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Mantzouranis G, Fafliora E, Saridi M, Tatsioni A, Glanztounis G, Albani E, Katsanos KH, Christodoulou DK. Alcohol and narcotics use in inflammatory bowel disease. Ann Gastroenterol 2018; 31:649-658. [PMID: 30386114 PMCID: PMC6191867 DOI: 10.20524/aog.2018.0302] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/03/2018] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to evaluate alcohol consumption and narcotics use among patients with inflammatory bowel diseases (IBD). A comprehensive literature search was conducted in Medline using relevant keywords. The references of the retrieved articles were also searched to identify additional articles. Only English-language studies that provided evidence on alcohol consumption and/or narcotics use among non-hospitalized IBD patients were included in the present review. Twelve studies were included that examined the use of alcohol among IBD patients. The prevalence of alcohol consumption among IBD patients appeared to be similar to that of the general population. The majority of the studies reported worsening of IBD symptoms among patients who consumed alcoholic beverages. Four studies were identified that evaluated narcotics use as analgesia among IBD patients. Narcotics use was prevalent among IBD patients and correlated with a longer disease duration and comorbid mental illnesses. The available evidence suggests that alcohol consumption may have a deleterious effect on IBD symptoms. Furthermore, a considerable proportion of IBD patients are reported to use a narcotic as analgesia and this was correlated with their mental health status. Further studies are needed to address these important facets of IBD.
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Affiliation(s)
- George Mantzouranis
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Eleftheria Fafliora
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Maria Saridi
- Department of Social Sciences, University of Peloponnese, Corinth, Academic Tutor at Hellenic Open University (Maria Saridi), Greece
- Correspondence to: Maria Saridi, PhD, Research Fellow, Faculty of Social Sciences, University of Peloponnese, Corinth, Greece, Academic Tutor at Hellenic Open University, Greece, Sina 33, 20131 Corinth, Greece, e-mail:
| | - Athina Tatsioni
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - George Glanztounis
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Eleni Albani
- Department of Nursing, TEI of Western Greece (Eleni Albani), Greece
| | - Konstantinos H. Katsanos
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Dimitrios K. Christodoulou
- Department of Gastroenterology, University of Ioannina, Medical School (George Mantzouranis, Eleftheria Fafliora, Athina Tatsioni, George Glantzounis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
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Fafliora E, Hatzoglou C, Gourgoulianis KI, Zarogiannis SG. Systematic review and meta-analysis of vascular endothelial growth factor as a biomarker for malignant pleural effusions. Physiol Rep 2017; 4:4/24/e12978. [PMID: 28039396 PMCID: PMC5210377 DOI: 10.14814/phy2.12978] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 01/18/2023] Open
Abstract
Conventional methods may fail to identify the cause of pleural effusion (PE), thus establishing reliable biomarkers is deemed necessary. This study aimed at examining the role of vascular endothelial growth factor (VEGF) as a biomarker in the differentiation between malignant and benign PEs in adults. A comprehensive literature search in PubMed (Medline), Scopus (ELSEVIER), and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted using keywords. We included studies that evaluated pleural and/or serum levels of VEGF among patients presenting with undiagnosed PE and the association between these levels and the final diagnosis. We performed a meta‐analysis to calculate the summary effect using the random effects model. Statistical analysis was performed with the statistical package for meta‐analysis Comprehensive Meta‐Analysis. Twenty studies were included in the systematic review, while 11 of them in the meta‐analysis. Pleural fluid VEGF levels among patients with malignant PE were increased by 1.93 ng/mL as compared to patients with benign PE (95% CI: 1.32–2.54, Q = 173, df (Q): 10, I2 = 94.2%, P < 0.05). Serum VEGF levels among patients with malignant PE were increased respectively by 1.90 ng/mL (95% CI: 0.93–2.88, Q = 182, df (Q): 6, I2 = 96.7%, P < 0.05). This study showed that malignant PEs were associated with higher levels of both pleural fluid and serum VEGF. VEGF appears to represent a promising biomarker for the differential diagnosis between benign and malignant PEs.
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Affiliation(s)
- Eleftheria Fafliora
- Primary Health Care, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Chrissi Hatzoglou
- Primary Health Care, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Primary Health Care, Faculty of Medicine, University of Thessaly, Larissa, Greece .,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios G Zarogiannis
- Primary Health Care, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
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Velissaris D, Karanikolas M, Pantzaris N, Kipourgos G, Bampalis V, Karanikola K, Fafliora E, Apostolopoulou C, Gogos C. Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a Greek University Hospital. J Clin Med Res 2017; 9:987-993. [PMID: 29163731 PMCID: PMC5687902 DOI: 10.14740/jocmr3206w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 10/09/2017] [Indexed: 12/23/2022] Open
Abstract
Background Acute abdominal pain (AAP) is a common symptom in the emergency department (ED). Because abdominal pain can be caused by a wide spectrum of underlying pathology, evaluation of abdominal pain in the ED requires a comprehensive approach, based on patient history, physical examination, laboratory tests and imaging studies. The aim of this study was to investigate predictive factors for admission to the hospital in patients who presented to the ED with AAP as the main symptom. Methods This prospective observational study enrolled 125 patients who presented with AAP in the ED of the Patras University Hospital in western Greece. The sample of patients who enrolled in the study was representative of patients who receive care in this academic institution. All patients underwent clinical examination, laboratory testing and radiological assessment. Clinical and laboratory data were analyzed in an attempt to identify clinical or laboratory factors predicting hospital admission. Results Based on clinical, laboratory and radiologic evaluation, 37.6% of patients enrolled in the study were admitted to the hospital, whereas 62.4% were not admitted. Compared to patients who were not admitted, patients admitted to the hospital had higher age and significantly higher inflammatory markers, white blood count and C-reactive protein (CRP). Binary logistic regression analysis showed that abnormal imaging findings (odds ratio (OR) = 6.47, 95% confidence interval (CI): 2.11 - 19.77, P < 0.001) and elevated serum CRP levels (OR = 6.24, 95% CI: 2.16 - 18.03, P < 0.001) were significant predictive factors for hospital admission. Conclusions Assessment of AAP remains a challenging problem in the ED. Comprehensive history combined with detailed clinical examination, appropriate laboratory testing and radiologic imaging facilitates effective assessment of patients who present in the ED with AAP and guides the decision to admit patients to the hospital for further care.
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Affiliation(s)
- Dimitrios Velissaris
- Internal Medicine Department, University of Patras, University Hospital of Patras, Greece
| | - Menelaos Karanikolas
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63144, USA
| | | | | | | | | | | | | | - Charalampos Gogos
- Internal Medicine Department, University of Patras, University Hospital of Patras, Greece
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Fafliora E, Bampalis VG, Zarlas G, Sturaitis P, Lianas D, Mantzouranis G. Workplace violence against nurses in three different Greek healthcare settings. Work 2017; 53:551-60. [PMID: 26835853 DOI: 10.3233/wor-152225] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Healthcare workers are at high risk of facing workplace violence and nurses represent the most affected group. OBJECTIVE This study aimed to assess workplace violence encountered by nurses working in three different healthcare settings. METHODS This was a cross-sectional study conducted in a tertiary hospital, a non-tertiary hospital and a primary care unit. The research tool was an anonymous self-report questionnaire concerning the prevalence, characteristics, consequences, causes and preventive measures of workplace violence. The statistical analysis was performed with SPSS 17.0. RESULTS Eighty nurses participated in the study. The majority (76%) had experienced workplace violence. Men (OR, 0.08; 95% CI, 0.01-0.56) and more experienced nurses (OR, 0.82; 95% CI, 0.70-0.97, for each additional year of working experience) were less affected in the last year. Verbal violence was the dominant type (98%). The vast majority (80%) reported a negative psychological impact, while 65% reported that they feel sometimes, rarely or never safe in their workplace. One of the main suggested causes of workplace violence was the long waiting time (99%), while the most common suggested measure of prevention was entrance control (93%). CONCLUSIONS This study revealed a high prevalence of workplace violence against nurses working in different healthcare facilities. Country and unit-specific studies may be beneficial for implementing appropriate interventions for reducing work place violence.
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Affiliation(s)
- Eleftheria Fafliora
- Department of General Practice, University General Hospital of Patras, Rio, Patras, Greece
| | - Vasileios G Bampalis
- Department of General Practice, University General Hospital of Patras, Rio, Patras, Greece
| | - George Zarlas
- Department of General Practice, General Hospital of Patras, Patras, Greece
| | | | - Dimitrios Lianas
- Department of General Practice, General Hospital of Patras, Patras, Greece
| | - George Mantzouranis
- Department of General Practice, University General Hospital of Patras, Rio, Patras, Greece
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Jelastopulu E, Fafliora E, Plota A, Babalis V, Bartsokas C, Poulas K, Plotas P. Knowledge, behaviours and attitudes regarding HPV infection and its prevention in female students in West Greece. Eur Rev Med Pharmacol Sci 2016; 20:2622-2629. [PMID: 27383314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Infection with several types of human papilloma viruses (HPV) has been correlated with the development of cervical cancer. Apart from other preventive strategies, two prophylactic vaccines have been added recently to the HPV prevention arsenal. The objectives of this study were to assess HPV vaccination coverage rates and to evaluate the level of knowledge regarding cervical cancer, HPV and Papanicolaou test among female students in a Greek city. PATIENTS AND METHODS A cross-sectional study was carried out among five hundred female students of the Technological Educational Institute (TEI) of Patras, Greece. They completed an eighteen-item self-administrated questionnaire regarding their knowledge related to cervical cancer. RESULTS Only 31.7% of the students had a high level (> 66%) of total knowledge. The majority (70.4%) had not been vaccinated against HPV. Students who achieved low and moderate total knowledge scores were less likely to be vaccinated against HPV. CONCLUSIONS Implementing strategies for improving young females' knowledge on the different aspects of the natural course of HPV infection and increasing HPV vaccination coverage rates seem to be crucial.
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Affiliation(s)
- E Jelastopulu
- Department of Public Health, School of Medicine, University of Patras, Greece.
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Mantzouranis G, Fafliora E, Glanztounis G, Christodoulou DK, Katsanos KH. Inflammatory Bowel Disease and Sexual Function in Male and Female Patients: An Update on Evidence in the Past Ten Years. J Crohns Colitis 2015; 9:1160-8. [PMID: 26254470 DOI: 10.1093/ecco-jcc/jjv140] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 08/04/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel diseases [IBD] are a group of chronic, debilitating inflammatory intestinal conditions. The aim of this review was to assess the recent data regarding the impact of IBD in sexual function of male and female patients. METHODS A literature search was conducted on MEDLINE using, among others, the following search terms or their combinations: ulcerative colitis; Crohn's disease; sexual function; sexual health; relationship status; erectile dysfunction; surgery. All English-language studies published in the past 10 years which provided data evaluating the sexual function in IBD patients were included. RESULTS Fourteen studies were identified; six included IBD patients registered on a national database or presented in a clinical setting, whereas eight evaluated sexual function after a surgical intervention for IBD. The majority of the studies used the validated for general populations International Index for Erectile Function [IIEF] and the Female Sexual Function Index [FSFI] for the assessment of sexual function among males and females, respectively. An impaired sexual function has been reported in general cohorts of IBD patients; females seemed to experience worse sexual dysfunction than males. Furthermore, depression was a consistent negative predictive factor across studies. Surgery did not seem to affect sexual function in the majority of studies, except a prospective one which reported a significant improvement in male sexual function [IIEF, p < 0.05] but not female [FSFI, p = 0.6]. CONCLUSIONS Sexual function among IBD patients may be impaired, thus more studies are needed in order to develop the appropriate instruments and proper and effective management strategies.
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Affiliation(s)
- George Mantzouranis
- Department of General Practice, University General Hospital of Patras, Rio, Greece
| | - Eleftheria Fafliora
- Department of General Practice, University General Hospital of Patras, Rio, Greece
| | - George Glanztounis
- Division of Surgery, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Konstantinos H Katsanos
- Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Mantzouranis G, Fafliora E, Bampalis VG, Christopoulou I. Assessment and Analysis of Workplace Violence in a Greek Tertiary Hospital. Arch Environ Occup Health 2015; 70:256-264. [PMID: 24456571 DOI: 10.1080/19338244.2013.879564] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study sought to assess workplace violence in a Greek tertiary hospital for the first time. The authors conducted a descriptive study with 175 participants and examined the characteristics of violent episodes, the responses of victims and the administration, and the perception of workplace safety in addition to the implications of these incidents. The vast majority of employees (83.4%) had experienced work-related violence; however, half of them (52%) had not reported the incident to the hospital administration. Verbal violence was the most common type of incident (98.6%). Nurses and other health care staff reported feeling safer than physicians (odds ratio [OR] = 4.47, 95% confidence interval [CI]: 1.94-10.28 and OR = 2.80, 95% CI: 1.64-8.74, respectively). A large proportion of victims (72.6%) suffered psychological consequences following the violent incident. This study reveals the high prevalence of workplace violence in a Greek tertiary hospital and underscores its negative impact on health care workers.
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Affiliation(s)
- George Mantzouranis
- a Health Center Aitolikou, Department of General Medicine , University Hospital of Patras , Patras , Greece
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Fafliora E, Bampalis VG, Lazarou N, Mantzouranis G, Anastassiou ED, Spiliopoulou I, Christofidou M. Bacterial contamination of medical devices in a Greek emergency department: impact of physicians' cleaning habits. Am J Infect Control 2014; 42:807-9. [PMID: 24775562 DOI: 10.1016/j.ajic.2014.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/14/2014] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
Abstract
We investigated the bacterial contamination of physicians' stethoscopes, electrocardiography machines, cardiac monitors, and pulse oximeters, as well as physicians' self-reported cleaning habits in the emergency department of a university hospital. Among 100 devices evaluated (stethoscopes included), 99% developed a positive bacterial culture. Coagulase-negative staphylococci predominated (80.3%). Only 13% of physicians reported cleaning their stethoscope after each patient examination; multinomial regression analysis found less contamination on those stethoscopes (P < .001). Studies on the implementation of hygiene measures are needed.
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