Markos Sgantzos

Fathers’ Feelings and Experience Related to their Wife/Partner’s Delivery in Northern Greece

Objectives: The study aims at exploring the feelings and the experience of fathers about their wife/partner’s delivery. Background: During the last decades birth attendance by fathers is a common phenomenon across many countries. Fathers’ birth attendance may evoke both positive and negative feelings. Methodology: The study was conducted in a city of Northern Greece. The sample consisted of 417 fathers whose wife/partner had given birth during the previous one week to one year. Data were collected using the Kuopio Instrument for Fathers (KIF). Results: Father’s feelings about their wife or partner were very positive as nearly all (82.1%) of the participants were proud to become fathers and agree that they felt love and were grateful to their wife/partner. However, half of the fathers felt anxious and nervous. 40.7% quite agree that the staff was very professional, that they trusted the staff (45%) and that they were grateful to the staff (38.8%). There is correlation between the “feelings related to the wife/partner” and education (r=0.156, p=0.0047), “being afraid during the preparatory visit at the obstetric hospital” (r=-0.238, p=0.009), and “anxiety during the preparatory visit” (r=0.295 p=0.005). The subscale “feelings related to the environment and staff” correlates with “usefulness of preparatory visit” (r=-0.223, p=0.004) and the subscale of “experiences related to delivery” correlates with “usefulness of preparatory visit” (r=-0.357, p=0.001). Conclusions: Our results support the findings of previous studies, which indicated that birth attendance by fathers has evoked positive feelings about their wife/partner, the delivery, the staff and the hospital environment.

Body Composition in Severe Refractory Asthma: Comparison with COPD Patients and Healthy Smokers

Background Body composition is an important parameter for patients with chronic obstructive pulmonary disease (COPD) whereas the association between asthma and obesity is not fully understood. The impact of severe refractory asthma (SRA) on fat free mass (FFM) has not been investigated. Methodology and Principal Findings 213 subjects (70 healthy smokers, 71 COPD patients and 72 asthma patients) without significant comorbidities were included in the study. In all patients, body composition assessment (using bioelectrical impendance analysis, skinfold and anthropometric measurements) and spirometry were performed. Differences in fat free mass index (FFMI) between groups were assessed and determinants of FFMI in asthma were evaluated. Patients with SRA had lower values of FFMI compared to patients with mild-to-moderate asthma [18.0(17.3–18.3)–19.5(18.4–21.5), p<0.001], despite the fact that they were more obese. The levels of FFMI in SRA were lower than those of GOLD stage I–III COPD and comparable to those of stage IV COPD patients [18.0(17.3–18.3)–18.8(17.8–20.1), p = ns]. These differences were present even after proper adjustments for sex, age, smoking status, daily dose of inhaled corticosteroids (ICS) and daily use of oral corticosteroids (OCS). In multivariate analysis, independent predictors of FFMI in asthmatic patients were age, use of OCS and the presence of SRA, but not smoking, sex or cumulative dose of ICS used. Conclusions and Significance SRA is related to the presence of low FFMI that is comparable to that of GOLD stage IV COPD. The impact of this observation on asthma mechanisms and outcomes should be further investigated in large prospective studies.

Translation and standardisation into Greek of the standardised general Nordic questionnaire for the musculoskeletal symptoms

Musculoskeletal disorders represent a common reason for the general population to seek care from the health services.1,2 Standardised questionnaires are among the widely accepted methods for collection and analysis of relevant data. The standardised questionnaires for the analysis of musculoskeletal symptoms (Nordic Musculoskeletal Questionnaires, NMQs),3 the general form and the specific low back and neck/shoulder questionnaires, have been extensively used as a screening instrument in epidemiological studies across Europe and all over the world.4,5 The lack of specific questionnaires that are validated in the Greek language was the main reason for this study of translation and validation of the general NMQ into Greek.

Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

Quality assessment systems in rehabilitation services for people with a disability in Greece: A critical review

BACKGROUND Despite international interest on quality assessment systems (QAS) and their importance in health care accreditation, implementation of a Rehabilitation Services Quality Measurement System still remains a neglected subject in Greece. OBJECTIVE To identify appropriate tools for researchers and policy makers to assess the quality of rehabilitation services in Greece, within the current active debate on national health care reform. METHODS A critical review methodology was undertaken, using a systematic approach, aiming to identify the most appropriate tools in the field. Multi-step strategy was followed to gather relevant data, including bibliographical database, internet and hand searches. RESULTS Twenty-two studies, articles and documents were identified as meeting all inclusion criteria, representing four QAS, compared according to appropriateness, efficiency, and feasibility for general use. The European Quality in Social Services (EQUASS) was evaluated as meeting all of the desired features, such as proper certification, objective measuring, equality, education and training, established guidelines and person-centered approach. CONCLUSIONS EQUASS initiative, developed according to European standards and implemented in resource-limited settings, was recognized as the most adaptive and appropriate system for Greek rehabilitation settings. Health policy makers are urged to take findings into consideration in establishing an integrated, quality-assured rehabilitation system throughout the country.

Congenital peritoneal encapsulation of the small intestine: A rare case report

Highlights • Be aware of the rare occasion of PE in patients with intestinal obstruction without other etiological factors.• Preoperative diagnosis of PE may be impossible.• Management of PE in case of intestinal obstruction requires urgent surgery.

Implementing a system to evaluate quality assurance in rehabilitation in Greece.

BACKGROUND Use of a widely accepted quality assurance tool is an essential procedure of effective and result-oriented quality management in the rehabilitation sector, and generally in health care and social services, but is still lacking in Greece. OBJECTIVE This study aims to explore to what extent a Quality Assurance System in Rehabilitation (QASR) in the Greek setting could respond to the needs for quality evaluation of the facilities for people with a disability and to discuss possibilities of its use in rehabilitation organizations, sites and hospitals. METHODS The European Quality in Social Services (EQUASS) Assurance self-assessment questionnaire was officially translated and used as the basis for the new tool, which consisted of 110 questions in 11 sections on development and 6 questions on its evaluation. This tool was tested in 15 specialized centers. RESULTS The study received a high (93.75%) response rate. Overall score ranged from 11% to one perfect 100%; 53.3% of the facilities fell short of the preset qualification standards, while 4 (26.7%) were qualified for level-1 accreditation. Evaluation of the QASR questionnaire for the function of the rehabilitation facilities for the disabled was extremely positive. CONCLUSIONS The EQUASS assurance-based Greek QASR has received proper attention in its first implementation and it was shown promising to assess the needs of sites that would like to improve their services. The next steps are to establish its validity and reliability so that it can significantly emerge as the standard system for guiding policy in the rehabilitation sector in Greece.

Congenital Fusion of the Thalami (Atresia of the Third Ventricle) Associated with Parietooccipital Meningocele

In this article we present a case of a male newborn with a CNS malformation that is characterized mainly by complete fusion of the thalami resulting in atresia of the 3rd ventricle accompanied by fusion of the anterior peduncles of the fornix, the presence of a single occult interventricular foramen lying at the midline, absence of the septum pellucidum, hypoplasia of the corpus callosum, disorganization of the head of the left caudate nucleus, and greatly dilated lateral ventricles (hydrocephalus). The patient underwent surgical correction of the meningocele on his 4th postnatal day. On his 13th postnatal day he had projectile vomiting due to a left parietooccipital hygroma that was drained via a shunt. On his 31st postnatal day he developed seizures and marked dilatation of the lateral ventricles, for which he underwent a ventriculoperitoneal shunt (Brown). On the 14th postoperative day the patient developed aspiration pneumonia and died.

Hippocrates (ca 460-375 bc), Introducing Thoracotomy Combined With a Tracheal Intubation for the Parapneumonic Pleural Effusions and Empyema Thoracis

Hippocrates was the first physician to describe in accuracy pleural effusion and pneumonia. To treat empyema thoracis he had introduced a combined method of tracheal intubation with a simultaneously thoracotomy. The surgical incision was used for the pus to be progressively drainaged. If the patient was too weak to eat, he had suggested for nutritional mixtures to be administered through an oral-gastric tube. Thus Hippocrates composed in his operating theatre, an icon similar to modern surgical operations.

Paul of Aegina (c. 625–690 AD), the Origins of the Early Correction of Pediatric Strabismus in Byzantine Empire

ABSTRACT The eminent Greek physician Paul of Aegina, native of the Saronic island Aegina and pupil of the Alexandrian School, understood both exotropia and endotropia, his designation for esotropia and proposed therapeutic measures for their treatment during baby or toddler age. He had introduced an innovative method for the newborns to have a straight vision, “the congenital strabismus of the newborns must be treated with the placement of a facial mask (with 2 open holes in the middle axes of the eyes), so that the babies could only see in a straight line”, combined with a small oil lamp to assure a direct eye alignment. Although not even a diagram of the masks was saved until nowadays, Paul was the first to suggest the early correction of the eyes deviation, and considered to be the father of orthoptics.