Árta, Greece
Árta, Greece

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PubMed | Laiko General Hospital, General Hospital Of Thessaloniki G Gennimatas Ag Dimitrios, Serres General Hospital, General Hospital of Arta and 4 more.
Type: | Journal: International journal of cardiology | Year: 2016

Primary objectives were to evaluate tolerability, compliance, and perception of ranolazine effectiveness for chronic stable angina in a routine clinical setting. The secondary objective was safety evaluation.Prospective, multi-centre, observational, study with a 6-month follow-up and study visits at baseline, 3- and 6 months in patients with chronic stable angina. Ranolazine was administered according to the summary of product characteristics and investigator discretion. Data was collected on patient and disease characteristics, concomitant therapy, angina frequency and severity, quality of life (QoL), perception of effectiveness, compliance, and adverse events.Between July 2010 and July 2012, 189 patients were enrolled at 20 centres. Ranolazine decreased the proportion of patients experiencing angina attacks from 88.4% at baseline to 26.5% at 6 months (p<0.001). Heart rate and blood pressure were not appreciably affected. The proportion of patients without symptoms on normal exertion (Canadian Cardiovascular Society grading class I) increased from 22.3% to 75.3% (p<0.001); patients reporting limitations in daily activities decreased from 80.4% to 35.5%. (p<0.001). Patient- and physician-assessed QoL improved (both p<0.001). Therapeutic efficacy was rated good or very good in 67.7% of cases by physicians, and by 63.5% of the patients. Physicians rated compliance good or very good in 73.5% of cases. Adverse events were consistent with previous reports, and consisted of 40 events in 24 patients; 12 were serious.Ranolazine was associated with decreased angina frequency and severity, and improvements in QoL. The benefits provided by ranolazine in controlled clinical trials are maintained in the clinical setting.


PubMed | c Medical Affairs, Semmelweis University, a Medical & Scientific Affairs, General Hospital and 4 more.
Type: Journal Article | Journal: Expert opinion on pharmacotherapy | Year: 2016

To explore the treatment response, tolerability and safety of once-monthly paliperidone palmitate (PP1M) in non-acute patients switched from oral antipsychotics, stratified by time since diagnosis as recently diagnosed (3years) or chronic patients (>3years).Post hoc analysis of a prospective, interventional, single-arm, multicentre, open-label, 6-month study performed in 233 recently diagnosed and 360 chronic patients.The proportion achieving treatment response (defined as 20% improvement in Positive and Negative Syndrome Scale [PANSS] total score from baseline to endpoint) and maintained efficacy (defined as non-inferiority in the change in PANSS total score at endpoint [Schuirmanns test]).71.4% of recently diagnosed and 59.2% of chronic patients showed a20% decrease in PANSS total score (p=0.0028 between groups). Changes in PANSS Marder factors, PANSS subscales, and the proportion of patients with a Personal and Social Performance scale (PSP) total score of 71-100 were significantly greater in recently diagnosed compared with chronic patients. PP1M was well tolerated, presenting no unexpected safety findings.These data show that recently diagnosed patients treated with PP1M had a significantly higher treatment response and improved functioning, as assessed by the PSP total score, than chronic patients.


PubMed | Fetal Medicine Unit, National and Kapodistrian University of Athens, General Hospital of Arta, Greek Ministry of Reconstruction of Production and 3 more.
Type: Journal Article | Journal: Pediatric research | Year: 2016

This experimental study aims to investigate the impact of combinations of prenatal and postnatal food manipulation on body composition in rat offspring.On day 12 of gestation, 100 timed pregnant rats were randomized into two nutritional groups: standard laboratory and 50% starved. Pups born to starved mothers were subdivided, based on birthweight (BiW), into fetal growth restricted (FGR) and non-FGR. Pups were born on day 21, cross-fostered, then left undisturbed lactating until the 26th postnatal day when they underwent dual-energy X-ray absorptiometry (DXA) examination.Prenatally control-fed animals had a significantly greater body weight at 26 d postnatally than the prenatally starved groups, irrespective of their postnatal diet (P < 0.001). Postnatal control diet was associated with significantly increased abdominal and total fat in non-FGR compared to FGR rats (P < 0.001). non-FGR/CONTROL rats showed higher values of abdominal fat than prenatally starved animals that were starved postnatally irrespective of their birth weight (P < 0.001). Postnatal control diet significantly increased total bone mineral content (BMC), head BMC, head area, abdominal BMC in non-FGR compared to FGR rats (P < 0.001).Interaction between prenatal and postnatal nutrition affects growth, abdominal adiposity, and bone accrual in Wistar rats offspring at 26 d of life.


PubMed | General Hospital of Corfu, Chatzikosta Hospital, Scarborough General Hospital, General Hospital of Kastoria and General Hospital of Arta
Type: | Journal: Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese | Year: 2016

Hypothermia occurs when the core body temperature falls below 35C, which, in severe cases, can lead to electrocardiographic changes. Several conditions that occur in the psychiatric population increase the risk of hypothermia. This risk can be further increased by the use of several classes of medications such as antipsychotics, beta-adrenergic antagonists and benzodiazepines. We report on three psychiatric patients who were admitted for hypothermia and developed electrocardiographic manifestations (sinus bradycardia, QT prolongation and Osborn waves), which completely resolved after treatment.


Giannakopoulos X.K.,University of Ioannina | Giotis C.,General Hospital of Arta | Karkabounas S.C.,University of Ioannina | Verginadis I.I.,University of Ioannina | And 3 more authors.
International Urology and Nephrology | Year: 2011

Introduction Benign prostate hyperplasia (BPH) has been treated with various types of electromagnetic radiation methods such as transurethral needle ablation (TUNA), interstitial laser therapy (ILC), holmium laser resection (HoLRP). In the present study, the effects of a noninvasive method based on the exposure of patients with BPH to a pulsative EM Field at radiofrequencies have been investigated. Materials and methods Twenty patients with BPH, aging 68-78 years old (y.o), were enrolled in the study. Patients were randomly divided into two groups: the treatment group (10 patients, 74.0 ± 5.7 y.o) treated with the a-blocker Alfusosin, 10 mg/24 h for at least 4 weeks, and the electromagnetic group (10 patients, 73.7 ± 6.3 y.o) exposed for 2 weeks in a very short wave duration, pulsed electromagnetic field at radiofrequencies generated by an ion magnetic inductor, for 30 min daily, 5 consecutive days per week. Patients of both groups were evaluated before and after drug and EMF treatment by values of total PSA and prostatic PSA fraction, acid phosphate, U/S estimation of prostate volume and urine residue, urodynamic estimation of urine flow rate, and International Prostate Symptom Score (IPSS). Results There was a statistically significant decrease before and after treatment of IPSS (P<0.02), U/S prostate volume (P<0.05), and urine residue (P<0.05), as well as of mean urine flow rate (P<0.05) in patients of the electromagnetic group, in contrast to the treatment group who had only improved IPSS (P<0.05). There was also a significant improvement in clinical symptoms in patients of the electromagnetic group. Follow-up of the patients of this group for one year revealed that results obtained by EMFs treatment are still remaining. Conclusion Pulsed electromagnetic field at radiofrequencies may benefit patients with benign prostate hyperplasia treated by a non-invasive method. © 2011 Springer Science+Business Media, B.V.


The process of involuntary psychiatric examination and/or hospitalization is a rare experience for the average modern man. As part of it, the citizen shall be subjected to a restriction of his freedom and forced hospitalization without himself having sought neither of the above situations.The rarity of this experience, assisted by the severity of the threat to individual freedom and dignity that leads to, impose the existence of a clear legal framework which will describe the permissive or non-implementation of procedures, the pious keeping on behalf of the stakeholders of these legal provisions and the operation of a reliable system of registration and control of these processes. In our country legal act nr.2071 for involuntary hospitalization in a psychiatric unit became the legal framework, which in 1992 was decided to be adopted, to describe the necessary conditions and requirements needed be fulfilled for the realization of involuntary examination and/or hospitalization in patients with mental illness, while respecting individual rights and freedoms. Although the replacement of previous relevant law with the adoption of this law was hailed by many sides, full implementation thereafter and, where applicable, "stumbled" because it never met with the full agreement of all parties involved. It is estimated that, in Greece, 40 to 50% of all hospitalizations taking place in public psychiatric units are involuntary hospitalizations. This percentage is extremely high, being nearly four times the European average. Therefore, it is now more than ever important to undertake initiatives towards re-testing the conditions under which the involuntary examination and/or treatment is realized in our country. The purpose of this short article is to present a case where the prosecutor and the psychiatrist disagreed on the interpretation of a paragraph of law nr. 2071/92 so the first to prosecute the second. Fortunately, the psychiatrist, who defended the view that only the judiciary has the power and authority to order involuntary hospitalization of a mentally ill patient, of course after the evidences based medical positive opinion of the psychiatrists, was acquitted by the court. In conclusion, we suggest that for the obscure points of interpretation of the law, professionals involved in its implementation (that is psychiatrists, prosecutors, police personnel etc.) must (a) adopt a spirit of conciliation and (b) establish measures and procedures that will allow continuous monitoring of the implementation of each case of involuntary examination and/or hospitalization.


Bilanakis N.,General Hospital of Arta | Kalampokis G.,University of Ioannina | Christou K.,University of Ioannina | Peritogiannis V.,University of Ioannina
International Journal of Social Psychiatry | Year: 2010

Background: Coercive physical measures are commonly used in psychiatric units throughout the world for the management of severe behaviourally disturbed patients. Aim: The aim of this study was to assess the rates of coercive physical measures (seclusion and restraint) used in psychiatric inpatients in the psychiatric unit of a general hospital in Greece. Methods: A retrospective chart review of all admissions to the psychiatric unit of the University General Hospital of loannina during a six-month period was conducted. Differences between patients who were subjected to coercion and patients who did not receive any coercive treatment were statistically analyzed and compared. Results: Of the total of 282 admissions during the study period, 31 (11.0%) cases had been subjected to some form of coercive physical measures: 9.55% and 1.76% were affected by seclusion and mechanical restraint, respectively (one patient had been subjected to both). The mean duration of any one seclusion and mechanical restraint was 64.9 hours and the mean number of seclusion and restraint per affected case was 3.58. Statistical analysis between the group subjected to coercive measures and the group who was not did not reveal any association with demographic data or diagnosis. Coercive measures were found to be associated only with the type of admission at intake. Conclusions: Involuntary admissions were associated with statistically significant higher levels of restraint and seclusion in this patient sample. Strategies that will enhance patients' follow-up are expected to prevent involuntary admissions and reduce the use of coercive measures. © 2010 The Author(s).


PubMed | General Hospital of Arta
Type: Journal Article | Journal: International urology and nephrology | Year: 2015

Diabetes mellitus (DM) is currently considered a modern global epidemic, and diabetic nephropathy (DN) is the most common cause of chronic kidney disease (CKD). Anemia is one of the most significant complications of CKD, and it is mainly attributed to insufficient erythropoietin (EPO) production. However, anemia develops earlier in the course of CKD among patients with DM, and the severity of anemia tends to be more marked in these patients compared to nondiabetic subjects, regardless of the stage of CKD. In this review, we focus on the less known complex interacting mechanisms which are involved in the pathophysiology of anemia associated with DN. Although the major cause of anemia in DN is considered to be an inappropriate response of the plasma EPO concentration to anemia, several other possible mechanisms have been suggested. Glomerular hyperfiltration, proteinuria, renal tubular dysfunction and interstitial fibrosis are among the main culprits. On the other hand, systemic effects such as chronic inflammation, autonomic neuropathy and the renin-angiotensin system are also involved. Finally, several medications are considered to aggravate anemia associated with DN. Since anemia is an important predictor of quality of life and is implicated in the increased burden of cardiovascular morbidity and mortality, further research is required to elucidate its pathogenesis in diabetic patients.


Bilanakis N.,General Hospital of Arta | Papamichael G.,General Hospital of Arta
Annals of General Psychiatry | Year: 2011

Background: There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries.Methods: A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010) were examined.Results: Chemical restraint was applied in 33 cases (10.5% of total admissions). From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases), usually in combination with a benzodiazepine (61.7% of cases). In 36.4% of cases the patient was further subjected to restraint or seclusion.Conclusions: In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings. © 2011 Bilanakis et al; licensee BioMed Central Ltd.


Bilanakis N.,General Hospital of Arta | Vratsista A.,General Hospital of Arta | Kalampokis G.,General Hospital of Arta | Papamichael G.,General Hospital of Arta
Annals of General Psychiatry | Year: 2013

Background: Patients' informed consent prior to treatment initiation is an essential component of contemporary clinical practice, but sometimes, patients lack decision-making capacity for treatment. Such capacity can be reliably assessed with standardized tools used, and the MacArthur competence assessment tool for treatment (MacCAT-T) is one of the most widely used instruments.Methods: The objective of this study was to translate the MacCAT-T into Greek and evaluate the Greek version's reliability and validity in psychiatric patients. Thirty-nine psychiatric inpatients were examined with the MacCAT-T, and results showed an excellent inter-rater reliability.Results: Intraclass correlations ranged from 0.93 to 1 for the individual items of the tool. Severity of psychopathology was negatively correlated with reasoning, appreciation, and expressing a choice (Pearson's r 0.36, 0.539, and 0.338, respectively), but there were no associations with demographic characteristics of the patients. Of the five factors derived from the brief psychiatric rating scale, anergia was significantly correlated with appreciation, reasoning, and expressing a choice (Pearson's r 0.46, 0.45, and 0.37, respectively).Conclusions: The Greek version of the MacCAT-T is a reliable and valid instrument that can provide a standardized measure for assessing treatment decision capacity in Greek psychiatric patients and can be used for evaluation in the clinical practice. © 2013 Bilanakis et al.; licensee BioMed Central Ltd.

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