Publications by authors named "Georgios Vasilopoulos"

25 Publications

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"Living with a Stoma": Exploring the Lived Experience of Patients with Permanent Colostomy.

Int J Environ Res Public Health 2021 08 12;18(16). Epub 2021 Aug 12.

Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece.

Introduction: Living with a permanent colostomy brings severe changes in patients' lives. The general health status as well as the personal, social and professional life of patients are significantly affected.

Aim: The aim of the present study was to investigate the lived experience of patients undergoing permanent colostomy.

Material And Methods: A qualitative research design based on interpretive phenomenology was carried out. Semi-structured interviews were conducted as the data collection method to obtain in-depth information regarding the research topic. The study sample consisted of eight (8) patients who had undergone a permanent colostomy. The data analysis was performed by the method of content analysis.

Results: From the analysis of the data, three main themes emerged, namely: (A) Experiencing a traumatic event; (B) Living a new reality; (C) Efforts to improve quality of life. Five subthemes were formulated which were encompassed within the respective main themes accordingly.

Conclusion: Patients with permanent colostomy face significant life changes that are experienced in a traumatic way. Issues such as autonomy, family and organizational support, self-management and empowerment can significantly improve the patients' quality of life. Further research, regarding caregivers' experience, improved community nursing care as well as nurses' views on the needs of colostomy patients and their families, is suggested.
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http://dx.doi.org/10.3390/ijerph18168512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393572PMC
August 2021

Factors Affecting State and Trait Anxiety of Relatives of Hospitalized Patients.

J Caring Sci 2021 Mar 1;10(1):9-14. Epub 2021 Mar 1.

Department of Nursing, School of Health and Caring Sciences, University of West Attica, Athens, Greece.

Hospitalization is a stressful event for both patients and relatives. The aim of the study was to explorefactors affecting state and trait anxiety of relatives of hospitalized patients. In this cross-sectional study, was enrolled a convenience sample of 222 relatives of hospitalized patients in a public hospital in Athens, Greece. Data were collected by the completion of State-Trait Anxiety Inventory (STAI) which also included participants' characteristics. Data were analyzed using SPSS version 25, while the statistical significance level was P < 0.05. Of the 222 relatives, 72 were men and 150 women. The average state and trait anxiety score was 45.6 and 42, respectively, within the possible range of scores (20-80) thus indicating moderate levels of anxiety. Moreover, state and trait anxiety was statistically significantly associated with gender, degree of information of patient's health, whether they had readjusted family responsibilities, whether they had financial worries, whether they experienced uncertainty about future and finally whether they were anxious about their ability to respond to patients care. Factors associated with relatives' anxiety were gender, information regarding patient's health, family responsibilities, financial worries, uncertainty and anxiety to respond to patients' care. These factors need to be evaluated when planning psychological intervention to alleviate this emotional burden.
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http://dx.doi.org/10.34172/jcs.2021.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008228PMC
March 2021

Promiscuous phospholipid biosynthesis enzymes in the plant pathogen Pseudomonas syringae.

Biochim Biophys Acta Mol Cell Biol Lipids 2021 07 22;1866(7):158926. Epub 2021 Mar 22.

Microbial Biology, Ruhr University Bochum, Bochum, Germany. Electronic address:

Bacterial membranes are primarily composed of phosphatidylethanolamine (PE), phosphatidylglycerol (PG) and cardiolipin (CL). In the canonical PE biosynthesis pathway, phosphatidylserine (PS) is decarboxylated by the Psd enzyme. CL formation typically depends on CL synthases (Cls) using two PG molecules as substrates. Only few bacteria produce phosphatidylcholine (PC), the hallmark of eukaryotic membranes. Most of these bacteria use phospholipid N-methyltransferases to successively methylate PE to PC and/or a PC synthase (Pcs) to catalyze the condensation of choline and CDP-diacylglycerol (CDP-DAG) to PC. In this study, we show that membranes of Pseudomonas species able to interact with eukaryotes contain PE, PG, CL and PC. More specifically, we report on PC formation and a poorly characterized CL biosynthetic pathway in the plant pathogen P. syringae pv. tomato. It encodes a Pcs enzyme responsible for choline-dependent PC biosynthesis. CL formation is catalyzed by a promiscuous phospholipase D (PLD)-type enzyme (PSPTO_0095) that we characterized in vivo and in vitro. Like typical bacterial CL biosynthesis enzymes, it uses PE and PG for CL production. This enzyme is also able to convert PE and glycerol to PG, which is then combined with another PE molecule to synthesize CL. In addition, the enzyme is capable of converting ethanolamine or methylated derivatives into the corresponding phospholipids such as PE both in P. syringae and in E. coli. It can also hydrolyze CDP-DAG to yield phosphatidic acid (PA). Our study adds an example of a promiscuous Cls enzyme able to synthesize a suite of products according to the available substrates.
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http://dx.doi.org/10.1016/j.bbalip.2021.158926DOI Listing
July 2021

Information Needs in Percutaneous Coronary Artery Intervention: Validation and Reliability Analysis of NPCI-10 Item Scale.

Cureus 2021 Jan 15;13(1):e12718. Epub 2021 Jan 15.

Department of Nursing, University of West Attica, Athens, GRC.

Introduction: Percutaneous coronary intervention (PCI) is a nonsurgical procedure used in the treatment of coronary heart disease.

Purpose: The purpose of this study was to validate a scale created in order to assess the importance and fulfillment of information needs in patients after PCI.

Methods: A 10-item scale was created by the researchers to explore the level of information needs and the level of fulfillment of these needs. The total scores have a possible range of 10 to 40 with higher scores indicating higher importance and fulfillment. The validation of the questionnaire included face and content validity, construct validity, internal consistency, repeatability, and discriminant validity.

Results: Forty patients contributed to this validation. Mean and median scores for each question separately and also overall scores suggest that patients consider the need to be informed very important and that it was fulfilled to a very high degree (mean scores 39.5 and 39.3, respectively). All questions were found to be significantly correlated with the overall scores (rho > 0.3) meaning strong construct validity. Cronbach's α coefficients were high (>0.7) indicating great consistency. Both total scores had great repeatability, which suggests a high degree of reliability of the participants' responses (ICCs > 0.8). Regarding discriminant validity, a statistically significant association was observed only between marital status and the degree of fulfillment of the need to be informed (p = 0.036). More specifically, divorced or widowed patients had a lower degree of fulfillment than married patients (mean 38.6 vs. 39.6).

Conclusion: It is a reliable instrument that will help clinicians who are at close contact with patients after PCI to gain a better understanding of their needs.
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http://dx.doi.org/10.7759/cureus.12718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813540PMC
January 2021

Investigating the Six-Month Incidence Rate of Burn Disease in Children in Greece.

Cureus 2020 Oct 27;12(10):e11192. Epub 2020 Oct 27.

Nursing, University of West Attica, Athens, GRC.

Introduction Burns in children are painful, can be fatal, and involve a significant risk of complications, along with physical and psychological consequences. This study aimed to investigate the incidence of burns in children, for six months, and the most common causative factors, along with the existing correlations between demographic data and the characteristics of burn injuries. Methods The study was descriptive and prospective, and the sample consisted of minors up to 14 years old with burns in any areas of the body. The research was carried out in the Attica pediatric hospitals' selected departments for six months (from July to December 2018). Sources for completing the created database were the patients, their guardians, and their medical-nursing documentation and records. Results The cumulative six-month incidence rate of childhood burn disease was 4.9%. The most affected age group appeared to be younger than two years (60%), while liquid heat appeared to be the primary form of the burn factor (76%). The average duration of hospitalization for children with a deep partial-thickness to a total-thickness burn degree was 16.5 days. The correlations that emerged related to the extent of the burn were directly related to the accident's site, and patients with an increased likelihood of future additional surgeries had an increased mean total body surface area that was burned. Conclusion Continuous surveillance and removal of hazardous materials from the home environment is of utmost need. Early education/understanding of correct behaviors and proper attention to outdoor activities or excursions can significantly reduce burns. Training courses on burn prevention for parents are needed, as the best form of treatment is prevention.
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http://dx.doi.org/10.7759/cureus.11192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703708PMC
October 2020

Pre- and Post-Operative Nutrition Assessment in Patients with Colon Cancer Undergoing Ileostomy.

Int J Environ Res Public Health 2020 08 23;17(17). Epub 2020 Aug 23.

Department of Nursing, University of West Attica, 12243 Athens, Greece.

Introduction: Patients undergoing ileostomy surgery often experience electrolyte disturbances and dehydration, especially during the first post-operative period. Recently, research has also begun on how the newly constructed ileostomy affects the patient's nutritional status.

Aim: The aim of the present pilot study was to assess the nutritional status of patients before and after the construction of the ileostomy as well as nutrition-related factors.

Material And Method: This was a pilot study. The sample consisted of 13 adult patients diagnosed with colorectal or colon cancer who underwent scheduled ileostomy surgery. The evaluation tool used was "Original Full Mini Nutritional Assessment (MNA)". Patients underwent nutritional assessment before the surgery (time 0), on the 7th post-operative day (time 1), and on the 20th post-operative day (time 2). The statistical significance level was set at < 0.05.

Results: All patients had a drop in MNA score on the 7th and 20th post-operative days. Factors associated with MNA were weight loss, mobility, body mass index (BMI), number of full meals consumed per day, portions of fruits and vegetables consumed per day, and mid-arm circumference, < 0.05, respectively. Pre-operatively, 38.5%, of patients had severe weight loss (>3 kg), 23% moderate weight loss and 38.5% minimal weight loss. Pre-operatively, 92.3% of participants were able to move on their own and 69.2% on the 20th post-operatively day. Furthermore, BMI >23 kg/m had 84.6% of participants pre-operatively and 30.8% on the 20th post-operative day. In terms of portions of fruits and vegetables consumed per day, 30.8% of patients consumed at least 2 times, pre-operatively and no one (0%) on the 20th post-operative day. Moreover, pre-operatively all participants (100%) had arm circumference >22 cm while on the 20th post-operative day, only 38.5% of participants had arm circumference >22 cm.

Conclusions: In the first 20 days after the construction of an ileostomy, the nutritional status of the patients is significantly affected. Decreased patient nutrition in both quantity and ingredients and reduced fluid intake appear to adversely affect the patient's nutritional status.
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http://dx.doi.org/10.3390/ijerph17176124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503677PMC
August 2020

Effectiveness and Safety of Complete Decongestive Therapy of Phase I: A Lymphedema Treatment Study in the Greek Population.

Cureus 2020 Jul 19;12(7):e9264. Epub 2020 Jul 19.

Vascular Unit, 3rd Internal Medicine, University of Athens, Sotiria Hospital, Athens, GRC.

Background Lymphedema is a chronic condition caused by a failure in the lymphatic system that most commonly occurs in the limbs. Complete decongestive therapy (CDT) is the gold standard for lymphedema management. Objective To evaluate the effectiveness and safety of complete decongestive therapy (CDT) of phase I in the Greek population with lymphedema. Methods The patients' demographic and clinical characteristics were recorded. CDT was implemented in all patients for 20 sessions in a four-week treatment period. The edema's (excess volume (EV) and percent of excess volume (PEV)) measurements were carried out four times in the treatment period, whereas the percent reduction of excess volume (PREV) was calculated at the end of phase I. Moreover, we recorded every infection, trauma of skin, and pain of limb during the treatment. Results One-hundred five patients with lymphedema were enrolled in the present study, of whom 31.4% had upper limb lymphedema and 68.6% had lower limb lymphedema. All patients with upper limb lymphedema had a secondary type while the corresponding proportion of patients with lower limb lymphedema was 58.3%. A significant reduction (p<0.001) between the pre-treatment and post-treatment values of EV and PEV was found for both upper and lower limb lymphedema. For patients with upper limb lymphedema, the average PREV was 66.5% (interquartile range, 57.3%-80.6%), whereas for patients with lower limb lymphedema, a 71.5% (interquartile range, 64.5%-80.7%) median value was measured. No side effects from the treatment were recorded during CDT. Conclusion The proper treatment of the CDT phase I ensures safety and a great reduction in edema in patients with lymphedema that predispose the success of phase II of CDT.
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http://dx.doi.org/10.7759/cureus.9264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431294PMC
July 2020

A Comparative Study Between Two Support Surfaces for Pressure Ulcer Prevention and Healing in ICU Patients.

Cureus 2020 Jun 23;12(6):e8785. Epub 2020 Jun 23.

Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, GRC.

Objective The aim of this research was to compare the effectiveness of two mattresses used in intensive care unit (ICU) high-risk patients in terms of pressure ulcers (PUs) prevention and healing. Materials and Methods The studied sample consisted of 70 consecutive patients aged 18 to 65 years hospitalized in two ICUs of a general hospital in Athens, Greece. Virtuoso Mattress System (LINET, Slaný, Czech Republic) was used in 35 patients, and standard memory foam mattress was used in the rest of participants. Patients were firstly assessed on enrollment and then every 72 hours in order to record the appearance or not of PUs, location of PUs, and stage of PUs, with the maximum follow-up not exceeding the 21 days. A number of clinical and biochemical factors, medical treatment, and vital signs were also recorded at each time point. Results Of the 70 patients, 40 (57.1%) were men, and the mean ± standard deviation age of the sample was 46.1 ± 14.5 years. The most common area of PUs was the buttocks (34.3%) followed by the shoulders (22.3%), with no statistically significant difference detected between the two groups. Moreover, the proportion of patients having PUs at stage 2 or higher was 23.8% on the third day after admission and 61.1% on the sixth day, with no difference detected between the two groups. Cox proportional hazard model revealed that the Virtuoso mattress was associated with almost 56% lower risk of developing PUs compared with standard foam mattress (HR [95% CI]: 0.44 [0.20-0.93]). The percentage of patients healed using the Virtuoso mattress was significantly lower compared with the standard foam mattress at all time points, with the results reaching statistical significance only on the 12th day after admission (7.7% vs. 66.7%; p < 0.05). Conclusions The Virtuoso mattress seems to be more effective compared with standard foam mattresses in the prevention of PUs, whereas the standard foam mattresses are more effective in PU healing process.
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http://dx.doi.org/10.7759/cureus.8785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381843PMC
June 2020

Depression in diabetic foot ulcer: Associated factors and the impact of perceived social support and anxiety on depression.

Int Wound J 2020 Aug 26;17(4):900-909. Epub 2020 Mar 26.

Department of Nursing, University of West Attica, Athens, Greece.

Diabetic foot ulcer (DFU) exerts a heavy physical and emotional burden on patients with diabetes mellitus. The purpose of the present study was to explore the impact of anxiety and perceived social support on depression of DFU patients well as patients' characteristics associated with depression. The sample of the study consisted of 180 DFU patients. Data collected by the completion of "Self-rating Depression/Anxiety Scale- Zung" (SDS/SAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients had moderate levels of anxiety and depression (median: 36, 42, respectively) and high levels of perceived social support from their significant ones, their family and friends (median: 24, 24, 17, respectively). After multiple regression factors that were found to have an impact on depression after taking into account all other factors, were patient's age of above 70 years, patient's anxiety and the social support they received from their significant ones. More specifically, patients aged above 70 years had 9.51 points higher depression than patients aged <50 years of age (β = 9.51, 95% CI: [0.76, 18.25], P = .034). Moreover, one point increase in patient's anxiety score indicated an increase of 0.71 points in patient's depression (β = 0.71, 95% CI: [0.43, 1.00], P = .001). On the contrary, one point increase in patient's social support from their significant ones indicated a decrease of 1.52 points in patient's depression (β = -1.52, 95% CI: [-0.25, -2.79], P = .020). Clinically, a better understanding of factors having an impact on depression on DFU may provide an essential in planning cost effective interventions.
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http://dx.doi.org/10.1111/iwj.13348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948719PMC
August 2020

Quality of Life in Diabetic Foot Ulcer: Associated Factors and the Impact of Anxiety/Depression and Adherence to Self-Care.

Int J Low Extrem Wounds 2020 Jun 23;19(2):165-179. Epub 2020 Jan 23.

University of West Attica, Athens, Greece.

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus that needs a multidisciplinary approach. The purpose of this study was to assess the impact of patients' characteristics, anxiety/depression, and adherence to guidelines on the QoL of patients with diabetic ulcer. The sample of the study consisted of 195 patients. Data collected by the completion of SF-36 Health Survey, the Hospital Anxiety and Depression Scale, and a questionnaire that measured adherence to self-care activities. Patients had moderate- to high-quality levels in emotional well-being, pain, social functioning, and energy/fatigue (median: 68, 68, 63, and 60, respectively), while they had low levels of quality in physical functioning, role physical, and role emotional (median: 21, 0, and 33, respectively). In their general health, patients had moderate levels (median: 50). High levels of anxiety and depression were observed in 13.8% and 20.0% of the participants, respectively. After multiple regression, regarding general QoL, patients living in the capital city had 9.89 points worse general health than patients living in Attica (β = -9.89, 95% confidence interval [CI] = -16.86 to 2.93, = .006). Patients with moderate or high levels of anxiety had 9.37 and 16.08 points, respectively, worse general health than those with low levels (β = -9.37, 95% CI = -17.04 to 1.70, = .017, and β = -16.08, 95% CI = -26.65 to -5.51, = .003, respectively). Clinically, these findings may help health professionals attain effective treatment of emotional burden to DFU patients and increase adherence to self-care.
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http://dx.doi.org/10.1177/1534734619900415DOI Listing
June 2020

Perceived Social Support in Individuals With Diabetic Foot Ulcers: A Cross-sectional Survey.

J Wound Ostomy Continence Nurs 2020 Jan/Feb;47(1):65-71

Fotini Laopoulou, MSc, RN, Tzaneio General Hospital of Piraeus, Piraeus, Greece.

Purpose: Explore levels of perceived social support and the associated factors among patients with diabetic foot ulcers (DFUs).

Design: Cross-sectional survey.

Subjects And Setting: Outpatients (n = 140) with DFUs attending a diabetic clinic affiliated with a public hospital in Athens, Greece, for wound care and follow-up visits after healing.

Methods: Data collection included demographic, clinical, self-report, and perceived social support, measured with the Multidimensional Scale of Perceived Social Support (MSPSS), during one-on-one interviews at the post-healing follow-up visit.

Results: For perceived social support, 50% of patients (average age 70 years) scored above 24, 24, and 18 (median) on the MSPSS in the categories of receiving support from significant other, family, and friends, respectively, suggesting high levels of perceived social support. Other statistically significant associations were observed for perceived social support from significant other, family, and friends and marital status (P = .001, P = .001, and P = .004, respectively), patients level of information about their health (P =.002, P =.001, and P =.001, respectively), family level of information (P = .001, P = .001, and P = .004, respectively), and how closely they followed period foot checks (P = .001, P = .002, and P = .011, respectively) and diet (P = .001, P = .001, and P = .001, respectively).

Conclusions: Data from our study show that higher levels of perceived social support from significant others, family, and friends were linked to patients and others, being better informed about health status, and other self-care behaviors. Findings underscore the need for health care providers to recognize that social support is an important component of overall DFU management and may guide future interventions to determine which are most effective in enhancing socially supportive behaviors.
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http://dx.doi.org/10.1097/WON.0000000000000614DOI Listing
September 2020

Intervention for symptom management in patients with malignant fungating wounds - a systematic review.

J BUON 2019 May-Jun;24(3):1301-1308

Metaxa Cancer Hospital, Piraeus, Greece.

Purpose: To identify the latest data on interventions in the management of malignant fungating wounds (WFWs).

Methods: A systematic review has been conducted to explore the original research about symptom management of malignant fungating wounds. Keywords and time constraints were used for the period 2008-2017 using the online Medline database (NCBI) with combined inclusion and exclusion criteria.

Results: Eleven original research studies met the inclusion criteria. Nine of them referred to the use of materials and methods for managing the main symptoms which are malodour, exudate, pain and bleeding. An improvement in symptoms was observed in the involving intervention studies. According to the results, odor and exudates were significantly decreased by the use of honey and silver dressings. Wound cleaning with saline or tap water and the use of metronidazole had also positive results. Pain management was performed by the systematic use of opioids and the administration of an additional dose prior to the dressing change.

Conclusion: Patients with MFWs need a holistic treatment approach. They often seek late for health services and professional help. The disease is already locally advanced and a variety of symptoms leads to suffering and low quality of life. The effective management of symptoms by health professionals is vital to support patients in advanced disease. The need for constant briefing and updating of knowledge is imperative.
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March 2020

Association of State and Trait Anxiety Between Patients Who Had Undergone Traumatic Amputation and Their Family Caregivers.

Int J Low Extrem Wounds 2019 Jun 17;18(2):176-185. Epub 2019 May 17.

2 University of West Attica, Athens, Greece.

The purpose of this research was to explore the association between state and trait anxiety experienced by patients who had undergone traumatic amputation and their family caregivers. The sample studied consisted of 50 hospitalized patients who had undergone traumatic amputation and 50 family caregivers. The collected data included patients' and caregivers' characteristics and the State Trait Anxiety Inventory scores. Fifty percent of patients and caregivers scored below 50 and 47, respectively (median), in trait anxiety. In terms of state anxiety, at least 50% of patients and caregivers scored below 56 and 50.5, respectively. These values indicate moderate to high levels of the impact of amputation on the trait and state anxiety of amputees and their caregivers. A positive linear correlation was found between the trait and state anxiety of the patients as well as between the trait and state anxiety of caregivers, as expected (ρ = 0.915, < .001, and ρ = 0.920, < .001, respectively). A statistically significant positive correlation was also observed between state patient anxiety and state anxiety of caregivers (ρ = 0.239 and = .039) and between trait patient anxiety and trait anxiety of caregivers (ρ = 0.322 and = .030). More specifically, as the patient's anxiety score (either trait temporary) increases, the score of the caregivers' anxiety increases and vice versa. Nurses should be aware of the association between anxiety of amputees and caregivers and, therefore, work in multidisciplinary teams to maximize clinical outcomes for patients after amputation and their families.
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http://dx.doi.org/10.1177/1534734619848580DOI Listing
June 2019

Effect of anxiety and depression on the fatigue of patients with a permanent pacemaker.

Arch Med Sci Atheroscler Dis 2018 5;3:e8-e17. Epub 2018 Feb 5.

Laboratory of Physiology and Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta Lakonias, Greece.

Introduction: Permanent cardiac pacemakers (PPM) are the most common treatment for severe symptomatic bradycardia. This implanted life-saving device may involve a severe psychological burden to recipients or aggravate their symptoms such as fatigue. The aim of the study was to explore the effect of anxiety and depression on fatigue of patients' with a PPM.

Material And Methods: The study group consisted of 250 patients with a PPM. Data collected included: a) patients' characteristics, b) the Hospital Anxiety and Depression Scale (HADS) and c) the Fatigue Assessment Scale (FAS).

Results: High levels of anxiety and depression were observed in 27.2% and 14.0% of the sample, respectively. Regarding the fatigue total score it was found that 25% of the participants had a score higher than 26. Accordingly, with regard to physical and mental fatigue, 25% of enrolled patients had a score higher than 20 and 8, respectively. These values indicate moderate to low levels of fatigue. Furthermore, there was a statistically significant association between anxiety/depression and the total score of fatigue as well as between anxiety/depression and physical and mental fatigue ( < 0.001 for all associations).

Conclusions: Socio-demographic and patients' clinical characteristics are related to anxiety and depression. Understanding the association between psychological burden and fatigue after implantation as well as factors associated with these variables will help health professionals to provide beneficial care for PPM patients that will significantly contribute to better device outcomes.
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http://dx.doi.org/10.5114/amsad.2018.73231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374639PMC
February 2018

Respiratory Function in Wind Instrument Players.

Mater Sociomed 2018 Oct;30(3):204-208

University of West Attica, Department of Nursing, Athens, Greece.

Introduction: Wind instrumentalists require a sophisticated functioning of their respiratory system.

Aim: The purpose of this research is to examine the function of the respiratory system of wind instrumentalists.

Material And Methods: Thirty-two adult professional musicians from two philharmonic bands (Piraeus and Zografou Municipality) participated in the survey. Each participant, after completing a questionnaire given, went through two spirometric tests, one before and one after the rehearsal. The rehearsal lasted one hour and a half and included low-mid and high frequency notes. Respiratory volumes measured and analyzed were, vital capacity (VC), maximum expiratory volume of air in 1st second (FEV1), forced vital capacity (FVC), forced expiratory flow (FEF), and Tiffenau index (FEV1/FV%).

Results: The results showed that: 1) Participants did not show any noticeable change in their respiratory volumes before and after rehearsal. 2) Wind instrument players do not have a VC greater than their predicted age, height, weight and gender. 3) There is no statistically significant difference between the first and second assessment of respiratory indicators for smokers and non-smokers. 4) Regarding the type of instrument: a) Those who played wooden instruments improved the FEV1/FVC% indicator to a remarkable percentage between the first and second spirometry and b) individuals playing wooden instruments had a lower FVC, FEV1 and VC score than those playing bronze.

Conclusion: There is no significant strain sign in respiratory system even in smokers after exercising in wind instrument. There is an improvement in Tiffenau index in those who played wooden instruments between the two rehearsals. Undoubtedly, new research is needed to combine a respiratory disease scenario with a respiratory treatment program that involves practicing a wind instrument.
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http://dx.doi.org/10.5455/msm.2018.30.204-208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195392PMC
October 2018

Real-world data on Len/Dex combination at second-line therapy of multiple myeloma: treatment at biochemical relapse is a significant prognostic factor for progression-free survival.

Ann Hematol 2018 Sep 13;97(9):1671-1682. Epub 2018 May 13.

Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second line, according to routine clinical practice in Greece. First-line treatment included bortezomib-based (63.3%) or immunomodulatory drug-based (34.8%) therapies; 25% of patients underwent autologous stem cell transplantation. Overall response rate was 73.4% (17.8% complete response and 23.7% very good partial response); median time to best response was 6.7 months. Overall, median PFS and 12-month PFS rate was 19.2 months and 67.6%, respectively. 67.5% of patients had biochemical relapse and 32.5% had clinical relapse prior to initiation of Len/Dex. Median PFS was 24 months for patients treated at biochemical relapse vs. 13.2 months for those treated at clinical relapse (HR:0.63, p = 0.006) and the difference remained significant after adjustment for other prognostic factors. Type of relapse was the strongest prognostic factor for PFS in multivariate analysis. These real-world data confirm the efficacy of Len/Dex combination at first relapse; more importantly, it is demonstrated for the first time outside a clinical trial setting that starting therapy with Len/Dex at biochemical, rather than at clinical relapse, is a significant prognostic factor for PFS, inducing a 37% reduction of the probability of disease progression or death.
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http://dx.doi.org/10.1007/s00277-018-3361-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097756PMC
September 2018

Propranolol Versus Metoprolol for Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillator.

J Am Coll Cardiol 2018 05;71(17):1897-1906

Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Background: Electrical storm (ES), characterized by unrelenting recurrences of ventricular arrhythmias, is observed in approximately 30% of patients with implantable cardioverter-defibrillators (ICDs) and is associated with high mortality rates.

Objectives: Sympathetic blockade with β-blockers, usually in combination with intravenous (IV) amiodarone, have proved highly effective in the suppression of ES. In this study, we compared the efficacy of a nonselective β-blocker (propranolol) versus a β-selective blocker (metoprolol) in the management of ES.

Methods: Between 2011 and 2016, 60 ICD patients (45 men, mean age 65.0 ± 8.5 years) with ES developed within 24 h from admission were randomly assigned to therapy with either propranolol (160 mg/24 h, Group A) or metoprolol (200 mg/24 h, Group B), combined with IV amiodarone for 48 h.

Results: Patients under propranolol therapy in comparison with metoprolol-treated individuals presented a 2.67 times decreased incidence rate (incidence rate ratio: 0.375; 95% confidence interval: 0.207 to 0.678; p = 0.001) of ventricular arrhythmic events (tachycardia or fibrillation) and a 2.34 times decreased rate of ICD discharges (incidence rate ratio: 0.428; 95% CI: 0.227 to 0.892; p = 0.004) during the intensive care unit (ICU) stay, after adjusting for age, sex, ejection fraction, New York Heart Association functional class, heart failure type, arrhythmia type, and arrhythmic events before ICU admission. At the end of the first 24-h treatment period, 27 of 30 (90.0%) patients in group A, while only 16 of 30 (53.3%) patients in group B were free of arrhythmic events (p = 0.03). The termination of arrhythmic events was 77.5% less likely in Group B compared with Group A (hazard ratio: 0.225; 95% CI: 0.112 to 0.453; p < 0.001). Time to arrhythmia termination and length of hospital stay were significantly shorter in the propranolol group (p < 0.05 for both).

Conclusions: The combination of IV amiodarone and oral propranolol is safe, effective, and superior to the combination of IV amiodarone and oral metoprolol in the management of ES in ICD patients.
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http://dx.doi.org/10.1016/j.jacc.2018.02.056DOI Listing
May 2018

Anxiety and Depression in Patients with Permanent Atrial Fibrillation: Prevalence and Associated Factors.

Cardiol Res Pract 2018 19;2018:7408129. Epub 2018 Feb 19.

Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece.

Atrial fibrillation (AF) is an important public health problem that is increasing at an alarming rate, worldwide. The most common type is permanent AF followed by the paroxysmal and persistent AF. . This study was aimed at exploring anxiety and depression and the associated factors in patients with permanent AF. . The sample of the study included 170 AF patients. Data collection was performed by the method of interview using the "Hospital Anxiety and Depression Scale" (HADS) to assess anxiety and depression and a questionnaire including patients' characteristics. . 70% of the participants were men, and 32.4% were above 70 years old. Furthermore, 34.9% of the patients had high levels of anxiety, and 20.2% had high levels of depression. Anxiety levels were statistically significantly associated with gender (=0.022), age (=0.022), educational level (=0.025), years having the disease (=0.005), and relations with nursing staff (=0.040). Depression levels were statistically significantly associated with age (=0.037), degree of information of the state of health ( < 0.001), years having the disease ( < 0.001), and relations with medical staff (=0.041). . Patients' characteristics are associated with anxiety and depression and need to be evaluated when treating this frequently encountered arrhythmia.
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http://dx.doi.org/10.1155/2018/7408129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836417PMC
February 2018

Factors Affecting Health Related Quality of Life in Hospitalized Patients with Heart Failure.

Cardiol Res Pract 2017 1;2017:4690458. Epub 2017 Nov 1.

Faculty of Health and Caring Professions, Department of Nursing, Technological Educational Institute of Athens, Athens, Greece.

This study identified factors affecting health related quality of life (HRQOL) in 300 hospitalized patients with heart failure (HF). Data were collected by the completion of a questionnaire which included patients' characteristics and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Analysis of data showed that the median of the total score of MLHFQ was 46 and the median of the physical and mental state was 22 and 6, respectively. Also, participants who were householders or had "other" professions had lower score of 17 points and therefore better quality of life compared to patients who were civil/private employees ( < 0.001 and < 0.001, resp.). Patients not receiving anxiolytics and antidepressants had lower quality of life scores of 6 and 15.5 points, respectively, compared to patients who received ( = 0.003 and < 0.001, resp.). Patients with no prior hospitalization had lower score of 7 points compared to those with prior hospitalization ( = 0.002), whereas patients not retired due to the disease had higher score of 7 points ( = 0.034). Similar results were observed for the physical and mental state. Improvement of HF patients' quality of life should come to the forefront of clinical practice.
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http://dx.doi.org/10.1155/2017/4690458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671708PMC
November 2017

The efficacy of probiotics as pharmacological treatment of cutaneous wounds: Meta-analysis of animal studies.

Eur J Pharm Sci 2017 Jun 7;104:230-239. Epub 2017 Apr 7.

Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece. Electronic address:

The aim of the current meta-analysis of animal studies was to evaluate the efficacy of probiotics as pharmacological treatment of cutaneous wounds. A systematic electronic literature search was conducted and in total six animal studies which undertake twelve experiments met our inclusion criteria. We used the percentage (%) of wound area at the end of the first week after initial wounding to evaluate the efficacy of the probiotic treatment. The heterogeneity was estimated as statistically significant (p<0.0001) and therefore the meta-analysis was performed with the random-effect model. Based on the estimated Hedges' g (Hedges, 1982), the administration of probiotics was associated with acceleration of the wound contraction (g=-2.55; 95%CI=-3.59, -1.50; p<0.0001). The meta-regression analysis showed that the moderator sterile kefir extract has the greater effect on the overall estimated efficacy of probiotic treatment (g=-5.6983; p=0.0442) with bacteria probiotic therapies (70% kefir gel, L. brevis, L. fermentum, L. plantarum, L. reuteri) following (g=-2.3814; p=0.0003). For bacteria dose moderator, the results showed that increase in bacterial dose corresponds to increase of the estimated overall effect size (g=-10.2056; p=0.0053). The linear regression test of funnel plot asymmetry showed absence of publication bias. In conclusion, the results indicate that probiotics administration is an effective pharmacological treatment of cutaneous wounds. However, due to the heterogeneity among studies, further research is required.
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http://dx.doi.org/10.1016/j.ejps.2017.04.002DOI Listing
June 2017

Effect of ATP-binding Cassette Transporter A1 (ABCA1) Gene Polymorphisms on Plasma Lipid Variables and Common Demographic Parameters in Greek Nurses.

Open Cardiovasc Med J 2016 21;10:233-239. Epub 2016 Nov 21.

Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece.

Objective: The present study is on line with our previous studies evaluating the influence of ATP-binding cassette transporter A1 () gene polymorphisms on the lipid variables of Greek student-nurses. The current study was undertaken to (1) estimate the influence of variant(s) such as rs2066715 (V825I), R219K, R1587K, I883M of gene on lipid variables and (2) evaluate the effect of all four polymorphisms on common demographic parameters.

Methods: The study population involved 432 unrelated nurses (86 men) who were genotyped for polymorphisms and correlated according to lipid variables [total cholesterol (TC), triglycerides (TGs), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and apolipoprotein (apo) A] and demographic parameters (age, gender, BMI, waist circumference).

Results: According to lipid variables concentration there was no difference between genotypes and alleles of V825I, R219K and I883M polymorphisms. The LDL-C concentration was 13% lower in RR compared with RK genotype (100.7 . 113.9 mg/dl, p=0.013) of R1587K gene polymorphism. In regression analysis the effects of age, gender and only R1587K gene polymorphism on LDL-C concentrations were proved significant. Additionally, LDL-C was increased (by 1.29 mg/dl on average) by every year of increase of age. Moreover, females had lower LDL-C concentrations as compared with males.

Conclusion: Findings suggested that only R1587K polymorphism of gene was associated with lipid variables, age, and gender of Greek nurses. These findings may be helpful in assessing the risk factors for premature coronary heart disease and distinct individuals with lower/higher atherosclerotic burden.
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http://dx.doi.org/10.2174/1874192401610010233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120382PMC
November 2016

Pattern formation in discrete cell tissues under long range filopodia-based direct cell to cell contact.

Math Biosci 2016 Mar 31;273:1-15. Epub 2015 Dec 31.

Department of Mathematics and Maxwell Institute for Mathematical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK. Electronic address:

Pattern formation via direct cell to cell contact has received considerable attention over the years. In particular the lateral-inhibition mechanism observed in the Notch signalling pathway can generate a regular periodic pattern of differential cell activity, and has been proposed to explain the emergence of patterns in various tissues and organs. The majority of models of this system have focussed on short-range contacts: a cell signals only to its nearest neighbours and the resulting patterns tend to be of fine-scale "salt and pepper" nature. The capacity of certain cells to extend signalling filopodia (cytonemes) over multiple cell lengths, however, inserts a long-range or non-local component into this process. Here we explore how long range signalling can impact on pattern formation. Specifically, we extend a standard model for Notch-like lateral inhibition to include cytoneme-mediated signalling, and investigate how pattern formation depends on the spatial distribution of signal from the signalling cell. We show that a variety of patterns can be obtained, ranging from a sparse pattern of single isolated cells to larger clusters or stripes.
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http://dx.doi.org/10.1016/j.mbs.2015.12.008DOI Listing
March 2016

Association of gender, ABCA1 gene polymorphisms and lipid profile in Greek young nurses.

Lipids Health Dis 2012 Jul 9;11:62. Epub 2012 Jul 9.

Molecular Immunology Laboratory, Onassis Cardiac Surgery Center Athens, Athens, Greece. 2Thriassio General Hospital, Magoula, Attica, Greece.

Objective: One of the important proteins involved in lipid metabolism is the ATP-binding cassette transporter A1 (ABCA1) encoding by ABCA1 gene. In this study we evaluated the single nucleotide polymorphisms (SNPs) of ABCA1 gene. We analyzed SNPs in chromosome 9 such as rs2230806 (R219K) in the position 107620867, rs2230808 (R1587K) in the position 106602625 and rs4149313 (I883M) in the position 106626574 according to gender and lipid profile of Greek nurses.

Methods: The study population consisted of 447 (87 men) unrelated nurses who were genotyped for ABCA1 gene polymorphisms. Additionally, lipid profile [total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C) and apolipoprotein A1] was evaluated.

Results: The distribution of all three studied ABCA1 gene polymorphisms did not differ according to gender. However, only R219K genotype distribution bared borderline statistical significance (p = 0.08) between the two studied groups. Moreover, allele frequencies of R219K, R1587K and I88M polymorphisms did not differ according to gender. In general, blood lipid levels did not seem to vary according to ABCA1 gene polymorphisms, when testing all subjects or when testing only men or only women. However, a significant difference of LDL-C distribution was detected in all subjects according to R1587K genotype, indicating lower LDL-C levels with KK polymorphism (p = 0.0025). The above difference was solely detected on female population (p = 0.0053).

Conclusions: The ABCA1 gene polymorphisms frequency, distribution and lipid profile did not differ according to gender. However, in the female population the KK genotype of R1587K gene indicated lower LDL-C levels. Further studies, involving a higher number of individuals, are required to clarify genes and gender contribution.
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http://dx.doi.org/10.1186/1476-511X-11-62DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391977PMC
July 2012

ATP-binding cassette transporter A1 gene polymorphisms and serum lipid levels in young Greek nurses.

Lipids Health Dis 2011 Apr 13;10:56. Epub 2011 Apr 13.

Molecular Immunology Laboratory, Onassis Cardiac Surgery Center Athens, Greece.

Objective: The ATP-binding cassette transporter A1 (ABCA1) is essential protein involved in lipid metabolism. The present study was undertaken to detect the possible association of polymorphisms in the ABCA1 gene [rs2230806 (R219K) and rs2230808 (R1587K)] and lipid profile in Greek young nurses.

Methods: The study population consisted of 308 unrelated nurses who were genotyped and the ABCA1 polymorphisms were detected. Additionally, lipid profile [total cholesterol (TC), triglycerides (TGs), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and apolipoprotein (apo) A] was evaluated.

Results: There was no difference in the genotypic and allelic frequencies of the R219K polymorphism according to lipid profile. The R1587K genotypes differed significantly according to TC, LDL-C and TGs concentration (p = 0.023, p = 0.014 and p = 0.047, respectively). Particularly, significant difference in TC, LDL-C and TGs concentration was detected between RK and RR genotypes (p = 0.006, p = 0.004, p = 0.014, respectively). Women with RK genotype compared to RR genotype had higher concentration of TGs (134.25 mg/dl vs 108.89 mg/dl, p = 0.014, respectively), total cholesterol (207.41 mg/dl vs 187.69 mg/dl, p = 0.006, respectively), and LDL-C (110.6 mg/dl vs 96.9 mg/dl, p = 0.004, respectively).

Conclusions: These findings suggest that the R1587K polymorphism of ABCA1 gene was associated with lipid profile of Greek nurses. Women with RK genotype had higher TGs, total and LDL-C concentration compared to RR genotype. These observations may be significant in assessing the risk of CAD since a 1% change in LDL-C is associated with a 1% change of cardiovascular events. Also, TGs concentration were documented to play a significant role in women. However, this needs to be confirmed by larger studies.
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http://dx.doi.org/10.1186/1476-511X-10-56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090361PMC
April 2011
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