Basic principles of organization and performance of an Intensive Care Unit

Hippokratia 1999, 3 (4); 148-159

K. Chatzinikolaou

Abstract

Intensive Care Units (ICUs), developed during the last 40 years, in the context of the rapid medical and technological evolution, built-in today's independent hospital departments.
ICU is faced with critically ill patients, e.g. patients with life threatening acute derangement of one or more of their vital functions, following a severe insult.
The performance of the ICU consists of monitoring of the vital functions, support of the failing organ functions, treatment of the casual illness and intensive care of the critically ill patients. The following requirements are essential for a successfully functioning ICU:
a) specialized and adequate medical and nursing staff,
b) adequate space and modern equipment for monitoring, diagnosis, support and care of the critically ill,
c) cooperative work,
d) rationalistic use resources,
e) continuing education,
f) participation in research projects and last but not least
g) psychological support of the patients and their relatives.

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The role of antithrombine III in sepsis

Hippokratia 1999, 3 (4):160-165

Ch. Tsiotras

Abstract

Sepsis represents a systematic inflammatory reaction of the organism to infection. The septic procedure results in activation of the coagulation mechanism and the intravascular consumption of the clotting factors and AT III, depending on the severity of Sepsis. AT III is a coagulation mechanism balance regulator and has anti-inflammatory properties. As the microcirculation thromboembolic impairment and the intravascular consumption of the coagulation factors develop early during the septic process - before the multiple organ dysfunction appears-we could suggest the early replacement of the AT III deficit, by administering concentrated AT III preparation in order to eliminate the infectious reaction. The phase III results of the relative clinical randomized polycentric trials are being expected.

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Measures of protection of the sanitary personnel of the radiological department from blood born diseases

Hippokratia 1999, 3(4):166-170

N. Vougiouklis

Abstract

An important number of sanitary personnel daily make contact with the viruses of hepatitis B, C and AIDS and they are in danger to be infected. The evolution of the infection depends on the immunological status of the person, the kind and virulence of the virus, the concentration in the biological fluid and the kind of contact.In this review some epidemiological data are given concerning the risk of each of the above diseases and which show that the risk of infection from percutaneous contact is very low. The usual ways of contact are reported such as the puncture during the recapping of the used needle, in sites where minor operations take place. The infected sharp tools are disposed in special solid containers while the biological fluids in plastic bags.It is very important to have the full collaboration of the personnel during the procedure and to follow clearly defined instructions.

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HMG-Co-A reductase inhibitors in the treatment of hypercholesterolemic renal transplant recipients

Hippokratia 1999, 3(4):171-176

G Vergoulas, Gr Miserlis, D Gakis, A Papagiannis, V Papanikolaou, D Takoudas, A Antoniadis

Abstract

The aim of this study was to compare the safety and efficacy of lovastatin and fluvastatin in the treatment of hypercholesterolemic (HCH) renal transplant recipients (RTR). Fifty steady HCH RTR received either 20 mg/d lovastatin (Group A = 22 pts, mean age: 40 yrs) or 40 mg/d fluvastatin (Group Β = 28 pts, mean age: 41 yrs) for a period of one year. Total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and triglycerides (TG) were measured before and at the end of the 3rd and 12th month of treatment. Serum creatinine (Scr), SGOT, SGPT, CPK and total bilirubin (TB) were measured at the same time intervals. ANOVA for repeated measures and independent t test were used for statistical analysis. The TC levels were 304.54±38.38 mg/dl, 234.95±38.12 mg/dl, 240.23±39.09 mg/dl and 323.25±49.61 mg/dl (p:NS), 263.74±38.05 mg/dl (p:0.01), 262.90±31.39 mg/dl (p: 0.04), HDL-C levels were 43.83±11.23 mg/dl, 49.06±7.44 mg/ dl, 55.33±16.30 mg/dl and 46.08±12.77 mg/dl, 52.45±21.60 mg/dl, 55.33±16.30 mg/dl, LDL-C levels were 214.22v41.59 mg/dl, 169.33±41.76 mg/dl, 159.56+35.12 mg/dl and 237.52±53.80 mg/dl, 182.50±43.02 mg/dl, 178.05± 28.47 mg/dl, TG levels were 191.59±59.92 mg/dl, 155.53±53.67 mg /dl, 142.95±48.57 and 188.29±63.09 mg/dl, 151.59±54.09, 156.54±53.27 mg/dl in the Group A and Β at the measured time intervals respectively. In Group A serum TC (p=0.0001), LDL-C (p=0.025), andTG (p=0.002) levels and in Group BTC(p=0.0001), LDL-C (p=0.005) and TG (p=0.044) levels showed statistically significant (ss) fall at the end of 3rd and 12th month. Serum HDL-C did not show any significant change during time in either group. Serum total cholesterol levels of Group A were significantly lower than those of Group Β at 3rd and 12th month of treatment. Scr levels remained stable and no change was noticed in CPK, SGOT, SGPT, TB in both groups.Lovastatin and fluvastatin are safe and cause significant fall of serum TC, LDL-C and TG levels. This fall is evident from the first three months of treatment. Lovastatin causes a deeper fall of serum TC at the 3rd and 12th month than fluvastatin(ss). Both drugs have no significant effect on HDL-C levels.

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Lung cancer stage IIIA

Hippokratia 1999, 3 (4):177-179

A. Apostolidis, A. Liaros, N. Ntourmas, X. Fylahtos, D. Tsavdaridis, L. Papadopoulos

Abstract

This case refers to a man 50 years old smoker with attack to the upper right lung from primary CA. The diagnosis was based on a CT and has been certified with the help of surgical intervention-biopsy. After all the patient underwent radiotherapy and chemotherapy. The patient had 36 months survival with out metastases.

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Psychiatry, Medicine and their semiology

Hippokratia 1999, 3(4):180-183

Th. Didaskalou

Abstract

A semiologic description of the everyday psychiatric practice is made, especially in a General Hospital setting, and comparisons regarding the existing common ground and the differences between psychiatry and general medicine are detailed.An emphasis is given on the "different view" of psychiatry which does not detract this discipline from the medical mainstream but on the contrary extends it broaderly.
After examining the possible problems arising out of the collaboration between these two disciplines in a general Hospital, reference is been made to their "language" and their Weltanschauung, which are derivatives and at the same time manipulators of their practice.

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