Quarterly scientific journal

Rostrum of Asclepius Vol 13, No. 3 (2014): July - September 2014

Vima AsklipiouRostrum of Asclepius Vol 13, No. 3 (2014): July - September 2014


The contribution of phenomenology in the investigation of the clinical decision-making in the ICU | 222-224

Stelios Parissopoulos


Influence of the psychosomatic status of the pregnant woman on the psychology of the fetus | 225-234

Maria Iliadou , Eleni Maroka


Changes during pregnancy affect negatively or positively the fetus and his entire remaining course. Aim: The aim of the present study was to show the relationship between the pregnant woman and the formation of the psychology of the fetus. Method and Material: The methodology of this study includes bibliography research from both the review and the research literature on PubMed, Cinahl and PsycINFO databases (1990-2011) which refers to the factors that affect the fetus’ psychology. The keywords that were used were the following: “prenatal psychology”, “fetus psychology”, “pregnancy”, “stress”. Results: According to the bibliography, the negative intentions of being pregnant and stress during pregnancy have been associated with low-birth weight, pre-term birth, emotional and behavioral development of the child. Conclusions: If the pregnant woman keeps her balance then it is of great importance for the fetus, as if any disorder during prenatal and perinatal period can influence it negatively. On the contrary, the normal communication between the mother and the fetus is decisive for his normal development.

Keywords: Prenatal psychology, fetus psychology, pregnancy, stress

Assessment of changes in Intracranial Pressure (ICP) after the implementation of therapeutic measures for Intracranial Hypertation (IH) | 235-258

Nikoletta Arapoglou , Aikaterini Marvaki , Eleni Dokoutsidou , Olga Kadda


The Traumatic Brain Injury (TBI) constitutes the leading cause of death and permanent disability in all age groups and, by far, at ages 19-27 years. The morbidity and mortality remain high and depend on the neurological status of patients at admission, the treatment in the Intensive Care Unit (ICU), surgery and postoperative rehabilitation and recovery. The prevention and treatment factors that may maintain or exacerbate the IH is a very important and fundamental issue in neurological intensive therapy. Aim: The aim of the present systematic review was to investigate the effectiveness of various therapeutic measures for the treatment of intracranial hypertension. Material and Method: The methodology used was to review the Greek and international bibliographic databases (Iatrotek, Pubmed, Cinahl, Scopus,). The keywords used to search for the study was: "Hyperventilation", "therapeutic hypothermia", "hyperosmolar therapy", "corticosteroids", "traumatic brain injury" and were the last 15 years. Results: Hyperventilation, the hyperosmolar therapy, barbiturates, patient position, sedatives-neuromuscular blocking agents, therapeutic hypothermia, corticosteroids and some aggressive surgical methods (decompressive craniotomy and drainage of CSF) make up the puzzle of modern intensive care patients with severe TBI. The cornerstone for the control of intracranial hypertension are the hyperosmolar therapy, therapeutic hypothermia and patient position (supine-neutral to 30o-45o inclination). With skepticism, seems to treat hyperventilation, sedatives-neuromuscular blocking agents, the barbiturate coma and surgical methods of treatment. This is due to the plurality of complications that causing. Last but not least, corticosteroids have been implicated as a measure which does nothing to help patients with increased ICP, contrary aggravates their condition. Conclusions: Direct surgical treatment of IH accompanied by better results in terms of mortality, morbidity and neurologic outcome. For patients with inoperable brain lesions treated with prophylactic and therapeutic measures against IH and cerebral ischemia, the main of which are: sedation and / or muscle relaxation , pain control , temperature control, placement of head and body in the position of 30-400, the treatment of mannitol or other hypertonic solutions. Finally hyperventilation is useful tool immediate, but temporary, intervention by the deterioration of the neurological profile and until such time as an objective fact.

Keywords: Hyperventilation, therapeutic hypothermia, hyperosmolar treatment, corticosteroids, traumatic brain injury

Special Article

Organ transplantation and presumed consent: the laws n.2737/1999 and n. 3984/2011, the international experience and the glimpse at the future | 259-270

Athanasios Panagiotou


Organ donation and the issue of consent in cadaveric donations are subject of legislation in many countries. The major goals of legislation in this case are both the increase of the available organs and the respect of the dead donor’s wishes. During the last years many European countries have adopted the system of presumed consent (opt out system).In Greece, until the 1st of June 2013 an opt-in system (donor’s card) had been implemented with the dead donor’s family playing a decisive role in nearly every case. The opt-in system, taking into account that Greece had one of the lowest rates of organ donations was proved to be unsuccessful concerning its major goal. However from June 2013 (law n.3984/2011) Greece adopted a system of presumed consent as the dead donor’s family continues to play an important role in the decisions (soft opt-out) The system of presumed consent – as we know from the discussion which has taken place abroad as well as from its implementation in various countries-has both advantages and drawbacks. As a result, it is apparent that simply legislating the system of consent in organ donation is not enough in order to increase the number of available organs. Consequently, other solutions should also be adopted; solutions related to the organization of public services and the mentality of both the society and health professionals towards the issue of organ donation.

Keywords: Organ donation, cadaveric donations, presumed consent, opt-in system, opt-out system, law 3984/2011

The Role of Nurse in Education and Psychological Support of Patients with Renal Failure | 271-280

Evridiki Kampa , Georgia Gerogianni


Education helps patients with renal failure to increase their knowledge about their condition and effectively manage their treatment. Additionally, psychological support helps patients to overcome all problems caused by their condition and adapt effectively to their new way of life. The main purpose of education should be the physical, mental and social rehabilitation of people with renal failure. Also, the appropriate psychological support helps these patients to accept their condition with maturity. Nurses play a key role in education and psychological support of patients with renal failure. Finally, education is necessary to be carried out before and after the initiation of renal replacement therapy.

Keywords: Education, psychological support, renal failure, nursing role

Original Papers

Musculoskeletal disorders in nursing staff | 281-296

Athanasios Bitsios , Evdokia Tsigganou


Nursing as a profession is proved to be particularly burdensome for the musculoskeletal system due to the activities required in its practice including frequent moving of patients, moving materials and even the handling or transportation of special equipment. Purpose: The recording of musculoskeletal disorders and the investigation of potential risk factors related to the working conditions of nurses in general hospitals of Central Macedonia. Material and Methods: Six hundred questionnaires were distributed including the NMQ (The general Nordic for the Musculoskeletal symptoms Questionnaire) to employed Nurses of Central Macedonia- on May of 2013, of which 440 (73%) were completed. Analysis was performed using the statistical package SPSS 10, with the use of descriptive statistics and the chi-square test. Results: A large percentage (85%) of the nursing staff which has manifested musculoskeletal disorder in the previous six months such as lower back pain, pain in the neck and hands, believes that the work is an important risk factor for these symptoms. It was also reported that 63% had sick leave due to musculoskeletal disorders. Only 12.04% of the staff had been trained in ergonomics. Statistical significant difference was found between the occurrence of musculoskeletal disorders and work sections. Specifically, the nursing staff working in the surgical field had higher incidence of musculoskeletal disorders (40.21%) compared to the emergency department (15.28%), p=0,048. Conclusions: Musculoskeletal disorders are associated with the work activities of nursing staff in each specific work department. A factor that could contribute in the prevention of musculoskeletal disorders is relevant education.

Keywords: Musculoskeletal disorders, nursing staff, musculoskeletal burden, back pain

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