Quality of life in adults with cystic fibrosis: the Greek experience

INTRODUCTION: Recent developments in treatment have steadily raised the median predicted age of survival for people with Cystic Fibrosis (CF). We report the health-related quality of life (HRQoL) in CF adult patients and correlate our findings with the patients’ demographic characteristics. MATERIAL AND METHODS: The Cystic Fibrosis Quality of Life (CFQoL) questionnaire was answered by 77 CF adult patients. The questionnaire included questions pertaining to age, sex and level of education and covered eight sections of functioning. RESULTS: The highest score was reported in the “Social Functioning” section, while the lowest in the “Concerns for the Future” section. When different age groups were compared, statistical significances were reported in “Physical Functioning”, “Interpersonal Relationships”, and the “Career Concerns” section, with older patients reporting statistically higher HRQoL scores than younger ones (p < 0.005). No statistically significant difference was reported amongst the scoring between male and female CF patients. When different educational levels were compared, patients that had received a higher educational training scored statistically higher in all but one sections of the questionnaire when compared with patients of a lower educational level (p < 0.005). CONCLUSION: More than half Greek adult CF patients report that they are capable to participate in social activities but most of them are worried about the outcome of their disease and its effect on their lives.INTRODUCTION: Recent developments in treatment have steadily raised the median predicted age of survival for people with Cystic Fibrosis (CF). We report the health-related quality of life (HRQoL) in CF adult patients and correlate our findings with the patients’ demographic characteristics. MATERIAL AND METHODS: The Cystic Fibrosis Quality of Life (CFQoL) questionnaire was answered by 77 CF adult patients. The questionnaire included questions pertaining to age, sex and level of education and covered eight sections of functioning. RESULTS: The highest score was reported in the “Social Functioning” section, while the lowest in the “Concerns for the Future” section. When different age groups were compared, statistical significances were reported in “Physical Functioning”, “Interpersonal Relationships”, and the “Career Concerns” section, with older patients reporting statistically higher HRQoL scores than younger ones (p < 0.005). No statistically significant difference was reported amongst the scoring between male and female CF patients. When different educational levels were compared, patients that had received a higher educational training scored statistically higher in all but one sections of the questionnaire when compared with patients of a lower educational level (p < 0.005). CONCLUSION: More than half Greek adult CF patients report that they are capable to participate in social activities but most of them are worried about the outcome of their disease and its effect on their lives

Kardiopulmonalno oživljavanje: povijesni pregled od početka do kraja XIX. stoljeća

Social laws and religious beliefs throughout history underscore the leaps and bounds that the science of resuscitation has achieved from ancient times until today. The effort to resuscitate victims goes back to ancient history, where death was considered a special form of sleep or an act of God. Biblical accounts of resuscitation attempts are numerous. Resuscitation in the Middle Ages was forbidden, but later during Renaissance, any prohibition against performing cardiopulmonary resuscitation (CPR) was challenged, which finally led to the Enlightenment, where scholars attempted to scientifically solve the problem of sudden death. It was then that the various components of CPR (ventilation, circulation, electricity, and organization of emergency medical services) began to take shape. The 19th century gave way to hallmarks both in the ventilatory support (intubation innovations and the artificial respirator) and the open- and closed chest circulatory support. Meanwhile, novel defibrillation techniques had been employed and ventricular fibrillation described. The groundbreaking discoveries of the 20th century finally led to the scientific framework of CPR. In 1960, mouth-to-mouth resuscitation was eventually combined with chest compression and defibrillation to become CPR as we now know it. This review presents the scientific milestones behind one of medicine’s most widely used fields.Društveni zakoni i religijska vjerovanja tijekom povijesti ogledalo su skokovitog razvoja znanosti oživljavanja od starine do danas. Pokušaji oživljavanja idu daleko u povijest, kada se smrt smatrala posebnim oblikom sna, odnosno Božjom voljom. Brojni su biblijski primjeri pokušaja oživljavanja. U srednjem je vijeku, međutim, oživljavanje bilo zabranjeno da bi posloje u renesansi takve zabrane kardiopulmonalnog oživljavanja bile stavljene pod pitanje te da bi konačno u doba prosvjetiteljstva znanstvenici pokušali riješiti problem nagle smrti. Upravo su se u to doba prvi put osvijestili različiti dijelovi kardiopulmonalnog oživljavanja poput ventilacije, cirkulacije, struje i organizacije hitnih službi. U XIX. se stoljeću naglo razvila ventilacijska potpora (inovacijama u intubaciji i umjetnim plućima) te potpora za otvorenu i zatvorenu cirkulaciju u prsnom košu. U međuvremenu su se razvile nove tehnike defibrilacije te je opisana ventrikulska fibrilacija. Dvadeseto stoljeće pak donosi važna otkrića koja su napokon dala znanstveni okvir kardiopulmonalnom oživljavanju. Godine 1960. sjedinjeni su disanje usta na usta s kompresijom prsnog koša i defibrilacijom, tj. onim što danas smatramo kardiopulmonalnim oživljavanjem. Ovaj se pregled osvrće na najvažnija mjesta u povijesti razvoja jednoga od najviše korišteni polja medicine

Lipemic serum in hyperlipidemic pancreatitis

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Hypoxia/reoxygenation-induced myocardial lesions in newborn piglets are related to interindividual variability and not to oxygen concentration

OBJECTIVE: Evaluation of myocardial histological changes in an experimental animal model of neonatal hypoxiareoxygenation. METHODS: Normocapnic hypoxia was induced in 40 male Landrace/Large White piglets. Reoxygenation was initiated when the animals developed bradycardia (HR <60 beats/min) or severe hypotension (MAP <15 mmHg). The animals were divided into four groups based on the oxygen (O2) concentration used for reoxygenation; groups 1, 2, 3, and 4 received 18%, 21%, 40%, and 100% O2, respectively. The animals were further classified into five groups based on the time required for reoxygenation: A: fast recovery (<15 min); B: medium recovery (15-45 min); C: slow recovery (45-90 min); D: very slow recovery (>90 min), and E: nine deceased piglets. RESULTS: Histology revealed changes in all heart specimens. Interstitial edema, a wavy arrangement, hypereosinophilia and coagulative necrosis of cardiomyocytes were observed frequently. No differences in the incidence of changes were observed among groups 1-4, whereas marked differences regarding the frequency and the degree of changes were found among groups A-E. Coagulative necrosis was correlated with increased recovery time: this condition was detected post-asphyxia in 14%, 57%, and 100% of piglets with fast, medium, and slow or very slow recovery rates, respectively. CONCLUSIONS: The significant myocardial histological changes observed suggest that this experimental model might be a reliable model for investigating human neonatal cardiac hypoxia-related injury. No correlation was observed between the severity of histological changes and the fiO2 used during reoxygenation. Severe myocardial changes correlated strictly with recovery time, suggesting an unreported individual susceptibility of myocardiocytes to hypoxia, possibly leading to death after the typical time-sequence of events

Kardiopulmonalno oživljavanje: povijesni pregled od početka do kraja XIX. stoljeća

Social laws and religious beliefs throughout history underscore the leaps and bounds that the science of resuscitation has achieved from ancient times until today. The effort to resuscitate victims goes back to ancient history, where death was considered a special form of sleep or an act of God. Biblical accounts of resuscitation attempts are numerous. Resuscitation in the Middle Ages was forbidden, but later during Renaissance, any prohibition against performing cardiopulmonary resuscitation (CPR) was challenged, which finally led to the Enlightenment, where scholars attempted to scientifically solve the problem of sudden death. It was then that the various components of CPR (ventilation, circulation, electricity, and organization of emergency medical services) began to take shape. The 19th century gave way to hallmarks both in the ventilatory support (intubation innovations and the artificial respirator) and the open- and closed chest circulatory support. Meanwhile, novel defibrillation techniques had been employed and ventricular fibrillation described. The groundbreaking discoveries of the 20th century finally led to the scientific framework of CPR. In 1960, mouth-to-mouth resuscitation was eventually combined with chest compression and defibrillation to become CPR as we now know it. This review presents the scientific milestones behind one of medicine’s most widely used fields.Društveni zakoni i religijska vjerovanja tijekom povijesti ogledalo su skokovitog razvoja znanosti oživljavanja od starine do danas. Pokušaji oživljavanja idu daleko u povijest, kada se smrt smatrala posebnim oblikom sna, odnosno Božjom voljom. Brojni su biblijski primjeri pokušaja oživljavanja. U srednjem je vijeku, međutim, oživljavanje bilo zabranjeno da bi posloje u renesansi takve zabrane kardiopulmonalnog oživljavanja bile stavljene pod pitanje te da bi konačno u doba prosvjetiteljstva znanstvenici pokušali riješiti problem nagle smrti. Upravo su se u to doba prvi put osvijestili različiti dijelovi kardiopulmonalnog oživljavanja poput ventilacije, cirkulacije, struje i organizacije hitnih službi. U XIX. se stoljeću naglo razvila ventilacijska potpora (inovacijama u intubaciji i umjetnim plućima) te potpora za otvorenu i zatvorenu cirkulaciju u prsnom košu. U međuvremenu su se razvile nove tehnike defibrilacije te je opisana ventrikulska fibrilacija. Dvadeseto stoljeće pak donosi važna otkrića koja su napokon dala znanstveni okvir kardiopulmonalnom oživljavanju. Godine 1960. sjedinjeni su disanje usta na usta s kompresijom prsnog koša i defibrilacijom, tj. onim što danas smatramo kardiopulmonalnim oživljavanjem. Ovaj se pregled osvrće na najvažnija mjesta u povijesti razvoja jednoga od najviše korišteni polja medicine

Primary Congenital Coronary Artery Anomalies: An Angiographic Study in Greece

Abstract Background: Primary congenital coronary anomalies are anatomical variations of the origin, course and termination of coronary arteries, which are not associated with complex congenital heart disease. In Greece, apart from some case reports, there are no published data. Thus, the aim of this study was to assess the prevalence of the different forms of primary coronary artery anomalies in a Greek adult population. Methods: 5051 coronary arteriographies obtained from January 2008 to December 2010 were retrospectively analyzed. Coronary anomalies were classified according to the criteria proposed by Angelini and coworkers as anomalies of origin and course, anomalies of intrinsic coronary anatomy, and anomalies of termination. Results: 123 variations of coronary artery anatomy (incidence 2.44%) were identified. Of these, 76 (61.8%) patients had anomalous origin and course, 25 (20.3%) patients had ectasias, 14 (11.4%) patients had myocardial bridging, and 8 (6.5%) patients had small coronary fistulas. The most common anomalies observed were the separate origin of the left anterior descending (LAD) and left circumflex (LCx) coronary arteries, the ectopic right coronary artery (RCA) and the anomalous LCx from the opposite sinus. Conclusions: The incidence of primary congenital anomalies in Greece is similar to that reported in other populations. Congenital coronary anomalies do not predispose to accelerated atherosclerosis of the anomalous vessel. Although the majority of coronary anomalies were not associated with symptoms and were detected incedentaly during coronary angiography, awareness of these anatomical variants is clinically important for the appropriate management of cardiac patients