Quarterly scientific journal

Rostrum of Asclepius Vol 16, No. 3 (2017): July - September 2017

Vima AsklipiouRostrum of Asclepius Vol 16, No. 3 (2017): July - September 2017

Editorial

Interprofessional conflicts, sources and management | 142-144

Zoe Roupa

Special Article

Toxic factors and autism | 145-159

Charalampos Depastas

AbstractMore

Autism is a neurodevelopmental disorder. Today it has observed a continuing and rapid increase in its prevalence. Autism increase, in combination with unknown factors that cause it, so far, has drawn the interest of several researchers (from different scientific fields). It could be characterized as a multiple-factors disorder. In recent decades, many researchers have implicated mainly environmental, chemical, genetic, hereditary, and biological factors. The present article focuses on environmental factors that their exposure causes irreversible brain damages (toxicity) - autism. Some of these factors are (mainly) mercury, brominated, thalidomide, misoprostol, valproic acid, chloropiryfos, ethanol etc. However, according to literature review, it has not been proved a direct correlation with the factors which have been implicated for autism disorder. As a result, the question “what causes autism” is still unanswered. Today, diagnostic criteria, early diagnosis, methods for autistic education and medication (under circumstances) are continuously improving

Keywords: Autism, autism spectrum disorder (A.S.D), environmental health, environmental exposure, toxic factors, toxicity

Original Papers

Economic crisis affects modern Greek house conditions: maintenance and heating deterioration | 160-175

Elpida Roussakou , Fotoula Babatsikou , Eleni Konsolaki , Elias Chaidoutis , Athanasios Zisimopoulos , Charilaos Koutis

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Introduction: Home safety is a health promoting factor for all citizens. Poor quality of housing is inextricably linked to the morbidity rate of the population, injuries and socio-psychological disorders. The main affected areas of the civilians’ lives by economic crisis include their income, their living conditions and their health status related to accommodation as well as personal and social welfare. The present study aims to assess the deterioration of the modern Greek residence focusing on maintenance procedures and heating problems due to the economic crisis. Aim: The assessment of the health and safety conditions in modern residence during a period of socio-economic crisis and the examination of causal factors that contribute to the gradual deterioration of the residence. Material and Method: The sample consisted of 205 subjects lived in houses in Attica: Salamina, Piraeus-South suburbs, Athens, West Attica, Eastern and the Northern suburbs. Anonymous questionnaire was used for data collection analyzed with SPSS 20. Descriptive statistics and tests of independence were performed. Results: 72.25% (n=148) of the residents mentioned damage to the ceilings, walls, electrical cables and bathtubs in their houses. From 2009 until today, 53.7% (n=110) of the subjects postponed house repair and maintenance procedures due to financial problems. Concerning heating problems 48.3% (n = 99) of the subjects replied that they unavoidably change the type of heating system of the residence, while 30.61% (n=62) stopped the use of oil central heating system and selected other types of heating systems such a fireplaces, air-conditions, and heaters. Conclusions: The economic crisis affects the hygiene of the modern greek house and the health conditions of the residents. Serious hygienic problem may be presented due to heating and maintenance problems. As the relationship between health status and housing conditions has not been explored in depth yet, further investigation is required and new guidelines must be developed. 

Keywords: house, heating, urban population, Greece, economic crisis

Practices of Baby friendly Hospitals: Case study of starting breastfeeding at a public hospital a public hospital and a private clinic in the city of Chania | 176-191

Stavroula Stivanaki , Elisavet Frengidou

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Introduction: Breast milk has an unquestionable value. It has been documented through numerous studies that hospital practices have a decisive impact on successful breastfeeding. The Baby Friendly Hospital Initiative (BFHI) has a measurable and proven effect on exclusive breastfeeding. Aim: The aim of the present study was to investigate in which extent the "10 Steps" for Successful Breastfeeding as well as the International Code for Marketing Substitutes of Breast Milk were implemented through the self-reported experience of mothers. Material and Methods: A cross-sectional study was conducted during December 2015 to March 2016 and the study population consisted of 152 mothers who had delivered a baby at a public hospital and a private clinic in the city of Chania. Data collection was performed with an anonymous questionnaire that was filled out voluntarily. Results: The level of breastfeeding at discharge was very high (96,1%) while the rate of exclusive breastfeeding was 50,7%. Based on the self-reported experience of the mothers, the public hospital complies with the 7th step, that refers to “rooming-in” (91,4%), and also with the aspect of the 5th step, that refers to offering assistance with breastfeeding within six hours of birth (85,9%). The private clinic meets the Global Criteria just for one aspect of the 9th step, that refers to babies being cared without using pacifiers (92,5%). Conclusions: The promotion of procedures for the designation of Greek maternity hospitals as “Baby Friendly” is expected to have a significant effect on the establishment of breastfeeding in Greece. 

Keywords: breastfeeding, ten steps for successful breastfeeding, international code for marketing substitutes of breast milk, baby friendly hospitals

The use of complementary and alternative medicine among hypertensive patients | 192-203

Neriman Akansel , Aysel Ozdemir , Hicran Yildiz , Ayse Baran , Munise Dirik

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Introduction: Complementary and Alternative Medicine (CAM) is widely used method by patients especially with chronic diseases. Although safety and sufficiency of these practices are questionable their use among hypertensive patients is increasing. There is a lack of research studies related to variety of CAM use among hypertensive patients and factors may influence it. Aim: The aim of this descriptive study was to determine the CAM use among patients diagnosed with hypertension. Method and Material: The descriptive design was used for this study in one university hospital located in western Turkey. Data were collected form patients by using a questionnaire with diagnoses of hypertension. There were 127 patients eligible this study. Demographic variables, perceptions related to hypertension and CAM practices of patients were investigated. Results: The mean age of the patients was 59.33±11.97 years. Most of the patients (78.7%) reported using CAM practices. Nutritional, cognitive and behavioral approaches, vitamins and herbal medications were mostly preferred methods for controlling the blood pressure. Conclusions: Nutritional arrangements were commonly practiced by hypertensive patients. Although hypertensive patients are on medical treatment currently most of them consider using CAM to lower their blood pressure. Adherence to medical treatment among hypertensive patients is also questionable. 

Keywords: Hypertensive patients, complementary medicine, alternative medicine

Systematic Review

The consequences of the lower limp amputation in health related quality of life | 204-221

Athanasia Vozani , Georgia Fasoi , Evridiki Kampa , Martha Kelesi-Stavropoulou

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Introduction:The lower limb amputation have significant effects on physical and mental health of patients, while at the same time consists a serious socio-economic problem, as it is associated with increased morbidity, multiple surgeries, prolonged hospital stay and increased disability rates. Purpose: The purpose of this study was to determine the effect of the amputation of the lower extremity in quality of life of these people. Methodology:The present systematic review included medical and nursing literature review using electronic databases such as MEDLINE, CINAHL, PUBMED and PsycINFO. The following keywords were used: amputee, leg, knee, foot, amputation, QoL, prosthesis, mobility, rehabilitation, psychology. Results: Fourteen articles met the inclusion criteria. Eleven studies were cross sectional, one prospective, one retrospective and one mixed study-design. The studies were found to be heterogeneous with respect to the study objectives and instruments used to assess QoL. The factors affecting the QOL in patients with lower limp amputation is depression, perceived prosthetic mobility, social support, comorbidity, addition problems, age, and participation in social activities. Immediately after the amputation, participants reported reduced QOL, but over time, the level increased due to the adjustment in position. The young age, the male gender, the highly education level and the traumatic origin were associated with better QOL. Conclusions: Amputee specific standardized and validated QoL instruments are needed to capture the multitude of facets influencing QoL in amputees, and thereby, facilitating direct comparison across studies. 

Keywords: Amputation, lower extremity, quality of life, psychological impact, physical impact

Patients’ information after myocardial infarction as regard risk factors of coronary heart disease | 222-240

Stamatia Kapetaniou , Martha Kelesi-Stavropoulou , Georgia Fasoi , Eugenia Vlachou

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Introduction: Coronary Heart Disease (CHD) is the main representative of cardiovascular diseases and the leading cause of death and morbidity around the world. The information of patients throughout educational programmes is necessary, whilst it plays an important role in lifestyle modification and psychological support. Aim: The aim of this review was to explore the importance of information of patients with myocardial infarction with regard to risk factors of coronary heart disease. Material-Method: Source data were obtained from a PubMed and Google Scholar search of the medical literature. A time limited criteria was applied with respect to the publication of articles (articles published in the last 15 years). Fifty one articles were found but only thirteen met the criteria for participation in the review. Results: According to the results of studies, the information of patients, education, consulting for lifestyle modification, compliance of medication and increased of physical activity contribute to improvement quality of their lives. Conclusions: Secondary prevention with implementation of the cardiac rehabilitation programmes offers the right education and information to patients with CHD. Also there is reduction of cost-effectiveness because cardiac rehabilitation improves prognosis of disease and recurrences.

Keywords: Myocardial infarction, coronary heart disease, cardiac rehabilitation

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