Rostrum of Asclepius Vol 2, No. 2 (2003): April - June 2003

It is well known that patients, who need to stay in bed rest for a long period, develop a number of biological and psychosocial problems. The approach for treatment presents series of particularities, which make the rehabilitation more difficult. They require a lot of care in order to confront their disease effectiveness and complication by bed rest. The nurses and the physiotherapists compose two self-dependent professionals units in the multidisciplinary team, who are called out to cover these problems with the ways, which are available to them. Atrophy and the loss of bone mass are prevented by using exercise. The exercise for the heart and the respiratory system help the dismissal secretion and prevent of heart insufficiency. Appearing of bedsores is prevented by the regular change of positions.

Keywords: Nurse, physiotherapist, multidisciplinary team, patient, bed rest, handle, patients education

Η σχέση μεταξύ της προεγχειρητικής προετοιμασίας και του μετεγχειρητικού πόνου μελετήθηκε και μελετάται από πολλούς ερευνητές. Στην παρούσα εργασία γίνεται μια ανασκόπηση των μελετών που αφορούν την επίδραση που μπορεί να έχει μια ολοκληρωμένη και συστηματική νοσηλευτική προεγχειρητική ενημέρωση και προετοιμασία πάνω στο φαινόμενο του μετεγχειρητικού πόνου.

Keywords: Preoperative preparation, preoperative information, preoperative anxiety, postoperative pain

During the last decade there has been an increasing interest among health care professionals for the quality of life of women with breast cancer. It is well known that the problems arising from chemotherapy such as nausea, vomiting or the surgical interventions such as mastectomy or irradiation treatment seriously affect the quality of life of women suffering from breast cancer. The fear of changes in body image or even handicap is common. The aim of the therapeutic approach is the estimation of the seriousness of the problems and the quality support in diagnosis, treatment and rehabilitation. A holistic approach is needed, in order, to support the patient, her family in a somatic, psychologic and social way. The estimation  of the quality of life of women with breast cancer is a matter of interest for nursing blems, quality o f life, latest data research for more interventions towards a holistic approach.

Keywords: Breast cancer, nursing problems, quality o f life, latest data

The purpose of this study was firstly to analyze the health care systems of various countries according to social, economic and cultural factors and secondly to examine more extensively the greek system of care with particular accent to the primary health care. More specifically, the main issues that are examined are its diachronic development and the way it is organized and operates, while the main problems of its action are extensively analyzed. In addition, it is generally ascertained that the Primary Health Care, as it is structured and functions in our country, is limited and it doesn't rise to its role regarding the beneficial improvement of the services of medical care. Finally, proposals for further improvement of current situation are presented while the creation of networks providing health care is accented. Thus, the primary health care will constitute as the cornerstone of the new reforming effort for the modernization and the improvement of provided health care services to the greek citizen.

Keywords: Primary health care, gene- ral/family practitioner, managed care, health care, networks, evaluation, social- economic and political model

The rarity of small intestinal tumors and also the fact that they cause vague intestinal symptoms are both factors for a delayed diagnosis or an incidental diagnosis during surgery for other causes. Increased clinical suspicion and awareness of the factors that predispose to the development of such tumors are expected to increase the frequency of a timely diagnosis. This article focuses on the epidemiology, the histological typing, the predisposing diseases or precursor lesions and the prognosis of adenocarcinomas and endocrine (neuroendocrine) tumors that arise in the duodenum, the jejunum and the ileus. Information regarding the association between adenocarcinoma of the small intestine and familial polyposis coli, hereditary non-polyposis colorectal cancer, Crohn's disease, celiac disease, Peutz-jeghers syndrome and juvenile polyposis as well as evidence in favor of the adenoma-carcinoma sequence theory are given. Concerning the biologic behavior of the endocrine tumors of the small intestine which is notoriously difficult to predict, emphasis is given on the clinicopathological parameters which are important for prognosis.

Keywords: Small intestine, adenocarcinoma, endocrine tumor, carcinoid

Professional and ethical codes embody principles related to the dignity and privacy of individuals. Social science may focus on controversial and politically sensitive issues concerning cloning and preserve the relational dimension of living beings as union.

Keywords: Bioethics, biolaw, biopower

Managing activities for occupational health and safety, as well as the improvement in working conditions constitute a primary goal for decision-makers either in national or in microsocial level. In this article, through quantitative analysis, it is attempted to present the design and development of an integrated model for the prevention and reduction of work related accidents. By following up the trends and norms of ratios such as frequency, severity and incidents of work related accidents, and developing an integrated occupational health and safety management model we aim through total quality philosophy (TQM), to improve both working conditions and quality of work as a whole.

Keywords: Occupational health and safety model, work related accidents ratios, quantitative analysis of working accidents

We conducted a retrospective study of critically ill ICU- patients. The objective of the study was to analyze the quality of life of critically ill patients before their ICU admission and its relation to nosocomial urinary tract infections, blood stream infections and pneumonia. Method-Patients Data related to the quality of life of each patient were collected in a questionnaire that includes three subscales. Subscale I that refers to the basic physiologic activities, subscale II that refers to the normal daily activities and subscale III that refers to the emotional state. Results Our results showed that pre-IGU quality of life was 6.7±7.64 points, and 29.3% of patients had a normal quality of life with a 0 points score, 30.3% scored between 1-5 points, 11.1% scored 6-10 points, 15.2% scored 11-15 points, and 14.1% scored >15 points. In addition, the normal daily activities score (subscale II) was correlated with nosocomial pneumonia and the emotional state score (subscale III) was correlated with the nosocomial urinary tract infections. Furthermore, there was no correlation between quality of life and blood-stream infections. Conclusions In conclusion, the quality of life of critically ill patients before their ICU admission is not good and a high proportion of patients have a poor pre- ICU quality of life. The preadmission quality of life is correlated with (APACHE II score of admission), nosocomial urinary tract infections and nosocomial pneumonia but is not correlated with blood-stream infections. Further studies are required that would analyze the influence of quality of life of critically ill patients before their ICU admission on the development of nosocomial urinary tract infections and nosocomial pneumonia.

Keywords: Quality of life, ICU