealed that changes in a child's life setting (relocation or vacation, OR = 7.16), paternal smoking (OR = 4.51), upper respiratory tract infection within the previous month (OR = 3.04) and the density of people in the house/100m2 (OR = 3.16), were independent risk factors associated with IMD. Overall 18.8% of patients had a MBL2 genotype with low functionality compared to 10.1% of healthy controls, but this was not statistically significant (p = 0.189).ConclusionPrevention strategies aimed at reducing parental smoking and other risk factors identified in this study could decrease the risk of IMD among children in Greece.

Changes in Health-Related Quality of Life in Greek Adult Patients Two Years after Successful Renal Transplantation

Abstract Introduction. This study was undertaken to compare and evaluate the heath-related quality of life (HRQOL) in Greek adult transplant recipients before and 2 years after successful renal transplantation (RT). The SF-36 survey score was used. Methods. Eighty-five Greek hemodialysis patients underwent RT at the Transplant Unit of Evangelismos General Hospital of Athens, including 44 men and 41 women (mean age 43.8 years; range 21-59 years). The scale scores of a Greek version of the SF-36 survey were compared between the transplant and the hemodialysis patients. We also examined the relationships of the scale scores with the patients′ age and the type of donor. Results. According to the SF-36 health survey, transplant recipients had better results for general health perception (p≤0.001), role-physical functioning (p≤0.01), role-emotional functioning (p≤0.01), and vitality (p≤ 0.01). In addition, the scale score of physical functioning, general health and vitality of the patients who were younger than 30 years at the time of transplantation were significantly higher than those of the patients who were older than 30 years, while the scores of bodily pain, general health, and physical functioning were significantly lower in cadaveric graft recipients compared with living-related recipients. Conclusions. The SF-36 health survey is a validated and comprehensive instrument for evaluating renal transplant patients′ HRQOL. Our data demonstrated an improvement in HRQOL in renal transplant patients 2 years after successful renal transplantation. The data also confirmed that the recipients′ age at transplantation and the type of donor were important factors affecting the HRQOL.

Impact of patients' professional and educational status on perception of an antibiotic policy campaign: a pilot study at a university hospital.

Antibiotics are overused in many European countries, particularly Greece, leading to emerging antimicrobial resistance with sustained high mortality among hospitalised patients. Limited data are available regarding factors influencing people's knowledge and the impact of public campaigns on antibiotic misuse. Patients' beliefs regarding antibiotics were investigated in the outpatient clinic of a university hospital in Athens, Greece. A questionnaire-based survey was conducted to examine patients' opinions on antibiotic use in the waiting room of the outpatient clinic. All participants read an illustrated pocket-sized leaflet endorsed by official authorities on the European Antibiotic Awareness Day (EAAD). Volunteers then completed a questionnaire containing information on demographics, knowledge on antibiotic use and overuse, and remarks on the quality of the leaflet's content. In a logistic regression analysis including age, sex, educational level and professional status of 605 eligible participants, women were more aware [odds ratio (OR)=3.2, 95% confidence interval (CI) 1.8-5.8; P<0.0001] and people with elementary education were less aware (OR=0.4, 95% CI 0.1-0.9; P=0.04) of antimicrobial misuse. Workers were also more aware than retired or unemployed people (P=0.007). However, only 16.0% of participants knew about the EAAD. All participants agreed on antibiotic misuse in Greece, mentioning patient accountability as the main cause (26.8%), an opinion more pronounced in highly educated individuals. In conclusion, targeted interventions taking into account variations in educational level and employee status should be considered in future scheduled educative campaigns on antibiotic overconsumption in highly prescribing antibiotic countries.

Intestinal Perforation in Renal Transplant Recipients: A Single Center Experience of 2123 Recipients.

Intestinal perforation remains a clinical challenge and potentially lethal complication in renal transplant recipients. Immunosuppression not only places the patient at risk for intestinal perforation but also masks classic clinical symptoms and signs of acute abdominal pain, leading to delayed diagnosis and proper treatment. The aim of our study is to present the experience of our center on the treatment of intestinal perforation in renal transplant recipients. This study reported 11 patients (0.52%) with intestinal perforation among a group of 2123 patients who received renal transplants in the Transplantation Unit at Laikon General Hospital in Athens, Greece from 1983 to August 2015. One patient died from septic shock before any surgery, and 3 patients died during the early postoperative period, resulting in a morality rate of 36.3%. All patients who died had a functioning graft. From the patients who were discharged, the mean follow-up was 16 months (range, 4-32 months). Intestinal perforation after renal transplant is a major and potentially lethal complication. Clinical presentation is usually equivocal, and the transplant surgeon should be highly suspicious when treating a renal transplant recipient with acute abdominal pain, even in cases without other predisposing factors (diverticulitis, ischemic colitis, and so forth), so that this condition could be investigated and unmasked.