Rostrum of Asclepius Vol 8, No. 2 (2009): April - June 2009

Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide. Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke. The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke. Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive), carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet. Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

Keywords: stroke, risk factors, type of stroke, etiology

Diabetes mellitus is a disease related to numerous complications, including neuropathy, peripheral vascular disease and trauma. These complications in conjunction with the infection of the foot ulcers is the leading cause of amputations of feet (non-traumatic lower limb amputation). Aim: The purpose of this study was to systematically review the evidence on the way and methods of caring diabetic foot. Method and material: The method οf the present study included research of medical and nursing literature data-bases using specific keywords. Results: The review of the literature showed that the most effective intervention to prevent and treat ulceration of diabetic foot is patients’ education which should be mainly focused on early recognition of the diabetic foot, daily self-care, proper footwear, modification of the way of living and adherence of the participants to the instructions of healthcare team. Relevant research has shown that diabetic patients attending education programs should initially be stratified according to their needs and afterwards to be determined the type of intervention management according to the foot risk category they belong. The ultimate goal of every educative intervention is to reduce the incidence of ulceration and amputation through reinforcing patients' knowledge of prevention and self-management. Conclusions: Foot care education is absolutely necessary to be incorporated in the diabetic treatment approach. Through educative interventions diabetic patients will acquire the essential knowledge and skills that contribute to the improvement of their clinical outcome.

Keywords: diabetic foot, lower limb amputation, diabetic foot ulceration, prevention, education

Pain accompanies human beings during the course of their life. Pain causes sorrow to ill, his family and those who take care of them. Man have wanted and tried to explain pain since the beginning of time. The aid towards the person who is in pain is one of most important characteristics of nursing. The professional life of nurses is dedicated to the relief of human pain. The effective relief of pain is not easy for nurses. A good professional orientation, a continuous learning, the evaluation of the patient and a sincere quest of meaning of life are needed. According to the Orthodox belief, pain is considered as a means of discipline and mental alert. Orthodox Christians are asked to follow the example of Jesus Christ and the Saints. The Fathers of the Church consider pain and disease as an indication of God’s Concern as a way of schooling for the repentant man.

Keywords: Pain, Nursing and Pain, Nurse and Disease, Theology and Pain, Disease and Church

Atrial and ventricular septal defect constitute the most common congenital heart disease. Aim: Τhe aim of the present retrospective study was to record data and factors that affect atrial and ventricular septal defect. Method and material: The sample study included patients of both sexes who were hospitalized with diagnosis atrial and ventricular septal defect in a Cardiac Surgery hospital of Athens. A specially constructed printed form was used for data collection, where were recorded the demographic and personal variables, the pathological, surgical, cardiology and obstetric history, the habits of adults, as well as the personal characteristics of mothers. Analysis of data was performed by descriptive statistical analysis. Results: The sample study consisted of 101 individuals with diagnosis atrial or ventricular Septal Defect, of which 40% were boys and 60% girls. The 70% of the sample study suffered from atrial Septal Defect and the 30% suffered from ventricular Septal Defect. Regarding age, 12% of the sample study was 0-1 years old, 35% was >1 years old, 8% was >12-18 years old and 45% over than 18 years old. Regarding educational status of the adult participants, 9% was of 0-6 years education, 22%>6 -12 years, 13%>12 years. 14% of the adult paticipants smoked, 4% consumed alcohol and 5% smoked in conjunction with alcohol. In terms of the obstetric history of the sample studied, 32% of the cases had normal birth, 4% had a twin birth and 1% had a triplet one. According to the variables related to mothers, the mean age of the mother was 30 years and 3 months, 10% were smokers at pregnancy and 3% used chemical substance and mainly hair color. Also, the results of the present study showed that individuals of 12-18 and >18 years old did not suffer from ventricular Septal Defect, whereas the infants 0-1 years old did not suffer from Atrial Septal Defect. The mean value of age at the admission in intensive care unit was 7 months (12%) for the infants, 4 years and 8 months for children (35%), 15 years and 2 months (8%) for adolescents and 41 years and 4 months for the adult. 58% of the sample study manifested clinical symptoms at the admission in intensive care unit, whereas complications during their care manifested the 79% of cases. Conclusions: It is a matter of great importance, if society in collaboration with health care professionals could early organize systematic diagnostic and educational programs for improving the knowledge of the disease.

Keywords: atrial septal defect, ventricular septal defect, danger factors

The transplantation of organs and tissues comprised the highlight invention of great utility of the medicine for the twentieth century. The institution of the transplant coordinator contributed to the rise of disposable grafts in Greece. From 1997 onwards begins the rise of the disposable graft but this didn’t last for a long time. Contrarily noted that grafts’ number decreased considerably. The aim of this study was the measurement of behavior of Transplant Coordinator in a Intensive Care Unit of General Hospital of Crete. Methodology: For the measurement of behavior of Transplant Coordinator was used as a tool a questionnaire structured in three parts. The sample consisted of 30 nurses that worked in the Intensive Care Unit of hospital. Results: From the nurses that answered the 93% knew about the institution and the role of transplant coordinator and the 90% knew who the transplant coordinator in the hospital was. The 60% of the nurses support that the institution of transplant coordinator contributed in the increase of transplantation. Moreover, the 44% supports that the transplant Coordinator should be a team composed of nurse, doctor and psychologist. The 60% of the nurses reports that many patients were lost which were the right donors because of the transplant coordinator’s delinquency to find donors. It must be noted that nurses who were asked the 80% answered that they had participated in the procedure of transplantation because of Coordinator’s absence. The biggest percent 55% reports that the coordinator has no interest in transplant’s coordination, the 39% answered “I don’t know” and the 6% that the coordinator has many responsibilities. Finally, they evaluate and attach importance to the policies reported in the role of transplant coordinator that would contribute in the increase of transplantation in Greece: education of coordinators, postgraduate title of “coordinator of transplantation”, personnel of ICU, evaluation of coordinators, motives in the coordinators , change coordinator each year. Conclusively: The Transplant Coordinator’s transfers his duties and responsibilities in the nurses of the Intensive Care Unit. Nurses assume the responsibility for the organization of transplant procedure whereas they have never been trained. That means that it will be more easy to be lost patients which were the right donors for transplantation.

Keywords: Transplants, Coordinator, Organization, transplant coordination