Clinical Studies

Acute coronary syndrome is a debilitating and progressive disease, which can affect patient’s quality of life (QOL) and life satisfaction, which are two important components of patients’ treatment and care. The present study was conducted to determine the effects of educational programs and telephone follow-up on the QOL and life satisfaction in patients with acute coronary syndrome. Ninety patients with acute coronary syndrome were enrolled in a randomized clinical trial. The patients in the study were randomly classified into three groups: Group A (n=30) received educational program, Group B (n=30) received educational program plus ten telephone calls, and Group C (n=30) received no interventions. MacNew’s questionnaires of patient’s QOL and patient’s satisfaction were applied for all the groups. During hospitalization, the patients in Groups A and B received three 30-minute sessions of heart-disease-related educational program together with educational booklets. The patients in Group B received additional ten telephone calls for the consistency of the educational program for two months after patient’s discharge. Statistical analysis was performed through the analysis of variance and Pearson’s correlation test (p<0.05). The results showed that the effects of intervention in Groups A and B on the total score of QOL were not significant compared to the control group. The emotional and physical dimensions of QOL were significantly different between the patients with intervention and Group C. Comparison between satisfaction means of the three groups before intervention showed no significant difference. However, there was significant difference between them after intervention (p < 0.001). There was also a significant difference between satisfaction scores of Groups A and B compared to Group C. However, there was no statistically significant difference between Groups A and B.

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The goal of of the present study is to investigate short-term and long-term functional outcome of a 8-bed, multidisciplinary pediatric intensive care unit (PICU) of a general hospital 300 PICU patients were enrolled prospectively in this observational cohort study. Functional outcome was evaluated through Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC) scales at admission (baseline), at PICU and hospital discharge, at 3 and 6 months, and at 1 and 2 years. Delta DPCPC and DPOPC alterations at discharge were related to major diagnostic categories and 2-year survival.Baseline PCPC and POPC scores were normal in 67% and 58.7% of study population, mild disability were recorded in 17.3% and 14.7%, moderate disability at 8% and 14%, severe disability at 4.3% and 9.3% and coma at 3.3% and 3.3%, respectively.

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The aim of this study was to evaluate resuscitation skills and knowledge of the nursing staff of University Hospital “AHEPA”, who have previously successfully participated in a validated training CPR/AED course, held in ourhospital.In our study 60 professionally active nurses were involved. After completion of a predesigned questionnaire, they were expected to respond to a simulated cardiac arrest-CA scenario in an area where automated external defibrillation-AED was available. The questionnaire consisted of several questions regarding demographic data, participant’s personal opinion on the resuscitation training program, CPR performance and nurse’s attitudes when facing a CA. Participants were evaluated according to the European Resuscitation Council assessment form for basic life support-BLS with the use of AED (consisting of performance in 17 skills).The vast majority of the study population were female nurses (86.7% and 83.3% respectively), 41-50 years old (70%) with more than 21years working experience (53.3%).

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Neurologic complications after liver transplantation are quite common, with central pontine myelinolysis (CPM) being a rare but fatal complication. In this report, we describe the case of female liver transplant recipient who developed CPM after orthotopic liver transplantation (OLT).A 62-year old woman was admitted to the ICU for postoperative recovery after OLT. The procedure was described as uneventful. The patient had a history of decompensated cirrhosis, tension ascites, class I hepatic encephalopathy and chronic hyponatremia which necessitated repeated hospitalizations in the year prior to transplantation.The patient was unable to be weaned from ventilator support and did not show an improvement in mental status (GCS=5) despite the cessation of sedation. After neurologic consultation, a brain MRI was performed which showed evidence of CPM in the pons. Despite supportive therapy, the patient did not show an improvement of mental status and after a 55-day hospitalization in the ICU she died from septic complications.The etiology of CPM is multifactorial, with liver transplant recipients being at an increased risk. Supportive treatment is the standard of care, and there are not enough evidence supporting other types of treatment.

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The aim of this study was to compare the combination of oral tramadol and midazolam to oral midazolam alone, in children undergoing adenotonsillectomy, as an oral premedication, regarding also sedation and postoperative pain relief. Sixty children selected for elective adenotonsillectomy were enrolled in this randomized, controlled prospective study. Patients were randomly allocated into two groups. Group M (n=30) received 0.5 mg.kg-1 oral midazolam and group MT (n=30) received 0.2 mg.kg-1 oral midazolam with 1 mg.kg-1 oral tramadol as a premedication 30min preoperatively. Standard general anesthesia technique was used.

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This study was undertaken to evaluate the immediate postoperative complications in renal transplant recipients requiring Intensive Care Unit (ICU) admission. All renal transplant recipients with immediate post-transplantation complications (<1 week) admitted to our ICU from 1992 to 2012 were studied. Patients’ characteristics, transplant variables and prognosis were evaluated and data were analyzed to identify factors of outcome. Over the study period 13 men and 3 women, (26.2 % of renal transplant recipients requiring ICU admission) aged 45.4±10 years, were included in the study. APACHE II and SOFA scores on ICU admission were 17.8±4.6 and 8.4±3.6 respectively.

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The purpose of this study (prospective one year study of all patients requiring a central line) is to present central line colonization, central line infection, central line-associated and catheter-related bloodstream infection rates, risk factors, and the outcomes in a multidisciplinary Greek pediatric intensive care unit.

81 patients required 136 episodes of catheterization with duration of 9 (5.25-14.75) days. Device utilization ratio was 0.8. Eleven patients developed 17 episodes of central line-associated blood-stream infection (CLABSI) in 1629 catheter days, given a CLABSI rate of 10.43:1000. 3 catheter tip cultures revealed the same microorganism as the bloodstream infection (BSI), specified a catheter-related (CRBSI) rate of 1.84:1000. Catheter tip infection occurred at a rate of 3.69:1000, whereas catheter colonization at 8.59:1000. Gram-positive microorganisms predominated in CLABSIs (52.94%), whilst Gram-negative pathogens predominated in colonization (64.28%), infection (66.66%), and CRBSI (66.66%), Acinetobacter baumanii being the principal pathogen. CLABSI patients had longer duration (days) of catheterization (17 vs 9, P=0.014), mechanical ventilation (17 vs 8, P=0.014), and unit stay (17 vs 10, P=0.037), without an impact on mortality. CLABSIs occurred more often in patients with Hickman catheters (P=0.003), co morbidities (P=0.000), multiple catheterizations (P=0.003), complications (P=0.008) and corticosteroid use (P=0.044). Hickman catheters [odds ratio (OR) 8.381; 95% confidence intervals (CI): 1.1-66.1, P=0.044]and co morbidities [OR: 5.904; 95% CI: 1.2-28.9, P=0.029)] were independent predictors of CLABSIs.

CLABSI rate in our study is higher than the international standards. Preventive measures, such as improvements in central line insertion and maintenance bundles of care, are necessary, to lower this baseline rate in future comparisons.

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Factors affecting cardiac function in dialysis patients include arterial blood pressure, anemia, intra-vascular volume and the arteriovenous fistula (AVF). We investigated the acute and chronic effects of basilic vein transposition (mean upper arm brachial artery-basilic vein anastomosis) on both the cardiovascular system and the oxygen status.

Sixteen patients with end stage renal failure were enrolled in this study. Patients with heart failure, pericardial effusion or valvular heart disease were not included in the study. Echocardiography (preoperatively and six months after, stages 1 and 2 respectively) and a Swan-Ganz catheter (perioperatively) were used to assess the hemodynamic status during the phases of AVF construction. Flow measurements were made in the parts of the AVF system before, during and after the construction of the AVF.Moreover, at the same time phases blood sampling from the arterial line and the pulmonary artery catheter was performed, in order to assess oxygen and acidbase status.

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The study compares the efficacy of postoperative analgesia after the intravenous administration of opioids (nalbuphine, tramadol or morphine) in combination with ketamine in patients undergoing radical prostatectomy.Eighty eight patients scheduled for radical prostatectomy were randomly assigned in three groups. In Group A (n=31) Morphine was administered {bolus dose (BD) 0.05mg/Kg and continuous infusion (CI) at a dose [mg/24h =18-(agex0.15)]}, in Group B (n=28) Nalbuphine (BD 0.2mg/kg and CI at a rate 0.05mg/kg/h) and in Group C (n=29) Tramadol (BD 1.5mg/Kg and CI at a rate 0.15mg/Kg/h).

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The goal of this observesional study was to evaluate the improvement of the visual view of the la-rynx in neonates, infants and children with difficult airway using the Airtraq® Optical Laryngosco-pe, compared with visual views of the first conventional laryngoscopy with Macintosh blade. We studied clinical and/or laryngoscopic manifestations of difficult airway and advanced airway mana-gement of nine consecutive pediatric patients (2 neonates, 5 infants and 2 children) admitted from 1/1/2011 to 31/08/2012 for elective/emergency surgery or diagnostic procedure under general anes-thesia.

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