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101.
Konstantinos Kotsis Paraskevi V. Voulgari Niki Tsifetaki Myrela O. Machado André F. Carvalho Francis Creed Alexandros A. Drosos Thomas Hyphantis 《Arthritis care & research》2012,64(10):1593-1601
Objective
Symptoms of psychological distress, including anxiety and depressive symptoms, and illness perceptions are important in determining outcome in patients with rheumatic disease. We aimed to compare psychological distress in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) and to test whether the association between psychological variables and health‐related quality of life (HRQOL) was similar in the 2 forms of arthritis.Methods
In 83 PsA patients and 199 RA patients, we used the Patient Health Questionnaire 9 (PHQ‐9), the Symptom Checklist‐90‐Revised, and the Brief Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short Form to assess HRQOL. We used hierarchical regression analysis to determine the associations between psychological variables and HRQOL after adjusting for demographic variables and disease parameters.Results
The prevalence of moderate to severe levels of depressive symptoms (PHQ‐9 score ≥10) was 21.7% in PsA patients, 25.1% in RA patients, and 36.7% in those PsA patients with polyarthritis. After adjustment for severity of disease and pain, anxiety (β = ?0.28) and concern about bodily symptoms attributed to the illness (β = ?0.33) were independent correlates of physical HRQOL in PsA. In RA, depressive symptoms (β = ?0.29) and concern about the consequences of the arthritis (β = ?0.27) were independent correlates of physical HRQOL.Conclusion
These findings suggest strongly that psychological factors are important correlates of HRQOL in PsA as well as in RA. Attention to patients' anxiety and their concern about numerous bodily symptoms attributed to the illness may enable rheumatologists to identify and manage treatable aspects of HRQOL in PsA.102.
103.
Douzenis A Seretis D Nika S Nikolaidou P Papadopoulou A Rizos EN Christodoulou C Tsopelas C Mitchell D Lykouras L 《BMC health services research》2012,12(1):166
ABSTRACT: BACKGROUND: Research on length of stay (LOS) of psychiatric inpatients is an under-investigated issue. In this naturalistic study we investigated factors which affect LOS in two groups of patients focusing particularly on the impact on LOS of medical comorbidity severe enough to require referral. METHODS: Active medical comorbidity was quantified using referral as the criterion. The study sample comprised of with 200 inpatients with the diagnosis of schizophrenia and 228 inpatients suffering from bipolar disorder (type I or II). Jonckheere and Mann-Whitney tests were used to estimate the influence of referrals on LOS, and regression analyses isolated variables associated with LOS separately for each group. RESULTS: Half of the patients needed one or more referrals for a non-psychiatric problem. The most common medical condition of patients with bipolar disorder was arterial hypertension. Inpatients with schizophrenia suffered mostly from an endocrine/metabolic disease - 12% of referrals were for Hashimoto's thyroiditis. A positive linear trend was found between LOS and number of referrals in both groups, the effect was greater for schizophrenia patients. The effect of referrals on LOS was verified by regression in both groups. Overall, referred patients showed greater improvement in GAF compared to controls. CONCLUSIONS: To our knowledge this is the first study to investigate physical comorbidity in psychiatric inpatients using the criteria of referral to medical subspecialties. Comorbidity severe enough to warrant referral is a significant determinant of hospital stay. This insight may prove useful in health care planning. The results show lack of effective community care in the case of schizophrenia and negative symptoms may be the cause of this. Our findings call for more attention to be paid to the general medical needs of inpatients with severe mental health and concurrent severe medical comorbidity. 相似文献
104.
105.
Evripidis Kaltsonoudis Eleftherios Pelechas Paraskevi V. Voulgari Alexandros A. Drosos 《Seminars in arthritis and rheumatism》2019,48(4):597-602
Objectives
To estimate the size of unmet needs in the treatment of early Rheumatoid Arthritis (eRA), using all the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or biological DMARDs (bDMARDs) in a long-term observational study.Materials and methods
538 patients with eRA were evaluated. The 2010 ACR/EULAR classification criteria were used. All patients were csDMARDs and bDMARDs-naive with disease duration less than one year. They were treated according to EULAR and ACR recommendations for RA. All the csDMARDs and bDMARDs were used. Clinical, laboratory findings with the disease activity score-28 and treatment decisions were all recorded as well as adverse drug reactions, reason of therapy termination, disease complications and comorbidities.Results
Methotrexate (58%) and Infliximab (37%) where the first csDMARD and bDMARD choice respectively. During follow-up, 14 patients were lost and 7 developed comorbidities. The final results are referred to 517 patients. Among those, 66% were treated with csDMARDs as monotherapy or in combination therapy with sustained low disease activity (LDA). However, 3.2% from this group neither achieved LDA, nor received bDMARDs, due to comorbidities. On the other hand, 34% were treated with bDMARDs with or without csDMARDs. The majority of them demonstrated sustained LDA. From this group, 17.7% never achieved LDA, despite that they switched and received all bDMARDs. Thus, 20.9% of our patients never achieved LDA.Conclusions
Using the current recommendations for RA therapy we successfully treated the majority of our patients. However, we found that the size of gap and the unmet needs for treatment is about 20%. 相似文献106.
Acute combined effects of olive oil and wine on pressure wave reflections: another beneficial influence of the Mediterranean diet antioxidants? 总被引:1,自引:0,他引:1
Papamichael CM Karatzi KN Papaioannou TG Karatzis EN Katsichti P Sideris V Zakopoulos N Zampelas A Lekakis JP 《Journal of hypertension》2008,26(2):223-229
OBJECTIVES: Combined consumption of olive oil and wine is common in the Mediterranean diet, but there are no data concerning their synergistic haemodynamic response. We sought to determine the combined postprandial effects of wine and olive oil on wave reflections and central haemodynamics. METHODS: Fifteen healthy subjects consumed four standard meals on different days, containing 50 g of olive oil and 250 ml of wine, in a randomized cross-over study design. Two types of wine [red (R) and white (W)] and two types of olive oil [green (G) and refined (O) (rich and poor in antioxidants, respectively)] were used in all possible combinations (RO, RG, WO and WG). Applanation tonometry and aortic pulse wave analysis were performed when fasting and 1, 2 and 3 h postprandially. A second group of 15 healthy individuals matched for age, gender and body mass index served as the control group. RESULTS: All meals decreased AIx (RO and RG, P < 0.001; WO, P = 0.007; and WG, P = 0.039). The AIx reduction after RG, RO, WO and WG was significantly different from the respective AIx response of the control group. No difference was observed in the reduction of AIx between sessions, but a significantly earlier peak decrease in AIx, as well as a more prolonged decreasing effect, was observed after RG and RO consumption compared to WO and WG. Central systolic and diastolic pressures were diminished after all four combinations of wine and olive oil (P < 0.05). CONCLUSIONS: Combined consumption of wine and olive oil provided beneficial postprandial effects on haemodynamics. These findings reveal an additional favourable effect of components of the Mediterranean diet on haemodynamics in the postprandial state. 相似文献
107.
Afroditi K Boutou Eleni A Tsiata Athanasia Pataka Paschalina K Kontou Georgia G Pitsiou Paraskevi Argyropoulou 《Primary care respiratory journal》2008,17(1):32-38
AIM: To identify the predictors of six-month continuous abstinence among Greek smokers treated in a Smoking Cessation Clinic, emphasising the role of sleep disturbance on the outcome. METHODS: A nested case-control design was used. Patients who attended the Smoking Cessation Clinic between November 2004 and October 2005, and who completed six months of follow-up, constituted the final study population (N=285). The patients were separated into two groups - those who managed to quit smoking and those who didn't. The cessation method included pharmacotherapy, one-to- one behavioral counselling, and follow-up by telephone communication. RESULTS: Among various baseline characteristics examined, multivariate regression analysis indicated that the time to first cigarette after awakening, and use of bupropion, independently predicted abstinence, while awakening during the night was negatively associated with abstinence. CONCLUSION: These multivariate factors, which can positively or negatively affect the outcome, should be taken into account so that smoking cessation treatment can be individualised. 相似文献
108.
Oikonomou A Chatzistefanou A Zezos P Mintzopoulou P Vadikolias K Prassopoulos P 《Journal of magnetic resonance imaging : JMRI》2012,35(2):426-430
The purpose of this study was to evaluate possible central nervous system (CNS) involvement in Rendu-Osler-Weber (ROW) disease in magnetic resonance imaging (MRI). Three patients with symptomatic ROW disease underwent brain MRI. Brain MRI depicted in all three of them increased signal intensity on T1-weighted images involving the globus pallidus and cerebral crura bilaterally. Laboratory studies of the two men showed iron deficiency anemia, while all three of them had normal liver function tests and increased manganese blood concentration. Gastroscopy and colonoscopy revealed a gastric and a cecal arteriovenous malformation (AVM) in the first one, while pulmonary and hepatic computed tomography (CT) angiography did not detect any intrahepatic shunts. Liver ultrasound in the second one revealed dilatation of intrahepatic artery branches consistent with intrahepatic shunts, while it was normal in the third patient. Chest radiographs were normal in all three patients. Pallidal T1 hyperintensity on T1-weighted imaging may be a biomarker of manganese overload in ROW disease. 相似文献
109.
Papadatou D Giannopoulou I Bitsakou P Bellali T Talias MA Tselepi K 《Journal of traumatic stress》2012,25(1):57-63
This cross-sectional study examined the factors associated with higher levels of posttraumatic stress disorder (PTSD) and depression symptoms in 1,468 adolescents, 6 months after a wildfire. The rate of probable PTSD was 29.4% and 20% for probable depression. Findings on predisaster, disaster-related, and postdisaster factors revealed that disaster-related factors-specifically objective and perceived threat to self and others-were associated with symptoms of PTSD but not depression. Predisaster life events, postdisaster losses, and escape-oriented coping strategies were associated with higher levels of both PTSD and depression symptoms, while control-oriented coping and perceived social support were differentially associated with symptoms of and depression. Findings have implications for the assessment and treatment of traumatized and depressed adolescents after a disaster. 相似文献
110.
Panagiotis V.S. Vasileiou Theodoros Xanthos Dimitrios Barouxis Charalampos Pantazopoulos Apostolos E. Papalois Paulos Lelovas Olympia Kotsilianou Paraskevi Pliatsika Evaggelia Kouskouni Nicoletta Iacovidou 《The American journal of emergency medicine》2014