Karamitri I.,General Hospital of Kalamata |
Karamitri I.,Hellenic Open University |
Bellali T.,Alexandreio Technological Educational Institute |
Galanis P.,National and Kapodistrian University of Athens |
Kaitelidou D.,National and Kapodistrian University of Athens
International Journal of Health Planning and Management | Year: 2013
Background: Problems of accessibility to healthcare services notably affect certain population groups such as poor and unemployed people, migrants and minorities, thus having a negative impact on their health. The aim of this study was to investigate these problems from the perspective of health professionals and to formulate empirically informed suggestions to solve the issue. Methods: Primary data were collected in 2010-2011 by using a panel of 36 experienced health professionals around Greece. A two-round Delphi method was undertaken to achieve the objectives of the study. The first questionnaire investigated the factors that hinder accessibility to health services. The second round aimed at determining the relative importance of each of the factors emerging in the first round. Results: The group of experts identified 345 factors in the first round, which were grouped in 55 statements. Consensus was achieved in 22 statements. The study revealed important issues, and health professionals proposed a number of actions to eliminate the accessibility problems. Conclusions: The use of medical interpreters and cultural mediators, transcultural education and stronger linkages among medical facilities are important to reduce accessibility problems. Restructuring primary healthcare and better documenting of the beneficiaries could also improve the quality of provided healthcare services. © 2012 John Wiley & Sons, Ltd.
PubMed | General Hospital of Kalamata, General Hospital of Chalkida, Technological Educational Institute of Athens, National and Kapodistrian University of Athens and 4 more.
Type: | Journal: Preventive medicine | Year: 2016
The association between depression status and 10-year cardiovascular disease (CVD) incidence among acute coronary syndrome (ACS) patients, in relation to nutritional and financial status, was evaluated.From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 Greek hospitals was enrolled. In 2013-14, the 10-year follow-up was performed. Depressive symptoms were evaluated using the validated CES-D score (range 0-60). Adherence to Mediterranean diet was assessed through MedDietScore (range 0-55) and financial status was determined by the annual income.Ranking from the 1st to 3rd CES-D tertile, recurrent fatal/non fatal ACS rates were 33%, 37% and 42%, respectively (p=0.006). Multiple logistic regression models revealed an adverse association of severe depression status (i.e. 3rd tertile) compared to no depression (i.e. 1st tertile) [odds ratio (OR)=1.31, 95% confidence interval (95% CI) 1.01, 1.69]. When controlling for financial status, the relationship between depression and ACS prognosis remained marginally significant; while subgroup analysis revealed that only patients with low/moderate income were negatively affected [OR=1.36, 95% CI 0.98, 1.88]. Further stratified analysis, by MedDietScore group, was applied; the above association remained significant only in patients with low compliance to this dietary pattern [OR=1.68, 95% CI 1.10, 2.18].ACS coexisting with severe depression status seems to result in adverse disease outcomes while financial status and Mediterranean diet are proposed as potential moderators. Public health programs should focus on vulnerable groups and minimize depressive symptoms through appropriate medical treatment and lifestyle interventions, so as to ameliorate the disease prognosis in clinical and community levels.
PubMed | General Hospital of Kalamata, General Hospital of Chalkida, National and Kapodistrian University of Athens, General Hospital of Karditsa and 3 more.
Type: Journal Article | Journal: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association | Year: 2016
The present study evaluated the association between long-term, exclusive olive oil consumption, in cooking preparation or as a dressing, and the 10-year (2004-2014) incidence of acute coronary syndrome (ACS) among cardiac patients.From October 2003 to September 2004, a sample of 2172 ACS consecutive patients from six major Greek hospitals were enrolled. During 2013-2014, the 10-year follow-up was performed in 1918 patients (88% participation rate). The development of fatal or nonfatal ACS was recorded through medical records or hospital registries. Among other dietary components, added fats (i.e. olive oil, butter, margarine and seed oils) consumption at baseline examination was assessed using a semi-quantitative food frequency questionnaire.Non-exclusive olive oil consumption on a daily basis was associated with an adverse effect on the ACS incidence after taking into account various potential confounders [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.05-1.86, P = 0.024]. However, significant interactions between olive oil consumption and body mass index (BMI) (P = 0.082) and educational level (P = 0.054) led to further stratified analysis. Using BMI as strata (i.e. 29.9 versus >29.9 kg m(-2)), the above association remained significant only in obese patients (OR = 1.80, 95% CI = 1.03-3.12, P = 0.038), whereas, on examining the education status (i.e. 9 versus >9 years of school), a significant association was observed only among the higher educated patients (OR = 1.83, 95% CI = 1.01-3.32, P = 0.047).Exclusive use of olive oil, either as a salad dressing or in cooking, should be promoted through the dietary management of ACS patients, with the aim of reducing the likelihood of recurrent cardiac episodes.
PubMed | Sismanoglio Public General Hospital of Attica, Alexander Technological Educational Institute of Thessaloniki, National and Kapodistrian University of Athens and General Hospital of Kalamata
Type: | Journal: Journal of psychiatric and mental health nursing | Year: 2016
children who are diagnosed with psychosis often rely on their parents for prolonged care. The impact of such care is partially understood since most studies use quantitative methods and preexisting theoretical frameworks that limit their investigation to emotional burden, and emotional responses.Explore the parents lived experience of caring for a child with psychosis.A hermeneutic phenomenological design was used with a sample of 16 parents of children with psychotic disorders who were hospitalized or attended the outpatient clinic of a large psychiatric Greek hospital.Identified themes were: (a) the psychosis experience, (b) redefinition of the parent-child relationship over the course of the disorder, and (c) challenges of parenting a child with psychosis.Caring for an intimate stranger reflects the parents overall experience, involving changes in the parent-child relationship, ambivalence towards caretaking, and profound guilt, compensated by self-sacrifice parenting practices.Findings highlight the necessity to train mental health professionals to provide individualized information, facilitate family communication, address the parents guilt, ambivalence, meaning attributions that compromise adjustment, and support them through the challenges of parenting a son or daughter with psychosis. This article is protected by copyright. All rights reserved.
Micha R.,Harvard University |
Micha R.,Agricultural University of Athens |
Michas G.,General Hospital of Kalamata |
Mozaffarian D.,Harvard University
Current Atherosclerosis Reports | Year: 2012
Growing evidence suggests that effects of red meat consumption on coronary heart disease (CHD) and type 2 diabetes could vary depending on processing. We reviewed the evidence for effects of unprocessed (fresh/frozen) red and processed (using sodium/other preservatives) meat consumption on CHD and diabetes. In meta-analyses of prospective cohorts, higher risk of CHD is seen with processed meat consumption (RR per 50 g: 1.42, 95 %CI=1.07-1.89), but much lower or no risk is seen with unprocessed meat consumption. Differences in sodium content (∼400 % higher in processed meat) appear to account for about two-thirds of this risk difference. In similar analyses, both unprocessed red and processed meat consumption are associated with incident diabetes, with much higher risk per g of processed (RR per 50 g: 1.51, 95 %CI=1.25-1.83) versus unprocessed (RR per 100 g: 1.19, 95 % CI=1.04-1.37) meats. Contents of heme iron and dietary cholesterol may partly account for these associations. The overall findings suggest that neither unprocessed red nor processed meat consumption is beneficial for cardiometabolic health, and that clinical and public health guidance should especially prioritize reducing processed meat consumption. © Springer Science+Business Media, LLC 2012.
Efthimiou I.,General Hospital of Kalamata |
Skrepetis K.,General Hospital of Kalamata |
Bournia E.,General Hospital of Kalamata
Current Urology | Year: 2013
Diagnosis of small prostate cancer foci is a real challenge for pathologists and urologists as it carries the risk of false positive or negative diagnosis with clinical consequences. Diagnosis of small prostate cancer foci requires a strict methodological approach which includes a search for major and minor features under low and high magnification. Ambiguous cases can be further clarified with the use of basal cell immunomarkers complemented by a positive indicator of malignancy. Despite the new diagnostic armamentarium, a few cases will continue to remain doubtful and might require an appropriate rebiopsy. © 2013 S. Karger AG, Basel.
Fouzas S.,University of Patras |
Politis P.,General Hospital of Aegion |
Skylogianni E.,University of Patras |
Syriopoulou T.,General Hospital of Kalamata |
And 3 more authors.
Pediatrics | Year: 2010
OBJECTIVES: The objective of this study was to assess the knowledge on pulse oximetry among health care professionals involved in pediatric care. METHODS: A multiple-choice questionnaire was distributed to 505 pediatric health care professionals from 19 hospitals and health centers throughout Greece. Exploratory factor analysis was performed to identify underlying factors that could explain most of the variance of the responses. The mean test and factor scores were calculated and compared between clinical settings. RESULTS: The mean test score was 61.9 ± 18.1%. After factor analysis, 2 distinct groups of deficits in knowledge regarding pulse oximetry were identified: 1 was interpreted as relating to practical knowledge and the other to theoretical knowledge. The mean score of the items that assessed practical knowledge was 82.7 ± 12.5% and of those that assessed theoretical knowledge was 44.2 ± 21.7%. Pediatricians and family practitioners, participants from level 3 institutions, and health care professionals working in ICUs scored better, particularly on the items that assessed theoretical knowledge. Logistic regression analysis revealed that only participants from level 3 institutions and those from ICUs had a greater likelihood of achieving a higher score (total score odds ratio: level 3, 2.89, ICU, 8.13; theoretical knowledge odds ratio: level 3, 3.40, ICU, 10.95). CONCLUSIONS: Pediatric health care professionals have marked deficiencies in their knowledge on pulse oximetry, particularly in regard to the principles underlying the method and its limitations. Strategies that are directed at improving knowledge on pulse oximetry are urgently needed at all levels of experience in pediatric care. Copyright © 2010 by the American Academy of Pediatrics.
Porfyris O.,General Hospital of Kalamata |
Kalomoiris P.,General Hospital of Kalamata
Journal of B.U.ON. | Year: 2013
Chemotherapy is the conventional treatment for castration-resistant prostate cancer (CRPC) which provides only modest benefits. In the last few years, immunotherapy has emerged as an exciting therapeutic modality for advanced prostate cancer. Several characteristics of prostate cancer make it an ideal target for immunotherapy, and FDA approved recently sipuleucel-T based on improvement in overall survival (OS) in patients with CRPC. Current trials investigate the role of various immunological approaches in the treatment of prostate cancer, as far as the clinical benefit they provide is concerned and also deal with the issue of the measurability of this benefit. Future studies will focus on the combination of immunotherapeutic agents with conventional treatments in an effort to optimize patient outcomes.
Drosos G.I.,Democritus University of Thrace |
Stavropoulos N.I.,General Hospital of Kalamata |
Kazakos K.,Democritus University of Thrace |
Tripsianis G.,Democritus University of Thrace |
And 2 more authors.
Archives of Orthopaedic and Trauma Surgery | Year: 2011
Introduction: The aim of the present study was to compare a new silicone ring tourniquet (SRT) with a classic pneumatic cuff tourniquet (PT) in terms of tolerance and recovery time following their use in healthy volunteers. Methods: Both tourniquets were applied in the arm and thigh of 15 healthy unmedicated volunteers. PT pressure was kept at 100 mmHg above the systolic blood pressure. The appropriate model of the SRT was used according to the systolic blood pressure. Pain was assessed by visual analogue scale and arterial blood pressure, pulse rate and oxygen saturation were monitored in all volunteers. Results: There was no statistically significant difference in tolerance time between SRT and PT in the arm (19.13 vs. 18.25 min) and thigh (21.52 vs. 21.39 min) nor in recovery time between the two devices. Conclusion: The SRT performed similarly to the classic PT in terms of tolerance and recovery time when applied in the arm and thigh of unmedicated healthy volunteers. © Springer-Verlag 2010.
Kousoulis P.,General Hospital of Kalamata |
Pantes A.,Hellenic Air Force General Hospital
Audiology and Neurotology | Year: 2011
Introduction: Airsickness affects many aviators, especially at the beginning of their flight training. From the symptoms of airsickness, stomach awareness and nausea are among the most common and unpleasant. Helicobacter pylori infection of the gastric mucosa is a common cause of gastrointestinal symptoms in the general population, although it has seldom been associated with motion sickness in the scientific literature. Methods: A retrospective review was conducted in all cases of pilot trainees taking basic flight training who were referred to the Hellenic Air Force Aeromedical Center due to airsickness and tested for H. pylori, for the time period 1996-2005. We compared the H.-pylori-positive pilots with the uninfected ones according to their responses to the habituation sorties and subsequent completion of the basic flight training as a whole. A statistical analysis was performed using Fisher's exact test. Results: The findings of the study suggest that diagnosing H. pylori infection and treating it with eradication therapy increases the possibility of a pilot trainee successfully completing the habituation flights, while it does not affect success in the basic flight training as a whole. Conclusions: Eradication therapy for H. pylori may provide a temporary reduction in reported nausea during flight training. The findings are not conclusive, but highly suggestive of a pathophysiologic link between H. pylori and motion sickness, needing further clarification through targeted studies. © 2010 S. Karger AG, Basel.