Quarterly scientific journal

Rostrum of Asclepius Vol 1, No. 4 (2002): October - December 2002

Vima AsklipiouRostrum of Asclepius Vol 1, No. 4 (2002): October - December 2002

Review

Palliative care in children with cancer | 164-168

Anastasios Avgeris

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Palliative care for children emphasizes on physical, phycosocial and spiritual care. It aims to improve quality of life for patients by providing holistic care and for them and their families during illness and bereavement. There is an increasing need for pediatric health care providers who should be able to effectively cure or control health care problems of children with cancer. This need comes out from the recent publication of the World Health Organization (WHO) article "Pain Relief and Palliative care for children with cancer". It suggests that the principles of pain and palliative care should be the major part of the care of any child with cancer. According to a recent survey many children have experienced physical and spiritual suffering during the last month of their life. Parents wanted to be actively involved in order to help but they reported that their children had unrelieved pain life, children and distressing symptoms.

Keywords: Palliative care, quality of life, children

Palliative care of nausea and vomiting in patients with cancer. | 169-177

Eleni Theodosopoulou , Zoe Tsampalaki

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Nausea and vomiting are among the most frequent and distressing symptoms of the gastrointestinal tract in patients with advanced cancer. Reports of its prevalence suggest that nausea occurs in 60% of terminal cancer patients whereas vomiting is less common, occurring in approximately 30% of the patients. Nausea and vomiting are of clinical significance in that they add to the adverseness of the terminal cancer stage, they indicate high levels of stress and anxiety for the patient and may directly interfere with life by compromising the patient through nutritional debilitation and metabolic derangement. Nausea and vomiting are significant concerns in terminal cancer patients and, according to this review, their optimal manage- miting, antiemetics, management ment can be critical to the patient s physical and emotional well being.

Keywords: Palliative care, nausea, vomiting, antiemetics, management

Dissociative (psychogenic) amnesia. Clinical description, epidemiology, etiological hypotheses, diagnostical-therapeutical approaches | 175-178

Nikitas Moschos

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The dissociative amnesia is included in the category of dissociative disorders characterized by the loss of the whole perception of self as well as by differentiated and separated behavior of a part of self. Specifically in DSM-IV the dissociative-psychogenic in DSM-lll-R-amnesia is marked by the sudden incapability of recalling information, without any neurological cause usually following a stress-causing event. Diagnostically it is a particular psychiatric disease though symptoms of dissociative amnesia can be traced to other psychiatric diseases and therefore in this article diagnostical criteria and issues of differential diagnosis are mentioned. This disease is examined through various hypotheses of different theoretical basis and there is also extensive report on the diagnostical means such as specifically structured clinical interviews and dissociative experience scales which are quite helpful to the assessment of disease. Moreover various types of clinical treatments such as the pharmaceutical ones, the supporting ones the supporting ones and the psychodynamical ones with use of hypnosis are suggested. The grave lowering of the activities of these patients from a personal, professional and  social aspect makes further knowledge and research into this disease most sigders, dissociative futique nificant, which is the aim of this study.

Keywords: Dissociative amnesia, psychogenic amnesia, dissociative disorders, dissociative futique

The course of the National Health System in Greece from the 19th century until today and the necessity for radical statutorial modifications in this structure and its role | 186-193

Eleni Lahana , Stiliani Kotrotsiou

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The health system consists a basic component of social politics and any alteration in its nature as well as its role affects its allocated components and therefore health also. In our country the health sectors’ development and organization course is parallel to that of the Greek governments' itself. A sequence of legislative measures from the 19th century till today formed a health system that, despite the significant steps that were made these past few years, faces major organization, management, efficiency and performance problems. At present the NHS requires radical statutorial modifications and due to the quantitative growth of the past years, efforts must focus towards the direction of the improvement in the quality and the efficiency of health services offered. The primary sections that require radical statutorial modifications are decentralization, first-degree health care, nursing, financing and social justice in the NHS structure. Every health system is an “open health system” which constantly changes and adapts to social alterations and to technological evolutionwithout it ever concluding. Margins for improvement alterations and reforstem, statutorial measures, problems, mational interventions will always exist just as long as they explicit, realistic, changes and non-dogmatic so that dialogue can be specific, honest and efficient.

Keywords: Social politics, health system, statutorial measures, problems, changes

Original Paper

The outcomes of implementation of nursing protocol for pressure ulcers management in 251 Hellenic Air Force hospital | 194-200

Sofia Diamanti , Sofia Bozoni , Elissavet Apostolidi , Ekaterini Saropoulou , Eirini Anastasopoulou , M. Adriakopoulou

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Objective Historically, pressure ulcers have been seen as a nursing problem, and still are to a certain extent today. Researche has shown that 6.2-9.4% of all adult hospitalized patients will develop a pressure ulcer. This number seems to be increased in the elderly. The goal of this study was the management and evaluation of patients at high risk for pressure ulcer development in 251 General Airforce Hospital. Material-Method The sample consisted of all patients with pressure ulcers between January 1999 and May 2000. A specific registration form was used for data collection. All these patients were evaluated for risk of pressure ulcer development and risk factors, diagnosis and effectiveness of treatment. Results Four hundred six pressure ulcers recorded in 240 patients. 35.8% of those patients had already one pressure ulcer during their admission. Other important results regarding stage, location and division in nursing wards were also recorded. Conclusions This study was very helpful in understanding the effectiveness and importance of skin care team in our hospital, for and effective management of patients with pressure ulcers. The results of this study also help nursing staff to pay attention in specific patients and apply the appropriate care.

Keywords: Pressure ulcers, pressure sores, risk assessment tools, causative factors, wound management, classification

Malignant melanoma of the stomach. Report of a case presenting with unknown primary lesion | 201-203

Thomais Oikonomou , Demosthenes Tsoutsos , Konstantina Fragia , Eleni Goga , S. Papadopoulos , Vasilios Georgountzos , Ioannis Ioannovich

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Although the gastrointestinal tract seems to be a common site for melanoma metastases it is extremely unlikely that a melanoma of the gastric mucosa is of primary origin. Only few cases have been reported in the literature and the diagnosis was made clinically, endoscopically or by postmortem material. Moreover, most of the patients had visceral metastases in other areas. A case of malignant melanoma of the stomach diagnosed endoscopically is presented. It was confirmed histologically without any other detectable primary lesion.

Keywords: Malignant melanoma, stomach, endoscopy

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