Prevention of Cardiomyopathy in Transfusion-Dependent Homozygous Thalassaemia Today and the Role of Cardiac Magnetic Resonance Imaging

Transfusion and iron chelation therapy revolutionised survival and reduced morbidity in patients with transfusion-dependent beta thalassaemia major. Despite these improvements, cardiac disease remained the most common cause of death in those patients. Recently the ability to determine the degree of cardiac iron overload, through cardiac magnetic resonance imaging (CMR) has allowed more logical approaches to iron removal, particularly from the heart. The availability of two oral chelators, deferiprone and deferasirox has reduced the need for the injectable chelator deferrioxamine and an additional benefit has been that deferiprone has been shown to be more cardioprotective than deferrioxamine. This review on the prevention of cardiac disease makes recommendations on the chelation regime that would be desirable for patients according to their cardiac iron status as determined by CMR determined by CMR. It also discusses approaches to chelation management should CMR not be available

Measuring pain self-efficacy and health related quality of life among hemodialysis patients in Greece: a cross-sectional study

Patients suffering from end-stage kidney disease often complain about pain. It is also known that the presence of chronic pain greatly impacts upon patients’ quality of life (QOL) and can play a crucial role in the co-morbidity of mental health symptoms such as depression and anxiety. The main aim of this study protocol is the investigation of pain self-efficacy, QOL as well as their relation in patients undergoing hemodialysis treatment. The final sample size will be around 70-80 patients. Each subject’s QOL and pain self-efficacy will be measured using the following instruments: i) the Missoula-ITAS Quality of Life Index-15 and ii) the Pain Self-Efficacy Questionnaire. QOL is expected to be related to pain self-efficacy scores. This probable association will be indicated performing regression as well as correlation analysis after controlling for gender, age, education and marital status

Intravitreal Bevacizumab for Photodynamic Therapy-Induced Massive Macular Detachment in Acute Central Serous Chorioretinopathy

We present a long followed up case of acute central serous chorioretinopathy (CSC) complicated by a severe visual loss due to massive pigment epithelium detachment of the macula after a full-dose photodynamic therapy (PDT). Rapid anatomical and functional improvement was observed after a single intravitreal injection of bevacizumab. To our knowledge, we report the first case of PDT-treated CSC complicated by severe visual loss. We can only speculate that the serous detachment of the posterior pole might have been caused by PDT-induced VEGF overexpression, explaining such an impressive response to Avastin treatment

Fatigue and Quality of Life after Pulmonary Rehabilitation Program

BACKGROUND. Fatigue and poor quality of life can play an important role in chronic obstructive disease and treatment outcomes. The aim of this study was to examine the levels of fatigue and quality of life (QoL) among chronic obstructive pulmonary disease patients before and after a pulmonary rehabilitation program. METHODS. In this experimental study, 31 chronic obstructive pulmonary disease patients at a large hospital of Athens were randomly followed a pulmonary rehabilitation program and completed two questionnaires pre- and post-intervention:the Fatigue Assessment Scale designed for measuring fatigue and the Missoula -Vitas Quality of Life Index-15 designed for measuring QoL. Statistical analysis of the data was performed via the Statistical Program SPSS version 19.0.The statistical significance was set up at 0.05. RESULTS. The results showed decreased levels of fatigue after the completion of the Pulmonary Rehabilitation Program compared to pre -intervention. Moreover, although QoL did not seem to change after the intervention, however the dimension "Transcendent" seemed to be increased for the majority of the participants. After the participation in the rehabilitation program a statistically significant and negative correlation was observed between mental fatigue and total score of quality of life (r= -0.436, p=0.014 <0.05) as well as between physical fatigue and the dimensions of "Interpersonal" (r= -0.470 p=0.008),"Well-Being" (r= -0.615, p=0.000), "Transcendent" (r= -0.636, p=0.000) and total score of QoL (r= -0.543, p=0.002). CONCLUSIONS. A pulmonary rehabilitation program seems to be a successful and innovative clinical prevention program leading to a lower level of fatigue for those patients who suffer from chronic obstructive pulmonary disease

Predictors of anxiety and depressive symptoms among Greek nurses

Introduction: The increasing needs of an aging population and the shortage of nursing personnel have a negative impact on the workload of nurses increasing the risk of developing anxiety and depressive symptoms. This research aims to evaluate the strength of occupational and demographic characteristics in predicting anxiety and depression among nurses. Methods: In this cross-sectional study, a sample of 164 Greek nurses from three hospitals employed full-time participated. Anxiety and depression were measured using the validated Greek versions of the State-Trait Anxiety Inventory – State and Trait Y forms and the Centre for Epidemiological Studies Depression scale, respectively. The statistical analysis of the data was performed using the statistical program SPSS version 19.0. The statistical significance level was set up at 0.05. Results: Younger nurses, unmarried, those without children, those with less work experience, and working in the general medical units were more vulnerable. The average number of patients per nurse during the day shift may not predict anxiety or depression scores. Strong positive correlation between state and trait anxiety (r [162] = 0.77, p < 0.001), state anxiety and depression (r [162] = 0.62, p < 0.001), and trait anxiety and depression (r [162] = 0.63, p < 0.001) was revealed. Conclusion: Anxiety and depression are prevalent among nurses. Demographic and working characteristics are strong predictors of anxiety and depression among nurses. Nursing managers should emphasize emotional interventions (cognitive behavioral therapy, training on emotional intelligence, strengthening coping skills, and development of high resilience) in supporting nurses at higher risk

The Impact of Self-Reported Anxiety and Body Ιmage on Female Sexual Function

Over the past years, female sexual function and dysfunction has acquired a growing body of research. Some studies have indicated that links may exist among the sexual function of women, their body image and anxiety. The purpose of this study is to examine the direct impact of self-report anxiety and body image on female sexual function but also the potential association of the age, the marital status, the occupation, the education level and the existence of a psychological disorder diagnosis with the self-reported anxiety, the body-esteem and the female sexual function. The sample consisted of sixty women from general population. Three questionnaires were used to measure each variable (Greek version of Zung's Self Anxiety Scale, Body–Esteem Scale for Adolescents and Adults, Female Sexual Function Index GR). The results showed that the correlations among anxiety, body image and sexual function were not statistically significant. From the demographic characteristics, only occupation status was significantly associated with the sexual function which was found significantly greater for private employees compared to university students (p = .001), with the last’s total score in FSFI being below the cutoff point. This result is constant with previous researched which have found women University students at risk of experiencing a sexual dysfunction

The Effect of Biopsychosocial Variables in Fatigue in Patients with Hemoglobinopathies

Purpose: The purpose of the present study was to explore the biopsychosocial variables affecting fatigue in patients with hemoglobinopathies. Methods: 102 patients undergoing transfusion treatment from one hospital in Athens, Greece participated in the study. Fatigue was measured with the Multidimensional Fatigue Inventory (MFI), quality of life with the Euro5D thermometer as self-perceived health and psychological variables with the Depression, Anxiety and Stress Scale (DASS 21). Statistical analysis was performed with SPSS21. Results: 63 were females (61,4%) and 39 males (38,6%). The mean age of the sample was 41.7±9.2 years, while the majority of participants were patients with a diagnosis of homozygous ?-Thalassemia (81.4%). Multivariate analysis revealed 6 independent models for each dimension of fatigue, while every one of the five dimensions of MFI as well the total score of the inventory, revealed a different model of correlations with mixed variables, related with disease complications, adherence to treatment, sex, the self-perceived quality of life, as well as the qualitative characteristics of fatigue related with disease complications. Conclusions: Fatigue has been identified as a very common symptom in patients with thalassemia with many variables affecting it in this population. Our results broadens the evidence regarding fatigue in hemoglobinopathies and leads us to the need for distinguishing the etiologies leading to fatigue in hemoglobinopathies since it is an important factor affecting HPQoL. Longitudinal studies are needed in order to understand the path of fatigue and the factors influencing the condition