Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic

Background: Human papillomavirus (HPV) infection is a causative factor for cervical cancer. Early detection of high risk HPV types might help to identify women at high risk of cervical cancer. The aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynecological outpatient clinic and to explore the determinants of the infection.Methods: A total of 225 women were studied. All women underwent a regular gynecological control. 35 HPV types were studied; 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 62, 66, 68, 70, 71, 72, 73, 81, 82, 83, 84, 85 and 89. Also, basic demographic information, sociodemographic characteristics and sexual behavior were recorded.Results: HPV was detected in 22.7% of the study population. The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). 66.2% of the study participants had a Pap test during the last year without any abnormalities. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P = 0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P < 0.001), and negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P = 0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P = 0.01).Conclusion: The prevalence of HPV in women attending an outpatient clinic is high. Number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income

Allocation of nursing time

The purpose of the study was to examine the allocation of nursing time to various activities of registered and assistant nurses during the day shift. Twenty-three registered (RN) and eighteen assistant nurses (AN) working in medical and surgical wards of five large hospitals were studied. The findings have shown that the most frequent activities performed were: indirect care representing 35.6% of the time, direct care representing 23.8% of the time, personal activities representing 16.8% of the time, and direct nursing interventions representing 8.2% of the time. Cross-tabulation revealed that RNs provided direct care less frequently and indirect care more frequently than ANs (25.3 activities per RN and 27.5 per AN, 62.1 activities per RN and 32.6 per AN, respectively). Many indirect care activities were found to be the responsibility of the head nurse (64), secretary (465), and others (104). Less expected results were the minimal amounts of time spent on both education and research activities (1.3% and 0.0% respectively). Nurse managers have to free nurses from subsidiary work and to find mechanisms to distribute nursing valuable time more efficiently

Current evidence on the associations of breastfeeding, infant formula, and cow&apos;s milk introduction with type 1 diabetes mellitus: A systematic review

Current evidence provides contradictory results in regards to the associations of breastfeeding or early introduction of cow&apos;s milk and formula with the development of type 1 diabetes (T1D). The aim of this systematic review was to evaluate the type of feeding, duration of breastfeeding, time of introduction of formula or cow&apos;s milk, and the potential impact on developing T1D. The literature search was conducted based on the standards outlined in the MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies and yielded a total of 161 studies, 28 of which were included in this review. Twenty seven of the included studies were case-control and one was a prospective cohort study. Eight of the studies indicated breastfeeding has a protective role against the development of T1D. Seven additional studies emphasized that a short period or absence of breastfeeding could be a risk factor for T1D development. The results of this systematic review indicate a short duration and/or a lack of breastfeeding may constitute a risk factor for the development of T1D later in life. © 2012 International Life Sciences Institute

Square-Wave Ocular Oscillation and Ataxia in an Anti-GAD-Positive Individual with Hypothyroidism

Cerebellar ataxia is an uncommon manifestation of hypothyroidism with unknown pathomechanism. The few descriptions of the clinical phenotype range from limb, gait, and trunk ataxia to various ocular motor abnormalities. We evaluated a 62-year-old woman with previously undetected severe hypothyroidism who presented with prominent saccadic intrusions and gait ataxia. She had high titers of antithyroid autoantibodies and anti-glutamic acid decarboxylase (anti-GAD) antibodies. Horizontal eye movement recordings revealed a series of nearly continuous pseudoharmonic square wave jerks (SWJs) constituting a square wave oscillation. Amplitudes reached maximum values of about 4, and wave frequency approached 100 cycles per minute. Thyroxine substitution and corticosteroid administration had little effect on SWJ parameters. The square wave oscillation nearly completely resolved after a single treatment session with intravenous immunoglobulin suggesting a causal link between an autoimmune process and the cerebellar dysfunction. Current concepts of the genesis of saccadic intrusions favor a role for anti-GAD antibodies in the etiology of SWJs. © 2015 by North American Neuro-Ophthalmology Society

Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?

Background: The effect of preoperative education on anxiety and postoperative outcomes of cardiac surgery patients remains unclear. Aim: The aim of the study was to estimate the effectiveness of a nurse-led preoperative education on anxiety and postoperative outcomes. Methods: A randomised controlled study was designed. All the patients who were admitted for elective cardiac surgery in a general hospital in Athens with knowledge of the Greek language were eligible to take part in the study. Patients in the intervention group received preoperative education by specially trained nurses. The control group received the standard information by the ward personnel. Measurements of anxiety were conducted on admission-A, before surgery-B and before discharge-C by the state-trait anxiety inventory. Results: The sample consisted of 395 patients (intervention group: 205, control group: 190). The state anxiety on the day before surgery decreased only in the intervention group (34.0 (8.4) versus 36.9 (10.7); P=0.001). The mean decrease in state score during the follow-up period was greater in the intervention group (P=0.001). No significant difference was found in the length of stay or readmission. Lower proportions of chest infection were found in the intervention group (10 (5.3) versus 1 (0.5); P=0.004). Multivariate linear regression revealed that education and score in trait anxiety scale on admission are independent predictors of a reduction in state anxiety. Conclusion: Preoperative education delivered by nurses reduced anxiety and postoperative complications of patients undergoing cardiac surgery, but it was not effective in reducing readmissions or length of stay. © European Society of Cardiology

Risk factors for prolonged stay in cardiac surgery intensive care units

Aims and objectives: To identify the factors that might affect the length of stay in the intensive care unit (ICU-LOS) among cardiac surgery patients. Background: ICU-LOS forms an important factor for assessing the effectiveness of the provided nursing care. A number of factors can be accused for increasing patient hospitalization. The nursing workload (NWL), among others, was found to play a significant role as it is closely associated with the quality of care. Design: An observational cohort study among 313 consecutive patients who were admitted to the cardiac surgery intensive care unit of a general, tertiary hospital of Athens, Greece from November 2008 to November 2009. Methods: Data collection was performed by using a short questionnaire (for basic demographic information) and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE, for assessing the NWL and the perioperative risk for each patient respectively. Results: ICU-LOS of more than 2 days increased with age and was more common among females (p &lt; 0·001 and p = 0·02, respectively). Multivariate logistic regression analysis revealed a positive association between increased perioperative risk and the increased ICU-LOS [odd ratio (OR) 1·9, 95% confidence interval (CI) 1·0–3·5, p = 0·04], while patients with a first day NAS of more than 61·6% had an almost 5·2 times greater probability to stay in the cardiac surgery unit for more than 2 days (OR 5·2, 95% CI 3·0–8·8, p &lt; 0·001). Conclusions: Increased level of NWL and patient perioperative risk are closely associated with increased ICU-LOS. Relevance to clinical practice: The correlation between patient perioperative risk and ICU-LOS encourages the early identification of high-risk patients for prolonged hospitalization. Furthermore, the relationship between NWL and ICU-LOS allows the early identification of these patients with the use of an independent nursing tool. © 2011 The Authors. Nursing in Critical Care and 2011 British Association of Critical Care Nurses

Knowledge and beliefs about pregnancy issues among women with inflammatory bowel disease in reproductive age

Introduction: Inflammatory bowel disease (IBD) affects women in reproductive age. Knowledge level and beliefs about pregnancy issues need to be assessed among women who desire to become pregnant. Purpose: The purpose of this study was to investigate the knowledge and beliefs of women in reproductive age who suffer from IBD in reproductive issues. Material and Method: The study was conducted from February to September 2016 with convenience sampling at a hospital of Athens. The study included from 82 women. 54.9% of patients suffered from Crohn&apos;s disease, and 45.1% from ulcerative colitis. Disease-related pregnancy knowledge was assessed using Crohn&apos;s and Colitis Pregnancy Knowledge Score (CCPKnow) and pregnancy beliefs with a structured tool consisting of 23 questions suitably formed for the purpose of this study. Τ-test and anova were performed and the level of statistical significance was set at p-value≤0.05. Results: Knowledge levels were low, adequate, good and very good at 63.4%, 22%, 11% and 3.7% respectively. The main knowledge deficient referred to fertility statements with 64.7% answering incorrectly to all ques-tions. About 41.5% of the participants answered correctly at least 2 of the 5 medication related questions and 40.2% were ignorant about disease inheritance. Highest CCPKnow scores were associated with higher education level (tertiary 7.37 vs secondary 5.08, p &lt;0.05) and use of biological agents (6.86 vs 4.69, p &lt;0.05). About 60,9% disagreed with the statement that a woman was less probably to conceive because of IBD. High percentage believed that it is important to get any medication if she has a flare when she is trying to become pregnant or when she is pregnant (75.5%, 78% respectively). 59.7% believed that medications which maintain remission should be continued during pregnancy. About 64.6% of women stated that breast feeding should be avoided under specific medications. Over 80% seemed to be worried about the effect of IBD on pregnancy and inheritance of disease. Lower CCPKnow scores correlated with beliefs that a woman should stop all medication or every IBD medication when she tries to get pregnant, or endure the symptoms to protect the unborn, and also with belief that breast feeding is forbidden even if woman does not take any IBD medication (p&lt;0,05). Conclusions: Most participants had poor knowledge level on IBD pregnancy-related issues. Beliefs about pregnancy influenced the overall knowledge score. Educating women of childbearing age may alleviate the lack of knowledge and beliefs of women who wish to be pregnant. © 2019, Hellenic Nurses Association. All rights reserved