Assessment of the needs of individuals enrolled in a support program for the elderly

Introduction: The aging of our population is the scourge of modern times. Health care systems worldwide are faced with an increased demand for health services from elderly persons, and this underlines the need for new types of care such as home care. Objective: The purpose of the present study was to present a Support Program for senior citizens as it is implemented to date by the social services of the health insurance fund of a large Organization in the Athens area. The goals of our study were: to explore socio-economic needs, health problems of the elderly, support provided on an individual and on a family basis as well as health counseling. Sample and method: Collection of data began in early June 2004 at the Service Archives, these consisting of 109 files. The total number of beneficiaries/pensioners belonging to the insurance scheme of the specific bank in question is equal to 3,104 in the region of Attica, averaging 72.1-1.16 years of age. We observed 109 persons who have been included in the "Senior Citizens' Support Program". The period of data collection lasted two months. Results and discussion: Data analysis showed that the largest segment of the population under observation was 80-89 years of age, i.e. a great deal higher than the average age of pensioners in Greece As to their health, the elderly persons we observed are primarily faced with orthopedic problems, at 62%, restricting their mobility and thus their access to their insurance provider for the provision of services. As a whole, beneficiaries displayed many diverse needs. What the elderly persons we observed needed most was household help, at a percentage of 62%. It is imperative that communities introduce support programs for the elderly. These should be individualized and provide basic assistance to senior citizens in carrying out their daily activities

Fungal Infections in the ICU during the COVID-19 Era: Descriptive and Comparative Analysis of 178 Patients

Background: COVID-19-associated fungal infections seem to be a concerning issue. The aim of this study was to assess the incidence of fungal infections, the possible risk factors, and their effect on outcomes of critically ill patients with COVID-19. Methods: A retrospective observational study was conducted in the COVID-19 ICU of the First Respiratory Department of National and Kapodistrian University of Athens in Sotiria Chest Diseases Hospital between 27 August 2020 and 10 November 2021. Results: Here, 178 patients were included in the study. Nineteen patients (10.7%) developed fungal infection, of which five had COVID-19 associated candidemia, thirteen had COVID-19 associated pulmonary aspergillosis, and one had both. Patients with fungal infection were younger, had a lower Charlson Comorbidity Index, and had a lower PaO2/FiO2 ratio upon admission. Regarding health-care factors, patients with fungal infections were treated more frequently with Tocilizumab, a high regimen of dexamethasone, continuous renal replacement treatment, and were supported more with ECMO. They also had more complications, especially infections, and subsequently developed septic shock more frequently. Finally, patients with fungal infections had a longer length of ICU stay, as well as length of mechanical ventilation, although no statistically significant difference was reported on 28-day and 90-day mortality. Conclusions: Fungal infections seem to have a high incidence in COVID-19 critically ill patients and specific risk factors are identified. However, fungal infections do not seem to burden on mortality

Serum CA 125 combined with transvaginal ultrasonography for ovarian cancer screening

Background: The aim of this study was to evaluate the combination of serum CA125 and Transvaginal Ultra Sonography (TVUS) score, as a screening procedure for ovarian cancer in premenopausal and postmenopausal women. Patients and Methods: A retrospective case-control pilot study was conducted. The files of 120 women with ovarian neoplasia detected by TVUS and increased CA125 level, within the framework of a prevention program, were reviewed. The relationship between the above tests and epithelial malignancy was investigated using the SPSS-12 program for Windows. Results: The combination of CA125 value exceeding 30U/ml and a TVUS score ≥35 had a sensitivity of 81.7% and specificity of 100% in predicting ovarian cancer. Mathematical analysis of the logistic model of our variables revealed a mathematical model that can calculate the likelihood of ovarian cancer detection, by using a combination of CA125≥30U/ml and TVUS score≥35. Conclusion: By combining TVUS and CA125, an accurate prediction for the presence of ovarian cancer may be achieved. Further investigation in a larger population is warranted

Comparison of the Ability of Different Clinical Treatment Scores to Estimate Prognosis in High-Risk Early Breast Cancer Patients: A Hellenic Cooperative Oncology Group Study.

Early breast cancer is a heterogeneous disease, and, therefore, prognostic tools have been developed to evaluate the risk for distant recurrence. In the present study, we sought to develop a risk for recurrence score (RRS) based on mRNA expression of three proliferation markers in high-risk early breast cancer patients and evaluate its ability to predict risk for relapse and death. In addition the Adjuvant! Online score (AOS) was also determined for each patient, providing a 10-year estimate of relapse and mortality risk. We then evaluated whether RRS or AOS might possibly improve the prognostic information of the clinical treatment score (CTS), a model derived from clinicopathological variables.A total of 1,681 patients, enrolled in two prospective phase III trials, were treated with anthracycline-based adjuvant chemotherapy. Sufficient RNA was extracted from 875 samples followed by multiplex quantitative reverse transcription-polymerase chain reaction for assessing RACGAP1, TOP2A and Ki67 mRNA expression. The CTS, slightly modified to fit our cohort, integrated the prognostic information from age, nodal status, tumor size, histological grade and treatment. Patients were also classified to breast cancer subtypes defined by immunohistochemistry. Likelihood ratio (LR) tests and concordance indices were used to estimate the relative increase in the amount of information provided when either RRS or AOS is added to CTS.The optimal RRS, in terms of disease-free survival (DFS) and overall survival (OS), was based on the co-expression of two of the three evaluated genes (RACGAP1 and TOP2A). CTS was prognostic for DFS (p3 positive nodes (LR-Δχ2 23.9, p3 positive nodes

Tumor Infiltrating Lymphocytes Affect the Outcome of Patients with Operable Triple-Negative Breast Cancer in Combination with Mutated Amino Acid Classes

<div><p>Background</p><p>Stromal tumor infiltrating lymphocytes (TILs) density is an outcome predictor in triple-negative breast cancer (TNBC). Herein we asked whether TILs are related to coding mutation load and to the chemical class of the resulting mutated amino acids, i.e., charged, polar, and hydrophobic mutations.</p><p>Methods</p><p>We examined paraffin tumors from TNBC patients who had been treated with adjuvant chemotherapy mostly within clinical trials (training cohort, N = 133; validation, N = 190) for phenotype concordance; TILs density; mutation load and types.</p><p>Results</p><p>Concordance of TNBC phenotypes was 42.1% upon local / central, and 72% upon central / central pathology assessment. TILs were not associated with mutation load, type and class of mutated amino acids. Polar and charged mutation patterns differed between TP53 and PIK3CA (p<0.001). Hydrophobic mutations predicted for early relapse in patients with high nodal burden and <50% TILs tumors (training: HR 3.03, 95%CI 1.11–8.29, p = 0.031; validation: HR 2.90, 95%CI 0.97–8.70, p = 0.057), especially if compared to patients with >50% TILs tumors (training p = 0.003; validation p = 0.015).</p><p>Conclusions</p><p>TILs density is unrelated to mutation load in TNBC, which may be regarded as an unstable phenotype. If further validated, hydrophobic mutations along with TILs density may help identifying TNBC patients in higher risk for relapse.</p></div

Coding mutations and mutated amino acid classes in association with TILs density.

<p>A: Training cohort, N cases = 130; B: Validation cohort, N cases = 179. The rate of LPBC was constant in the two cohorts, but the rate of tumors with <5% TILs was significantly higher in the validation cohort. The mutation load in LP tumors was similar to or lower than that observed in tumors with <5% TILs. No difference was observed in the distribution of mutation types according to TILs density.</p

Patient and tumor characteristics in the two study cohorts.

<p>Patient and tumor characteristics in the two study cohorts.</p