The health related quality of life of Greek patients with chronic obstructive pulmonary disease

SUMMARY.Background: Chronic Obstructive Pulmonary Disease (COPD) is an advancing disease, characterized by progressive deterioration of lung function. The impact of the disease on human health is massive and it affects the health related quality of life (HRQoL) of patients in every aspect. This study assessed HRQoL of Greek patients with COPD and its association with demographic and clinical factors, and compared the findings with with those of COPD studies in other countries. In addition, the cost of pharmaceutical treatment of these patients was assessed. Material and methods: The study group consisted of 136 Greek patients with COPD (103 men, mean age 64.7±9.2 years, mean FEV1 59±25.6% predicted).I Information was recorded about their demographic and clinical parameters. Their HRQoL was assessed using the Greek versions of the Medical Outcomes Study Short Form 12 (SF-12) and St George’s Respiratory Questionnaire (SGRQ). Results: The HRQoL of Greek patients with COPD was found to be significantly lower than both that in the general population and that of patients COPD reported in other countries. Almost all the HRQoL scores were shown to be associated with gender, educational and financial status, duration of symptoms, age at onset of symptoms, pack-years of cigarettes smoked, disease stage, degree of dyspnoea, pO2 and pCO2 levels, numbers of medical visits and hospital admissions, participation in rehabilitation programmes, and co-morbidities, such as cardiovascular disease and diabetes mellitus (DM). The average cost of pharmaceutical treatment was assessed at 110 ± 63 € / month and was associated with the stage of the disease, the smoking habit, the degree of dyspnoea, annual numbers of medical visits and admissions and nebulizer usage. Conclusions: The HRQoL of Greek patients with COPD is influenced by multiple parameters, which should all be taken into consideration when their treatment is being planned. Cost-effective studies should be made on populations of Greek patients with COPD and more emphasis should be placed on rehabilitation programmes in Greece. Pneumon 2013, 26(2):139-151

Burkitt lymphoma of the ovaries mimicking sepsis: a case report and review of the literature

Abstract Background It is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility. Case presentation We present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock – multiple organ failure as a result of a suspected gynecological infection of the ovaries. An immediate improvement of her clinical condition in combination with strong clinical suspicion and negative cultures led to the differential diagnosis of diseases other than sepsis. Based on the results of the biopsies that were obtained by research laparotomy, our patient suffered from primary Burkitt ovarian lymphoma. Her clinical condition improved with supportive treatment and chemotherapy. Chemotherapy is the dominant treatment for Burkitt’s lymphoma, while surgery or radiotherapy has no place. Conclusions All intensivists should be aware of clinical conditions that mimic sepsis as early diagnosis can lead to appropriate therapy and avoid unnecessary diagnostic tests and antibiotic abuse