Cost and reimbursement analysis of end-of-life cancer inpatients. The case of the Greek public healthcare sector.

Background: While hospital-based Palliative Care services are usually covered through the main funding healthcare framework, traditional reimbursement methods have been criticized for their appropriateness. The present study investigates for the first time the case of treating end-of-life cancer patients in a Greek public hospital in terms of cost and reimbursement.

Methods: This retrospective observational study used health administrative data of 135 deceased cancer patients who were hospitalized in the end of their lives.

Scales for assessing medication adherence in patients with hypertension.

Background: the choice of the appropriate tool for assessing level of medication adherence is a significant barrier in scientific research.

Aims: to translate into Greek and test the reliability of the Hill-Bone and A-14 scales among patients with hypertension. Also, to compare patients' responses in the Hill-Bone scale, A-14 scale and Morisky Medication Adherence Scale (MMAS).

Necessity of the Periodical Ultrasound Assessment of the Peripheral Venous System in Intensive Care Unit Patients.

The utility of periodic sonographic assessment and monitoring for early diagnosis of deep vein thrombosis (DVT) in patients hospitalized in intensive care units (ICUs) was investigated. Of 314 patients hospitalized in an ICU over a 24-mo period, 248 were examined. The first examination of the patients was carried out within the first 48 h of ICU admission, and weekly examination followed until discharge.

A novel mortality prediction model for the current population in an adult intensive care unit.

Background: The accurate and reliable mortality prediction is very useful, in critical care medicine. There are various new variables proposed in the literature that could potentially increase the predictive ability for death in ICU of the new predictive scoring model.

Objective: To develop and validate a new intensive care unit (ICU) mortality prediction model, using data that are routinely collected during the first 24 h of ICU admission, and compare its performance to the most widely used conventional scoring systems.

Clinical factors affecting costs in patients receiving systemic antifungal therapy in intensive care units in Greece: Results from the ESTIMATOR study.

Unlabelled: Invasive fungal infections are common in intensive care units (ICUs) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult ICU patients with or without documented invasive fungal infection receiving systemic antifungal therapy (SAT) we have performed a prospective, multicentre, observational study enrolling patients receiving SAT in participating ICUs in Greece. During the study period, 155 patients received SAT at 14 participating ICUs: 37 (23.

Circadian disruption of ICU patients: A review of pathways, expression, and interventions.

Intensive care unit patients typically exhibit pathologic wakefulness, poor quality of daytime sleep, nocturnal sleep fragmentation, and sleep patterns that feature the absence of slow wave sleep and rapid eye movement. This article offers a review of the existing literature examining circadian desynchronization in critically ill patients, highlighting contributing factors identified by scholars, and circadian abnormalities observed in these patients. It discusses potential implications for clinical practice and suggests avenues of future research.

Variable cost of ICU care, a micro-costing analysis.

Intensive care unit (ICU) costs account for a great part of a hospital's expenses. The objective of the present study was to measure the patient-specific cost of ICU treatment, to identify the most important cost drivers in ICU and to examine the role of various contributing factors in cost configuration. A retrospective cost analysis of all ICU patients who were admitted during 2011 in a Greek General, seven-bed ICU and stayed for at least 24hours was performed, by applying bottom-up analysis.

Adrenergic Effect on Cytokine Release After Ex Vivo Healthy Volunteers' Whole Blood LPS Stimulation.

Catecholamines are molecules with immunomodulatory properties in health and disease. Several studies showed the effect of catecholamines when administered to restore hemodynamic stability in septic patients. This study investigates the effect of norepinephrine and dobutamine on whole blood cytokine release after ex vivo lipopolysaccharide (LPS) stimulation.

Ad libitum and restricted day and night sleep architecture.

This study represents a first controlled comparison of restricted versus unrestricted sleep in both day and night sleep categories. A repeated measures study of a homogenous group of young women without sleep disorders (n=14) found that stage 1, 2, 3 and REM sleep, as well as sleep latency were not statistically different between day ad libitum sleep (DAL) and day interrupted (DI) sleep categories, while night interrupted (NI) and ad libitum (NAL) sleep showed strikingly different architecture.

First Peripherally Inserted Central Catheter Under Ultrasound Guidance in a Greek Intensive Care Unit: A New Role for Greek Perianesthesia Nurses.

We present a case of a 67-year-old Caucasian female who was admitted to the pulmonary clinic of a general hospital in Athens with fever and respiratory symptoms. A lung biopsy was ordered because a clinical diagnosis of interstitial lung disease was suspected. The patient was then hospitalized in the intensive care unit.

Translation and validation of the Greek version of the hypertension knowledge-level scale.

Aims And Objectives: To translate and validate a Greek version of the Hypertension Knowledge-Level Scale.

Background: The major barrier in the management of hypertension is the lack of adherence to medications and lifestyle adjustments. Patients' knowledge of the nature of hypertension and cardiovascular risk factors is a significant factor affecting individuals' adherence.

Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?

Background: The effect of preoperative education on anxiety and postoperative outcomes of cardiac surgery patients remains unclear.

Aim: The aim of the study was to estimate the effectiveness of a nurse-led preoperative education on anxiety and postoperative outcomes.

Methods: A randomised controlled study was designed.

Neuroprotective Effects of Erythropoietin in Patients with Severe Closed Brain Injury.

Aim: Our research was focused on the neuroprotective function of erythropoietin (Epo) in patients with severe closed traumatic brain injury (TBI).

Material And Methods: Our model examined the influence of the outcome and neurological recovery in 42 adults with TBI who were admitted to ICU within 6 hours of their injury and were recruited into a randomized controlled study of two groups; only the patients of the intervention group received 10,000 i.u.

Management of sudden hearing loss with hyperbaric oxygen therapy.

Unlabelled: Idiopathic sudden sensorineural hearing loss (ISSHL) is defined as the sensorineural hearing loss of a minimum of 30 dB in at least three frequencies for three days or more. This study aims to evaluate the clinical efficacy of hyperbaric oxygen therapy (HBO2) in the management of idiopathic sudden sensorineural hearing loss.

Material-methods: Patients with ISSHL received treatment including oral corticosteroids and HBO2.

Health-related quality of life and rehabilitation cost following intensive care unit stay in multiple trauma patients.

Objectives: The objective of this study was to assess changes in health-related quality of life (HRQOL) in multiple trauma patients due to motor vehicle crashes during a follow-up period of 2 years after discharge from an intensive care unit (ICU) and the effect of income and financial cost of rehabilitation in HRQOL.

Methods: The study was a prospective observational study of multiple trauma patients from January 2009 to January 2011 who were hospitalized in a general, medical, and surgical ICU of a district hospital in Athens, Greece. Eighty-five patients with multiple traumas due to motor vehicle crashes and with an ICU stay of more than 24 hours were included in the study.

The immune response after stimulation with wall components of gram-positive bacteria and fungi.

Although several components of the microbial wall of gram-positive bacteria and fungi possess immunostimulatory properties, their pathogenetic role remains incompletely evaluated. The purpose of this study was to assess the basic immune status of patients susceptible to infections and their capability for cytokine production after stimulation with wall components of gram-positive bacteria and fungi. We measured serum cytokine levels as well as cytokine production after ex vivo lipoteichoic acid (LTA) and mannan stimulation of whole blood.

A higher tidal volume may be used for athletes according to measured FVC.

We investigated whether professional athletes may require higher tidal volume (Tv ) during mechanical ventilation hypothesizing that they have significantly higher "normal" lung volumes compared to what was predicted and to nonathletes. Measured and predicted spirometric values were recorded in both athletes and nonathletes using a Spirovit SP-1 spirometer (Schiller, Switzerland). Normal Tv (6 mL/kg of predicted body weight) was calculated as a percentage of measured and predicted forced vital capacity (FVC) and the difference (δ) was used to calculate the additional Tv required using the equation: New Tv(TvN) = Tv + (Tv × δ).

Temperature multiscale entropy analysis: a promising marker for early prediction of mortality in septic patients.

A few studies estimating temperature complexity have found decreased Shannon entropy, during severe stress. In this study, we measured both Shannon and Tsallis entropy of temperature signals in a cohort of critically ill patients and compared these measures with the sequential organ failure assessment (SOFA) score, in terms of intensive care unit (ICU) mortality. Skin temperature was recorded in 21 mechanically ventilated patients, who developed sepsis and septic shock during the first 24 h of an ICU-acquired infection.

Spirometry may underestimate airway obstruction in professional Greek athletes.

Purpose: Lung development and consequently, lung volumes, are affected by the duration, type and intensity of sporting. Athletes may have higher spirometric values compared to predicted which may lead to misclassification of this population and misdiagnosis during clinical evaluation. The aim of the study was to compare measured spirometric values with those predicted from the European Community for Steel and Coal statement in Greek professional athletes.

Nursing Activities Score as a predictor of family satisfaction in an adult intensive care unit in Greece.

Aim: To study family satisfaction with care in an Intensive Care Unit (ICU) and its association with nursing workload estimated by the Nursing Activities Score (NAS).

Background: Few previous studies have investigated the association between workload in ICUs and family satisfaction.

Methods: Family Satisfaction ICU 24 (FS ICU-24) questionnaires were distributed to 161 family members (106 respondents).

Unplanned extubation in critically ill adults: clinical review.

Aims And Objectives: To investigate and synthesize the evidence on the incidence and consequences of unplanned extubation (UE) in intensive care unit (ICU) patients, and on risk factors for UE.

Background: ICU patients generally spend considerable time being intubated via the endotracheal route. Non-planned endotracheal tube removal, either deliberate or accidental, may pose significant safety risks for them.

Role of new biomarkers: functional and structural damage.

Traditional diagnosis of acute kidney injury (AKI) depends on detection of oliguria and rise of serum creatinine level, which is an unreliable and delayed marker of kidney damage. Delayed diagnosis of AKI in the critically ill patient is related to increased morbidity and mortality, prolonged length of stay, and cost escalation. The discovery of a reliable biomarker for early diagnosis of AKI would be very helpful in facilitating early intervention, evaluating the effectiveness of therapy, and eventually reducing cost and improving outcome.

Fever effects and treatment in critical care: literature review.

Considering that the incidence of fever may reach up to 75% among critically ill adults, healthcare professionals employed in the Intensive Care Unit (ICU) are called to evaluate and manage patient temperature elevation on a daily basis. This literature review synthesizes the evidence about the effects of fever and antipyretic treatment in ICU patients. Although the febrile response acts protectively against infections, noxious effects are possible for patients with cerebral damage, neuropsychiatric disorders or limited cardiorespiratory reserve.

The continuing question of how fever duration is associated with patient outcome.

Although fever magnitude and etiology have been associated with outcomes of critically ill patients, possible associations between fever duration and mortality remain inconclusive. Since long-lasting fever is generally attributed to severe pathologic conditions, it is expected to be an indicator of adverse outcome. It also seems plausible that persistent fever in specific patient groups, mainly those with cerebral damage or limited cardiorespiratory reserve, could lead to worsened outcomes.