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Kostagiolas P.A.,Ionian University | Kostagiolas P.A.,Hellenic Open University | Aggelopoulou V.A.,Hellenic Open University | Aggelopoulou V.A.,General Hospital of Athens | Niakas D.,Hellenic Open University
Health Information and Libraries Journal | Year: 2011

Background: Hospital pharmacists need access to high-quality information in order to constantly update their knowledge and improve their skills. In their modern role, they are expected to address three types of challenges: scientific, organizational and administrative, thus having an increased need for adequate information and library services. Objectives: This study investigates the information-seeking behaviour of public hospital pharmacists providing evidence from Greece that could be used to encourage the development of effective information hospital services and study the links between the information seeking behaviour of hospital pharmacists and their modern scientific and professional role. Method: An empirical research was conducted between January and February 2010 with the development and distribution of a structured questionnaire. The questionnaire was filled in and returned by 88 public hospital pharmacists from a total of 286 working in all Greek public hospitals, providing a response rate of 31%. Results: The hospital pharmacists in Greece are in search of scientific information and, more particularly, pharmaceutical information (e.g., drug indications, storage, dosage and prices). The Internet and the National Organization of Medicines are their main information sources, while the lack of time and organized information are the main obstacles they have to face when seeking information. Conclusions: The modern professional role of hospital pharmacists as invaluable contributors to efficient and safer healthcare services may be further supported through the development of specialized libraries and information services within Greek public hospitals. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.


Spragg R.G.,University of California at San Diego | Spragg R.G.,Veterans Affairs Medical Center 151C | Taut F.J.H.,Nycomed GmbH | Lewis J.F.,University of Western Ontario | And 6 more authors.
American Journal of Respiratory and Critical Care Medicine | Year: 2011

Rationale: Patients with acute lung injury have impaired function of the lung surfactant system. Prior clinical trials have shown that treatment with exogenous recombinant surfactant protein C (rSP-C)-based surfactant results in improvement in blood oxygenation and have suggested that treatment of patients with severe direct lung injury may decrease mortality. Objectives: Determine the clinical benefit of administering an rSP-C-based synthetic surfactant to patients with severe direct lung injury due to pneumonia or aspiration. Methods:Aprospective randomized blinded study was performed at 161 centers in 22 countries. Patients were randomly allocated to receive usual care plus up to eight doses of rSP-C surfactant administered over 96 hours (n 5 419) or only usual care (n 5 424). Measurements and Main Results: Mortality to28 days after treatment, the requirement for mechanical ventilation, and the number of nonpulmonary organ failure-free days were not different between studygroups.Incontrasttoprior studies,there wasnoimprovement in oxygenation in patients receiving surfactant compared with the usual care group. Investigation of the possible reasons underlying the lack of efficacy suggested a partial inactivation of rSP-C surfactant caused by a step of the resuspension process that was introduced with this study. Conclusions: In this study, rSP-C-based surfactant was of no clinical benefit to patients with severe direct lung injury. The unexpected lack of improvement in oxygenation, coupled with the results of in vitrotests, suggest that the administered suspension may have had insufficient surface activity to achieve clinical benefit. Clinical trial registered with www.clinicaltrials.gov (NCT00074906).


Wang E.,U.S. National Institutes of Health | Zhao Y.,U.S. National Institutes of Health | Monaco A.,U.S. National Institutes of Health | Uccellini L.,U.S. National Institutes of Health | And 5 more authors.
PLoS ONE | Year: 2012

Purpose: IFNa was the first cytokine to demonstrate anti-tumor activity in advanced melanoma. Despite the ability of high-dose IFNa reducing relapse and mortality by up to 33%, large majority of patients experience side effects and toxicity which outweigh the benefits. The current study attempts to identify genetic markers likely to be associated with benefit from IFN-a2b treatment and predictive for survival. Experimental design: We tested the association of variants in FOXP3 microsatellites, CTLA4 SNPs and HLA genotype in 284 melanoma patients and their association with prognosis and survival of melanoma patients who received IFNa adjuvant therapy. Results: Univariate survival analysis suggested that patients bearing either the DRB1*15 or HLA-Cw7 allele suffered worse OS while patients bearing either HLA-Cw6 or HLA-B44 enjoyed better OS. DRB1*15 positive patients suffered also worse RFS and conversely HLA-Cw6 positive patients had better RFS. Multivariate analysis revealed that a five-marker genotyping signature was prognostic of OS independent of disease stage. In the multivariate Cox regression model, HLA-B38 (p = 0.021), HLA-C15 (p = 0.025), HLA-C3 (p = 0.014), DRB1*15 (p = 0.005) and CT60*G/G (0.081) were significantly associated with OS with risk ratio of 0.097 (95% CI, 0.013-0.709), 0.387 (95% CI, 0.169-0.889), 0.449 (95% CI, 0.237-0.851), 1.948 (95% CI, 1.221-3.109) and 1.484 (95% IC, 0.953-2.312) respectively. Conclusion: These results suggest that gene polymorphisms relevant to a biological occurrence are more likely to be informative when studied in concert to address potential redundant or conflicting functions that may limit each gene individual contribution. The five markers identified here exemplify this concept though prospective validation in independent cohorts is needed.


Georgiadou E.,National and Kapodistrian University of Athens | Moschos M.M.,National and Kapodistrian University of Athens | Margetis I.,National and Kapodistrian University of Athens | Chalkiadakis J.,Ophthalmiatrio Athinon | Markomichelakis N.N.,General Hospital of Athens
Clinical and Experimental Optometry | Year: 2012

Background: The aim was to evaluate the correlation between the anatomical and functional outcomes before and after treatment of uveitic macular oedema. Methods: Thirty-three eyes of 33 patients with uveitic macular oedema were included in the present study. Visual acuity (VA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG) were measured before and after treatment of the macular oedema. Correlation analyses between VA, OCT and mfERG parameters were performed. Results: The VA and mfERG measurements showed statistically significant improvement after treatment of the macular oedema (p < 0.01) and OCT-measured central foveal thickness decreased significantly from 434 ± 135μm before treatment to 267 ± 92μm after treatment (p < 0.001). Correlation analyses showed that uveitic central foveal thickness before treatment was correlated with mfERG N1 response amplitude of area 1 (Spearman's r = -0.62, p < 0.001). VA (logMAR) after treatment had a negative correlation with the mfERG N1 response amplitude of area 1 (Spearman's r = -0.56, p = 0.001). Also, there was no correlation between the final VA and pre-treatment OCT and mfERG measurements. Conclusion: This study deals with cystoid macular oedema associated with recurrent uveitis. In cystoid macular oedema, the value of mfERG before treatment is related to the central foveal thickness and VA. In contrast, after treatment the decrease of macular thickness is not always followed by an improvement of mfERG and VA. This supports the view that in uveitic macular oedema, the decrease in macular thickness after treatment may not be used as a predictor of improvement of macular function. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.


Gogas H.,National and Kapodistrian University of Athens | Kirkwood J.M.,University of Pittsburgh | Falk C.S.,German Cancer Research Center | Dafni U.,National and Kapodistrian University of Athens | And 6 more authors.
Cancer | Year: 2010

BACKGROUND: Interferon is approved for adjuvant treatment of patients with stage IIB/III melanoma. The identification of predictive markers that would permit selection of patients would be beneficial. Specific human leukocyte antigen (HLA) class I and II antigens have previously shown an association with response to therapy or overall survival of patients with metastatic melanoma. METHODS: A total of 284 high-risk melanoma patients participating in a randomized trial and 246 healthy controls were molecularly typed for HLA class I and II. Specific allele frequencies were compared between the healthy and patient populations, as well as presence or absence of these in relation to recurrence. Alleles related to autoimmune disease were also investigated. RESULTS: No significant differences were found between the distribution of HLA genotype in the melanoma population compared with healthy controls. Correlations between nonrecurrence and the presence of HLA-Cw*06 allele were noted present in 19.3% of melanoma patients. The median relapse-free survival of the Cw*06-positive cohort was 100.2 months versus 37.3 months in the Cw*06-negative cohort (P =.013).The median overall survival for the Cw*06-positive cohort has not yet been reached, versus 78.9 months in the Cw*06-negative cohort (P = .025). HLA-Cw*06 was present in 29.79% of patients in the autoimmunity group and 15.38% of patients in the nonautoimmunity group (P =.049). CONCLUSIONS: No allele was associated with absence of recurrence in patients receiving adjuvant interferon with the exception of HLA-Cw*06, an allele correlated with psoriasis. HLA-Cw*06-positive patients have better relapse-free and overall survival. © 2010 American Cancer Society.


Magiakou M.A.,National and Kapodistrian University of Athens | Manousaki D.,National and Kapodistrian University of Athens | Papadaki M.,P And A Kyriakou Childrens Hospital | Hadjidakis D.,National and Kapodistrian University of Athens | And 8 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2010

Objective: The objective of the study was to evaluate the long-term effect of GnRH analog (GnRHa) treatment on final height (FH), body mass index (BMI), body composition, bone mineral density (BMD), and ovarian function. Subjects/Methods: Ninety-two females, evaluated in adulthood, were categorized as follows: group A, 47 girls with idiopathic central precocious puberty (33 GnRHa treated and 14 nontreated); group B, 24 girls with isolated GH deficiency (15 GnRHa and GH treated and nine GH treated); group C, 21 girls with idiopathic short stature (seven GnRHa and GH treated, seven GnRHa treated, and seven nontreated). Results: FH, BMD, and percent fat mass of GnRHa-treated patients in all three groups were comparable with those of the respective nontreated subjects. BMI values of GnRHa-treated and nontreated subjects in groups A and C were comparable, whereas in group B, a higher BMI was found in subjects treated only with GH. Nontreated patients with ICPP had greater maximal ovarian volumes, higher LH and LH to FSH ratio, and more severe hirsutism than GnRHa-treated ones. Menstrual cycle characteristics were not different between treated and nontreated subjects. The prevalence of polycystic ovary syndrome in treated and untreated girls with ICPP was comparable, whereas in the entire cohort, it was 11.1% in GnRHa treated and 32.1% in the untreated (P = 0.02). Conclusions: Girls treated in childhood with GnRHa have normal BMI, BMD, body composition, and ovarian function in early adulthood. FH is not increased in girls with ICPP in whom GnRHa was initiated at about 8 yr. There is no evidence that GnRHa treatment predisposes to polycystic ovary syndrome or menstrual irregularities. Copyright © 2010 by The Endocrine Society.


PubMed | Anticancer Oncology Hospital of Athens St Savvas, General Hospital of Athens and University of Thessaly
Type: Journal Article | Journal: Molecular and cellular probes | Year: 2016

Integration of HPV16 DNA into the host chromosome is considered to be a crucial step towards genomic instability and cervical cancer development. Aim of the present study was to investigate the presence of HPV16 rearranged intra-viral sequences in HPV16-positive normal, precancerous and cervical cancer samples using the method of Restriction Site-PCR (RS-PCR). Sequence analysis of HPV16 integrants revealed for the first time in clinical samples two distinct rearranged intra-viral sequences, concerning the conjunction of E2 and L1 genes and the conjunction of E1 and L1 genes with inverted orientation. Furthermore mapping analysis of the E1 and E2 genes in cervical samples with rearranged intra-viral sequences of HPV16 genome was conducted in order to determine the integrity of viral genes. The identification of intra-viral rearrangements provides valuable information regarding the HPV16 DNA integration, and may be a significant biomarker for the presence of chromosomal instability and DNA damages in clinical samples.


Bazoukis G.,General Hospital of Athens | Tsimos K.,University of Ioannina | Korantzopoulos P.,University of Ioannina
Annals of Noninvasive Electrocardiology | Year: 2016

Episodic (transient/ intermittent) left bundle branch block (LBBB) has been associated with different conditions such as bradycardia, tachycardia, anesthesia, acute pulmonary embolism, changes in intrathoracic pressure, chest trauma, cardiac interventional procedures, mad honey poisoning, and in other clinical settings. Of note, exclusion of an acute coronary syndrome in the setting of episodic LBBB is of great importance. Moreover, episodic LBBB is sometimes symptomatic and may be associated with left ventricular systolic and/or diastolic dysfunction or conduction disturbances leading to syncope. This review article provides a comprehensive overview of the conditions associated with episodic LBBB and discusses the clinical impact of this phenomenon. © 2016 Wiley Periodicals, Inc.


Melas C.D.,Technological Educational Institute of Crete | Zampetakis L.A.,Technical University of Crete | Dimopoulou A.,General Hospital of Athens | Moustakis V.,Technical University of Crete
Journal of Biomedical Informatics | Year: 2011

Recent empirical research has utilized the Technology Acceptance Model (TAM) to advance the understanding of doctors' and nurses' technology acceptance in the workplace. However, the majority of the reported studies are either qualitative in nature or use small convenience samples of medical staff. Additionally, in very few studies moderators are either used or assessed despite their importance in TAM based research. The present study focuses on the application of TAM in order to explain the intention to use clinical information systems, in a random sample of 604 medical staff (534 physicians) working in 14 hospitals in Greece. We introduce physicians' specialty as a moderator in TAM and test medical staff's information and communication technology (ICT) knowledge and ICT feature demands, as external variables. The results show that TAM predicts a substantial proportion of the intention to use clinical information systems. Findings make a contribution to the literature by replicating, explaining and advancing the TAM, whereas theory is benefited by the addition of external variables and medical specialty as a moderator. Recommendations for further research are discussed. © 2011 Elsevier Inc.


Karabinis A.,General Hospital of Athens | Fragou M.,General Hospital of Athens | Karakitsos D.,General Hospital of Athens
Journal of Critical Care | Year: 2010

Management of critically ill patients requires rapid and safe diagnostic techniques. Ultrasonography has become an indispensable tool that supplements physical examination in the intensive care unit. It enables early recognition of neurological emergencies, assists the diagnosis of abdominal and lung pathologies, and provides real-time information on the cardiac performance of critically ill patients. Furthermore, it detects possible infectious sites and renders therapeutic invasive procedures more convenient and less complicated. Whole-body ultrasound in the hands of adequately trained intensivists has the ability to reinvigorate the physical examination, without subjecting the patient to excessive irradiation and the risks of transport. © 2010 Elsevier Inc.

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