Επίπεδο πληροφόρησης και ικανοποίησης ασθενών για την μετάγγιση

Εισαγωγή: Η μετάγγιση αποτελεί μια πολύ συχνή ιατρική πρακτική στο νοσοκομειακό περιβάλλον. Τα οφέλη, οι κίνδυνοι και οι εναλλακτικές λύσεις για τις μεταγγίσεις αίματος δεν είναι πάντοτε γνωστά στους ασθενείς. Σκοπός: Σκοπός αυτής της μελέτης ήταν να διερευνήσει το επίπεδο και την ποιότητα των πληροφοριών που παρέχονται στους ασθενείς που χρήζουν μετάγγισης αίματος και προϊόντων του. Επίσης να ερευνηθεί το πόσο ικανοποιημένοι είναι από την πληροφόρηση και την διαδικασία της μετάγγισης, καθώς και τι προτείνουν οι ίδιοι για να νιώσουν περισσότερο ασφαλείς-ικανοποιημένοι. Υλικό-Μέθοδος: Η έρευνα πραγματοποιήθηκε σε ένα δημόσιο νοσοκομείο της Αθήνας, στους ασθενείς του Γ.Ν.Ν.Θ.Α. «Η ΣΩΤΗΡΙΑ». Το δείγμα αποτέλεσαν 178 ασθενείς, οι οποίοι μεταγγίστηκαν με συμπυκνωμένα ερυθρά (ΣΕ), την περίοδο από τον Μάιο του 2018 έως τον Αύγουστο του 2018. Τους χορηγήθηκε ερωτηματολόγιο μέτρησης επιπέδου πληροφόρησης και βαθμού ικανοποίησης. Για την ανάλυση των δεδομένων χρησιμοποιήθηκε περιγραφική και επαγωγική στατιστική. Αποτελέσματα: Τα αποτελέσματα της έρευνας έδειξαν ότι υπάρχει σημαντική συσχέτιση μεταξύ των μεταβλητών της ικανοποίησης από τη διαδικασία της μετάγγισης και την ενημέρωση τους σχετικά με αυτή, παρατηρήθηκε στατιστικώς σημαντική σχέση θετικής κατεύθυνσης και μάλιστα αρκετά ισχυρή. Όσο περισσότερο αυξάνεται το επίπεδο ενημέρωσης των ασθενών τόσο περισσότερο αναμένεται να αυξάνεται η ικανοποίηση τους και αντίστροφα. Τα αποτελέσματα δείχνουν στατιστικά σημαντικές διαφορές, ανάλογα με την κλινική στην οποία νοσηλεύονται οι ασθενείς, όσον αφορά το επίπεδο ενημέρωσης και ικανοποίησης. Παρατηρήθηκε επίσης ότι το επίπεδο ενημέρωσης όσο και το επίπεδο ικανοποίησης φαίνεται να σχετίζονται με το εκπαιδευτικό επίπεδο, τον αριθμό προηγούμενων μεταγγίσεων και την ηλικία τους. Συμπεράσματα: Οι ασθενείς επιθυμούν περισσότερη ενημέρωση για να νιώσουν πιο ασφαλείς-ικανοποιημένοι από τη διαδικασία της μετάγγισης, οι προτάσεις τους σκιαγραφούν αυτή την ανάγκη. Ωστόσο περαιτέρω έρευνα κρίνεται απαραίτητη.Introduction: Transfusion is a very common medical practice during hospitalization. The benefits, risks and alternatives to blood transfusions are not always known to patients. Purpose: The purpose of this study was to examine the level and quality of information provided to patients requiring blood transfusion and its components. Also examine how satisfied they are with the information and the transfusion process, and what they propose to feel more safe-satisfied. Material-Method: The research was carried out in a public hospital in Athens, called "SOTIRIA" hospital. The sample consisted of 178 patients, which were transfused with concentrated red blood cells during (RBC) the period from May 2018 to August 2018. They received a questionnaire measuring the level of information and satisfaction. Descriptive and inductive statistics were used to analyze the data. Results: The results of the research showed that there is a significant correlation between the variables of the satisfaction of the transfusion process and their updating, there was a statistically significant relationship of positive direction and quite strong. The higher the level of patient information is, the more it is expected to increase their satisfaction and vice versa. The results show statistically significant differences, depending on the clinic in which the patients are treated, in terms of the level of information and satisfaction. It was also noticed that the level of information and level of satisfaction appear to be related to the educational level, the number of previous transfusions and their age. Conclusions: Patients want more information to feel safer-satisfied with the transfusion process, their suggestions outline this need. However, further research is needed

Clarithromycin Enhances the Antibacterial Activity and Wound Healing Capacity in Type 2 Diabetes Mellitus by Increasing LL-37 Load on Neutrophil Extracellular Traps

Background: Type 2 diabetes mellitus (T2D) is characterized by susceptibility to bacterial infections and impaired wound healing. Neutrophil extracellular traps (NETs) and the cathelicidin antimicrobial peptide LL-37 have been implicated both in defense against bacterial infections and in wound healing process. Recently, it was shown that macrolide antibiotic clarithromycin induces the release of LL-37-bearing NETs. In T2D there has not been identified any link between NETs and LL-37 and the effect of clarithromycin in neutrophils/NETs is unknown yet.Methods: Peripheral blood neutrophils were obtained from treatment-naive hyperglycemic T2D patients (naive), normoglycemic T2D patients under antidiabetic treatment (well-controlled) and healthy donors (controls). NET release and NET proteins were studied. Co-culture systems of NET structures with E. coli NCTC 9001 and primary skin fibroblasts were deployed to examine the in vitro antibacterial and fibrotic NET properties, respectively. The effect of clarithromycin was also investigated. Analysis was performed using immunofluorescence confocal microscopy, myeloperoxidase-DNA complex and LL-37 ELISA, immunoblotting and qRT-PCR.Results: NETs were characterized by the presence of LL-37, however they lacked antibacterial activity, in both groups of T2D patients. Clarithromycin significantly increased the externalization of LL-37 on NETs generated from well-controlled T2D neutrophils, thus restoring NET antibacterial capacity and promoting the wound healing process via fibroblast activation and differentiation.Conclusion: This study suggests that clarithromycin may add further advantage to well-controlled T2D patients, by enhancing their antibacterial defense and improving wound healing capacity of fibroblasts, through upregulation of LL-37 on NET structures

Improved Text Emotion Prediction Using Combined Valence and Arousal Ordinal Classification

Emotion detection in textual data has received growing interest in recent years, as it is pivotal for developing empathetic human-computer interaction systems. This paper introduces a method for categorizing emotions from text, which acknowledges and differentiates between the diversified similarities and distinctions of various emotions. Initially, we establish a baseline by training a transformer-based model for standard emotion classification, achieving state-of-the-art performance. We argue that not all misclassifications are of the same importance, as there are perceptual similarities among emotional classes. We thus redefine the emotion labeling problem by shifting it from a traditional classification model to an ordinal classification one, where discrete emotions are arranged in a sequential order according to their valence levels. Finally, we propose a method that performs ordinal classification in the two-dimensional emotion space, considering both valence and arousal scales. The results show that our approach not only preserves high accuracy in emotion prediction but also significantly reduces the magnitude of errors in cases of misclassification

Gradient Infiltration of Neutrophil Extracellular Traps in Colon Cancer and Evidence for Their Involvement in Tumour Growth

<div><p>Background</p><p>The role of neutrophils in tumour biology is largely unresolved. Recently, independent studies indicated either neutrophil extracellular traps (NETs) or Tissue Factor (TF) involvement in cancer biology and associated thrombosis. However, their individual or combined role in colonic adenocarcinoma is still unexplored.</p><p>Methods</p><p>Colectomy tissue specimens and variable number of draining lymph nodes were obtained from ten patients with adenocarcinoma of the colon. NETs deposition and neutrophil presence as well as TF expression were examined by immunostaining. The effect of NETs on cancer cell growth was studied in <i>in vitro</i> co-cultures of Caco-2 cell line and acute myeloid leukemia primary cells. Proliferation and apoptosis/necrosis of cancer cells were analyzed by flow cytometry.</p><p>Results</p><p>TF-bearing NETs and neutrophil localization were prominent in tumour sections and the respective metastatic lymph nodes. Interestingly, neutrophil infiltration and NETs concentration were gradually reduced from the tumour mass to the distal margin. The <i>in vitro</i>-generated NETs impeded growth of cancer cell cultures by inducing apoptosis and/or inhibiting proliferation.</p><p>Conclusions</p><p>These data support further the role of neutrophils and NETs in cancer biology. We also suggest their involvement on cancer cell growth.</p></div

Neutrophil and NETs presence is diminished accordingly to the distance from the center of tumour.

<p>—Representative experiment where NETs and neutrophils were diminished at 3 cm from tumour mass. (A) Macroscopic photography of colectomy biopsy specimen for demonstration of successive section sampling. (B) Neutrophil elastase immunohistochemical staining in successive biopsy specimens from the center of tumour, up to 3–4 cm from the tumor mass in healthy tissue in patients with colon adenocarcinoma. (C) Neutrophil elastase and citrullinated H3 immunofluorescence staining in successive biopsy specimens from the center of tumour, up to 3–4 cm from the tumor mass in healthy tissue in patients with colon adenocarcinoma. Green: NE, Red: cit-H3, Blue: DAPI/DNA. (B),(C) One representative out of ten independent experiments is shown. Original magnification (B) 200x, (C) 600x, Scale bar– 5μm.</p

Presence of NETs and neutrophils in colon adenocarcinoma tumour and metastatic lymph nodes.

<p>(A) NETs visualized in colon adenocarcinoma specimens as extracellular structures decorated with neutrophil elastase and citrullinated H3 or neutrophil elastase and MPO, (confocal microscopy). (B) Abundance of neutrophil presence in colon adenocarcinoma demonstrated by neutrophil elastase immunohistochemical staining (light microscopy). Magnified section demonstrates neutrophils stained with neutrophil elastase. NETs (C) and neutrophil (D) presence in metastatic lymph nodes in patients with colon adenocarcinoma. (C) NE/cit-H3 and NE/MPO immunofluorescence confocal microscopy and (D) neutrophil elastase immunohistochemical staining. (A), (C) i-ii Green: NE, Red: cit-H3, Blue: DAPI/DNA, iii Green: MPO, Red: NE, Blue: DAPI/DNA (A), (B), (C), (D) One representative out of ten independent experiments is shown. (A), (C) Original magnification 600x, Scale bar– 5μm. Original magnification (B) 400x, (D) 200x.</p