Valachis A.,Malarjukhuset |
Polyzos N.P.,Vrije Universiteit Brussel |
Nearchou A.,Malarjukhuset |
Lind P.,Malarjukhuset |
And 2 more authors.
Journal of Clinical Oncology | Year: 2012
Purpose: A potential financial relationship between investigators and pharmaceutical manufacturers has been associated with an increased likelihood of reporting favorable conclusions about a sponsor's proprietary agent in pharmacoeconomic studies. The purpose of this study is to investigate whether there is an association between financial relationships and outcome in economic analyses of new targeted therapies in oncology. Materials and Methods: We searched PubMed (last update June 2011) for economic analyses of targeted therapies (including monoclonal antibodies, tyrosine-kinase inhibitors, and mammalian target of rapamycin inhibitors) in oncology. The trials were qualitatively rated regarding the cost assessment as favorable, neutral, or unfavorable on the basis of prespecified criteria. Results Overall, 81 eligible studies were identified. Economic analyses that were funded by pharmaceutical companies were more likely to report favorable qualitative cost estimates (28 [82%] of 34 v 21 [45%] of 47; P = .003). The presence of an author affiliated with manufacturer was not associated with study outcome. Furthermore, if only studies including a conflict of interest statement were included (66 of 81), studies that reported any financial relationship with manufacturers (author affiliation and/or funding and/or other financial relationship) were more likely to report favorable results of targeted therapies compared with studies without financial relationship (32 [71%] of 45 v nine [43%] of 21; P = .025). Conclusion: Our study reveals a potential threat for industry-related bias in economic analyses of targeted therapies in oncology in favor of analyses with financial relationships between authors and manufacturers. A more balanced funding of economic analyses from other sources may allow greater confidence in the interpretation of their results. © 2012 by American Society of Clinical Oncology.
Zavras N.,National and Kapodistrian University of Athens |
Tsamoudaki S.,Penteli General Childrens Hospital |
Ntomi V.,National and Kapodistrian University of Athens |
Yiannopoulos I.,General Hospital of Lamia |
And 2 more authors.
Korean Journal of Pain | Year: 2015
Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of 7.56 ± 2.61 years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results. © The Korean Pain Society, 2015.
Plagisou L.,General Hospital Asklepieio Voulas |
Tsironi M.,University of Peloponnese |
Zyga S.,University of Peloponnese |
Moisoglou I.,General Hospital of Lamia |
Prezerakos P.,University of Peloponnese
Hellenic Journal of Cardiology | Year: 2015
Introduction: The effective provision of cardiopulmonary resuscitation (CPR) increases patient survival and reduces in-hospital mortality. Nursing staff, as front-line healthcare professionals, are often the first present at cardiovascular arrests and respond by providing CPR. Their training has an impact on the efficiency of CPR and consequently on health outcomes; thus, assessment of their status in that respect may provide useful information for decision making. Methods: A cross-sectional study was undertaken in an NHS hospital in Greece to assess the theoretical knowledge of nurses and assistant nurses in relation to CPR. The study population surveyed consisted of nurses and assistant nurses of a specific public hospital. Results: The study revealed that nursing staff had poor theoretical knowledge, with a mean score for correct answers in the written test of 50.6 ± 25.9% and a mean 4.1 ± 2 correct answers. Fifty-three percent of participants reported taking part in a refresher course after attending a first course, while only 13.2% had participated in a relevant training program during the last 6 months prior to the study. Registered nurses who possessed a university (p=0.016) or a technological institution (p<0.001) diploma, achieved 36.1% and 20.9% higher mean scores, respectively, in the written test in comparison to assistant nurses. The vast majority (91.9%) of the participants expressed their willingness to participate in CPR training courses. Conclusions: It is crucial for nursing staff to participate in CPR courses in order to refresh and update their theoretical knowledge and performance skills and consequently to improve the safety and effectiveness of care. © 2015, Hellenic Cardiological Society. All rights reserved.
Mauri D.,General Hospital of Lamia |
Mauri D.,Panhellenic Association for Continual Medical Research PACMeR |
Valachis A.,Panhellenic Association for Continual Medical Research PACMeR |
Valachis A.,University of Crete |
And 5 more authors.
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2010
To address whether the use of bisphosphonates in the adjuvant setting of breast cancer might have any effect on the natural course of the disease, a meta-analysis was conducted of published and unpublished randomized controlled trials found in PubMed, the Cochrane Central Register of Controlled Trials, the ISI Web of Knowledge, and abstracts of major international conferences up to January 2009. All trials that randomized patients with primary breast cancer to undergo adjuvant treatment with any bisphosphonate versus non-use were considered eligible. Analysis included data from 13 eligible trials involving 6886 patients randomized to treatment with bisphosphonates (n = 3414) or either placebo or no treatment (n = 3472). Compared with no use, adjuvant breast cancer treatment with bisphosphonates did not reduce the overall number of deaths (odds ratio [OR], 0.708; 95% Cl, 0.482-1.041; P = .079), bone metastases (OR, 0.925; 95% Cl, 0.768-1.114; P = .413), overall disease recurrences (OR, 0.843; 95% Cl, 0.602-1.181; P = .321), distant relapse (OR, 0.896; 95% Cl, 0.674-1.192; P = .453), visceral recurrences (OR, 1.051; 95% Cl, 0.686-1.609; P = .820), or local relapses (OR, 1.056; 95% Cl, 0.750-1.487; P = .756). No significant heterogeneity was observed among the trials except for estimates of deaths and disease recurrences (P = .034 and P = .016, respectively). In subgroup analyses, use of zoledronic acid was associated with a statistically significant lower risk for disease recurrence (OR, 0.675; 95% Cl, 0.479-0.952; P = .025). However, these results should be interpreted with caution because the statistical significance for this association was weak and might be attributed to chance from multi-test analyses. Use of zoledronic acid was not associated with any significant difference in death (OR, 0.642; 95% Cl, 0.388-1.063) and bone metastasis rates (OR, 0.661; 95% Cl, 0.379-1.151). Currently available evidence does not support the hypothesis that use of bisphosphonates in adjuvant treatment of early breast cancer will alter the natural course of the disease. Nonetheless, a nonsignificant trend seems to exist for better outcomes in patients undergoing bisphosphonate treatment. Until further evidence from new clinical trials becomes available, adjuvant bisphosphonates should not be recommended routinely. © Journal of the National Comprehensive Cancer Network.
Mauri D.,General Hospital of Lamia |
Tsiara A.,General Hospital of Lamia |
Valachis A.,Onkologkliniken Sormland |
Kalopita K.,General Hospital of Lamia |
And 3 more authors.
BMJ Supportive and Palliative Care | Year: 2013
Background: Cancer cachexia is a common associate of cancer and has a negative impact on patients' survival. Nonetheless, cancer cachexia assessment and management are frequently less than satisfactory in daily practice. Aim: To scrutinise global cancer cachexia awareness and relative web guideline implementation among oncology societies. Methods: Systematical identification of scientific and policymaker oncology societies and their guideline implementation on cancer cachexia. Assessment of the general level of awareness on cancer cachexia and evaluation of intercontinental and national variations on guideline implementation. Results: 144 000 web pages were scrutinised, and 275 oncology societies identified covering a large array of oncology setting (educational/ clinical/research/policymaker); 71 were international (African, American, Asian, European, Oceania and Intercontinental), 110 belonged to the top 10 countries with the highest development index and 94 pertained to 10 countries with a long lasting tradition in medical oncology (not included in the top 10 high developed countries). Overall, only 10/275 web sites provided guidelines; six of them (2.2%) provided guidelines for physicians and four (0.7%) for patients. Half of the guidelines (4/10) were outdated. All guidelines for physicians reported references, while only one of the recommendations for patients reported references to support its sentences. Conclusions: Cancer cachexia global awareness appears extremely low; guideline implementation on the web was inconsistent for any category analysed (nation vs continent vs international vs society type vs physician vs patient oriented) and for updating.