Factors affecting parental satisfaction in the neonatal intensive care unit

Purpose: To evaluate possible parental satisfaction indicators, concerning the Neonatal Intensive Care Unit (NICU), which are related to sociodemographic variables. Design: Non-experimental design using a validated parental satisfaction questionnaire. The sample consisted of 550 parents (297 mothers, 253 fathers) whose infants were hospitalized in two Neonatal Intensive Care Units (NICU) in Greece. The parents completed the questionnaire on the day of discharge. Results: Younger Greek women, with basic education level, who live in rural areas and whose infant's length of stay was short, expressed higher levels of satisfaction. Conclusion: The parents' sex and the duration of the infant's hospitalization are the most significant factors affecting parental satisfaction. Background factors should be considered when evaluating parental satisfaction. © 2011 Neonatal Nurses Association

Helicobacter pylori infection as an environmental risk factor for migraine without aura

Helicobacter pylori (H. pylori) infection has recently been associated with various extraintestinal pathologies and migraine. The aim of this study was to investigate the correlation of the H. pylori infection with the pathogenesis of migraine without aura, especially in cases not affected by endogenous risk factors, like hereditary pattern or hormonal fluctuations. A total of 49 outpatients (37 females and 12 males; age range: 19-47 years; mean age: 31,±14 years) affected by migraine without aura was evaluated. We divided them in 2 subgroups: a) with positive familial history, and/or with menstrual type of migraine b) with negative familial history and with menstrual unrelated type of migraine. H. pylori infection was diagnosed by the 13 C- urea breath test (INFAI - test). Control subjects consisted of 51 patients without any primary headache history (38 females; mean age of 32,±14,4 years; range 21-49 years), who underwent upper gastrointestinal (GI) endoscopy for investigation of anaemia or non ulcer dyspepsia. H. pylori detection was based on the histologic analysis of gastric mucosa biopsy. The prevalence of H. pylori infection was significantly higher in the migraineurs without aura compared to controls (p = 0.016). The prevalence of H. pylori infection was significantly high in the mixed and in the female group of our patients without other predisposing factors for migraine without aura (81 and 87% respectively), while in the same groups with predisposing factors (menstruation and/or family history) the prevalence was only 36 and 37% respectively (p = 0,001 for the first group and p = 0,002 for the second group). Our results seem to highlight the role of H. pylori infection as a probable independent environmental risk factor for migraine without aura, especially in patients that are not genetically or hormonally susceptible to migraine. © Springer-Verlag Italia 2007

Palliative gastrectomy and other factors affecting overall survival in stage IV gastric adenocarcinoma patients receiving chemotherapy: A retrospective analysis

Objective: Most patients with gastric cancer present with locally advanced or metastatic disease and usually receive palliative therapy. We sought to identify factors influencing overall survival in patients with stage IV gastric cancer receiving palliative chemotherapy. Patients and methods: The records of 311 patients with histological diagnosis of gastric adenocarcinoma were retrospectively reviewed and 17 clinicopathological and therapeutic parameters were evaluated for their influence on overall survival. Results: In multivariate analysis nine factors were found to independently influence survival: no previous palliative gastrectomy [Hazard ratio (HR, 12; CI 7.969-18.099)], single agent chemotherapy instead of combination chemotherapy (HR, 1.35; CI 1.068-1.721), histological grade III (HR, 1.39; 95% CI 1.098-1.782), the presence of hepatic (HR, 1.6; 95% CI 1.246-2.073) and abdominal metastasis (HR, 1.33; 95% CI 1.039-1.715), CA 72-4 > 7 U/L (HR, 1.39; 95% CI 1.026-1.887), LDH > 225 U/L (HR, 1.72; 95% CI 1.336-2.236], need for blood transfusions (HR, 1.58; 95% CI 1.213-2.082), and weight loss > 5% (HR, 1.96; 95% CI 1.352-2.853) at the time of initial diagnosis. Patients were stratified as low (0-2 factors), intermediate (3-6 factors) and high (7-9 factors) risk and the median survival was 76, 40 and 11 weeks, respectively. Conclusion: Nine clinical and laboratory factors that adversely affect survival in patients with stage IV gastric cancer who receive chemotherapy were identified. Their concurrent presence seems to have an additive effect as patients with seven to nine factors have the worse prognosis. Palliative gastrectomy and combination chemotherapy appear to be associated with improved survival. © 2010 Elsevier B.V. All rights reserved