43 research outputs found
A National Representative, Cross-Sectional Study by the Hellenic Academy of NeuroImmunology (HEL.A.NI.) on COVID-19 and Multiple Sclerosis: Overall Impact and Willingness Toward Vaccination
No full textBackground: In the context of the coronavirus disease 2019 (COVID-19) pandemic, the constant needs of people with multiple sclerosis (PwMS) and their caregivers were urgently highlighted.Aim: The present study aims to capture the effects of the COVID-19 pandemic in several aspects of the quality of life of PwMS, in perception and behavior to COVID-19 and multiple sclerosis (MS), as well as concerning healthcare, working conditions, and the willingness toward COVID-19 vaccination.Methods: This study is an initiative of the Hellenic Academy of Neuroimmunology (HEL.A.NI.) and it has been included in the MS Data Alliance (MSDA) Catalog, which can be accessed after creating an account on . Two online questionnaires were administered: (i) impact of the COVID-19 pandemic on the quality of life, behavior, and healthcare of PwMS (Questionnaire A) and (ii) vaccination against COVID-19 (Questionnaire B). People with MS were invited to participate by the Hellenic Federation of Persons with Multiple Sclerosis (HFoPwMS).Results: Three-hundred-ninety PwMS responded to Questionnaire A, whereas 176 PwMS provided answers for Questionnaire B. Older age, longer disease duration, and higher MS-related disability were associated with the increased perceived sensitivity toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as well as the increased perceived severity of COVID-19 upon potential infection. A significant proportion of PwMS experienced restricted access to MS-related health professionals, disease-modifying therapy (DMT) prescription, and/or to MS-related laboratory examination due to the pandemic. Subgroups of PwMS reported exacerbated symptoms (i.e., chronic MS-related symptoms, fatigue and/or worsening of pre-existing fatigue, and sexual dysfunction and or/worsening of pre-existing sexual dysfunction). Overall, the majority of the participants reported either a strong willingness to get vaccinated against COVID-19 or a likeliness to undergo vaccination. Being aware of the HEL.A.NI. recommendations regarding COVID-19 vaccination for PwMS were reported to increase the willingness of the participants to receive the vaccine.Conclusions: Our results highlight the necessity of scientific and patient organizations in taking joint action to increase awareness on health-related issues during the pandemic and to provide accurate and up-to-date guidance for PwMS. Online information and communications technology (ICT) tools for polling public belief and behavior may prove valuable as means of retaining active routes of communication between stakeholders.We would like to acknowledge Vasiliki Maraka and Moira Tzitzika of the Hellenic Federation of Persons with Multiple Sclerosis (HFoPwMS) for rapidly and effectively bringing the initiative into public awareness via appropriate publicity measures, as well as the members of the General Assembly of the Hellenic Academy of Neuroimmunology (HEL.A.NI.) for reviewing the questionnaires and supporting the initiative
The effect of antihypertensive treatment on the structural and functional parameters of the left ventricle in hypertensive patients
No full textThe aim of this study is to evaluated the changes in hypertrophy, in systolic and diastolic function of left ventricular in hypertensives patients who were treated with different antihypertensives agents. 40 hypertensive patients (24male, 16 female mean age 52,05 +8,23 years) with left ventricular hypertrophy were divided in four groups. Group A comprised 10 patients (6 male, 4 female, m.a. 51,5±7,68 years), who were treated with lisinopril, group B comprised 10 patients (6 male, 4 female, m.a. 53,4±8,38 years), who were treated with atenolol, group C comprised 10 patients (6 male, 4 female, m.a. 51,2±7,25 years), who were treated with pindolol and group D comprised 10 patients (6 male, 4 female, m.a. 52,1±9,36 years), who were treated with verapamil. The echocardio-Doppler evaluation was performed both at rest and at the peak of test. Left ventricular dimensions were obtained from two dimensionally guided M-mode tracings using the criteria of the American Society of Echocardiography. Left ventricular peak filling rates and filling rate integrals were measured by a pulsed Doppler technique. Blood pressure regulation obtained in all patients. In group A patients decreased LV mass, LVEDd, end-systolic stress and increased EF, SF, in rest and stress were observed with statistical significance. In group B patients decreased LV mass in 6 months therapy, endsystolic stress and EF were observed with statistical significance. In group C patients decreased LV mass in 6 months therapy, LV mass in 4 months therapy and endsystolic stress were observed with statistical significance. Finally in group D patients decreased LV mass, LV mass in 4 months therapy and end-systolic stress and increased EF were observed with statistical significance. Diastolic indexes improved in all groups patients. From this thesis the following conclusions can be made: In lisinopril treated patients early left ventricular regression primarily due to the effect of the lisinopril and secondary due to control of the blood pressure Hemodynamic variation in atenolol, pindolol and verapamil treated patients need more time to cause regression in hypertrophic heart muscle of hypertensive patients. The optimal hypertensive therapy causing early and intensive LV regression, is the one causing smoother blood pressure normalization, applied in the beginning stages. Although the LV mass reduces, the antihypertensive agents without negative inotropic action improve systolic LV function. When reduction of the blood pressure is achieved, the negative inotropic effect of the atenolol does not degrade the patients systolic LV fuction in rest and in stress. In general improvement of the LV systolic function observed during stress is due to reduced need of the heart muscle in oxygen. Although the systolic LV function is often normal in early stages in hypertensive patients LV diastolic function are impair in hypertensive patients. Therefore in patients with normal systolic function, congestive heart disease symptoms can be observed. Early improvement of the LV diastolic function independently of the hypertensive agent used is due to decrease of the blood pressure, heart rate, oxygen demand, improvement coronary flow and suppression of theRAAS.H αυξημένη συχνότητα εμφάνισης αρτηριακής υπέρτασης στον γενικό πληθυσμό και οι αιμοδυναμικές και λειτουργικές μεταβολές που προκαλούνται προσδίδουνιδιαίτερη αξία στην προσπάθεια ελέγχου της επίδρασης διαφόρων αντιυπερτασικών φαρμάκων στους δείκτες λειτουργικότητας της αριστεράς κοιλίας. Σκοπός της διατριβής είναι να διερευνήσει τις δομικές και λειτουργικές μεταβολές της αριστερής κοιλιάς που προκαλούνται από τη χρόνια αντιυπερτασική αγωγή. Το υλικό της Μελέτης αποτέλεσαν 40 υπερτασικοί ασθενείς (24άντρες και 16γυναίκες μέσης ηλικίας 52±8,23 έτη) με υπερτροφία αριστερής κοιλίας στον υπερηχοκαρδιογραφηκό έλεγχο, και των οποίων η αρτηριακή πίεση ρυθμίστηκε ικανοποιητικά μετά τη χορήγηση αντιυπερτασικών φαρμάκων. Οι ασθενείς χωρίστηκαν σε τέσσερις ομάδες των 10 ασθενών τους ασθενείς της Ομάδος Α (6 άντρες και 4 γυναίκες μ.η. 51,5±7,68 έτη) στους οποίους χορηγήθηκε λισινοπρίλη, σε αυτούς της ομάδας Β (6άντρες και 4 γυναίκες μ.η. 53,4±8,38 έτη) ατενολόλη, στην ομάδα Γ (6άνδρες και 4 γυναίκες μ.η. 51,2±7,25 έτη) πινδολόλη και στην ομάδα Δ (6άντρες και 4 γυναίκες μ.η.52,1±9,36 έτη) βεραπαμίλη. Όπως φαίνεται από τα αποτελέσματα μας σωστή ρύθμιση της αρτηριακής πίεσης έγινε σε όλους τους ασθενείς των ομάδων με λόγω trough to peak μεγαλύτερο από 0,6. Μείωση της μάζας της αριστερής κοιλίας της τελοδιαστολικής διαμέτρου, του τελοσυστολικού στρες και αύξηση του κλάσματος εξώθησης και βράχυνση σε ηρεμία και σε κόπωσης στατιστικά σημαντική παρατηρήθηκε στους ασθενείς της ομάδας Α. Στους ασθενείς της Ομάδος Β παρατηρήθηκε στατιστικά σημαντική μείωση της μάζας της αριστερής κοιλίας στους έξι μήνες, μείωση του κλάσματος εξώθησης και του τελοσυστολικού στρες. Στους ασθενείς της Ομάδος Γ παρατηρήθηκε μείωση της μάζας της αριστερής κοιλίας στους έξι μήνες του δείκτη μάζας της αριστερής κοιλίας στους 4 μήνες και μείωση του τελοσυστολικού στρες. Το κλάσμα εξώθησης δεν μεταβλήθηκε σημαντικά. Τέλος στους ασθενείς της ομάδας Δ παρατηρήθηκε μείωση της μάζας της αριστερής κοιλίας του δείκτη μάζας της αριστερής κοιλίας στους 4 μήνες και μείωσης του τελοσυστολικού στρες και αύξηση του κλάσματος εξώθησης. Οι διαστολικοί δείκτες βρέθηκαν βελτιούμενοι στους ασθενείς όλων των ομάδων. Από την παρούσα μελέτη εξάγονται τα παρακάτω συμπεράσματα Η σωστή ρύθμιση της αρτηριακής πίεσης με τη χρησιμοποιείς προκαλεί πρωιμότερη υποστροφή της υπερτροφίας της αριστερής κοιλιάς που οφείλεται πρώτα στην ιδιότητα του φαρμάκου και μετά στη ρύθμιση της αρτηριακής πίεσης. Οι αιμοδυναμικές μεταβολές που συμβαίνουν σε ασθενείς υπό ατενολόλη, πινδολόλη και βεραπαμίλη χρειάζονται περισσότερο χρόνο για να προκαλέσουν υποστροφή του υπερτροφικού μυοκαρδίου των υπερτασικών ασθενών. Η ιδανική αντιυπερτασική θεραπεία με την οποία επιτυγχάνει ταχύτερη και εντονότερη υποστροφή της υπερτροφίας της αριστερής κοιλίας είναι αυτή που προκαλεί επιμηκέστερη ρύθμιση της αρτηριακής πίεσης, αρχίζει νωρίς την εξέλιξή της νόσου και δεν προκαλεί αντανακλαστική ενεργοποίηση διαφόρων τροφικών ορμονικών παραγόντων. Τα χορηγούμενα αντιυπερτασικά φάρμακα που δεν έχουν καρδιοκατασταλτικές ιδιότητες κατά υποστροφή της υπερτροφίας της αριστερής κοιλίας βελτιώνουν τη λειτουργία της αντλίας, παρά τη μείωση της μάζας του εργατικού μυοκαρδίου. Η αρνητική ινοτροπος ενέργεια της ατενολόλης όταν επιτυγχάνει μείωση της αρτηριακής πίεσης δεν είναι ικανή να επιβαρύνει τη συστολική λειτουργία των ασθενών, τόσο σε κατάσταση ηρεμίας όσο και στην κόπωση. Γενικά η βελτίωση της συνολικής λειτουργίας που παρατηρείται στους και κατά την άσκηση, παρά την υποστροφή της υπερτροφίας της αριστερής κοιλίας οφείλεται στη μείωση της ανάγκης του οξυγόνου του καρδιακού μυός Ενώ η συστολική λειτουργία αργεί να επηρεαστεί στους υπερτασικούς η διαστολική φαίνεται να επηρεάζεται πρόβλημα και σε ακραίες καταστάσεις μπορεί να προκαλέσει συμπτώματα συμφορητικής καρδιακής ανεπάρκειας ακόμα και σε ασθενείς με φυσιολογική συστολική λειτουργία. Η βελτίωση της διαστολικής λειτουργίας πρώιμα ανεξαρτήτως αντιυπερτασικού φαρμάκου παρά την υποστροφή ή όχι της υπερτροφίας της αριστερής κοιλίας οφείλεται τόσο στη μείωση της αρτηριακής πίεσης όσο και στη μείωση της καρδιακής συχνότητας, στη μείωση της ανάγκης των καρδιακών κυττάρων για οξυγόνο, στη βελτίωση της στεφανιαίας αιμάτωσης και στη ρύθμιση του συστήματος ρενίνης- αγγειοτενσίνης- αλδοστερόνης
Electrocardiographic findings in cerebrovascular attacks: clinical and laboratory observations
No full textAcute Myocardial Infarction Manifested with Headache
No full textWe report a very rare case of a patient who presented with headache as the sole symptom of an acute myocardial infarction (AMI). The patient underwent primary percutaneous coronary angioplasty followed by drug-eluting stent implantation and the headache was immediately relieved. The pathophysiologic explanation of the occurrence of headache as a sole manifestation of an AMI is discussed.</jats:p
Personalized e-Learning Implementation - The GIS Case
No full textPersonalized e-learning implementation is recognized as among one of the most interesting research areas in the distance learning Web-based education. In particular, the GIS e-learning initiatives that incorporate –by default– a number of sequencing spatial techniques (i.e. spatial objects selection and sequencing), will well benefit from a welldefined personalized e-learning implementation with embedded spatial functionality. This is the case addressed in this paper. The GIS e-learning implementation introduced in the current paper is based on a set of teaching (lecturing) rules according to the cognitive style of learning preferences of both the learners and the lecturers as well. It is important to note that, in spite of the fact that most of these teaching rules are generic (i.e. domain, view and user independent), there are no so far well-defined and commonly accepted rules on how the learning spatial GIS objects and techniques should be selected and how they should be sequenced to make “instructional sense" in a Web-based GIS course
Expanding the Use of the Filter Embolic Protection Devices in Difficult to Protect Lesions
No full textThere are anatomical limitations in the effective use of distal protection devices, related to the fact that a balloon or stent can only be deployed at a certain distance from the filter. We describe a way to limit the embolic load in a vein graft angioplasty, in a difficult for effective distal protection anatomic situation by doing full balloon inflations on a separate wire in parallel to the deployed FilterWire™; after removal of the Filter- Wire™, an appropriately sized stent was deployed at low pressure
Effects of renin-angiotensin system inhibition on right ventricular function in patients with mild essential hypertension
No full text Introduction: Systemic hypertension is known to affect both left and right ventricular (RV) function. Little is known about the effect of the renin—angiotensin system (RAS) inhibition on global RV function in patients with essential hypertension. Materials and methods: Forty patients (17 male, mean age 47 ± 10 years) with mild hypertension free of cardiovascular disease were assessed by echocardiography at baseline and after nine months of antihypertensive treatment with RAS inhibitors. Tissue Doppler imaging derived myocardial performance index (MPI) of the left and right ventricle was used as an index of global ventricular function. Results: Both left ventricular (LV) and RV MPI were increased at baseline and were reduced after treatment (LV MPI reduced from 0.42 ± 0.06 to 0.39 ± 0.05, p < 0.001 and RV MPI was reduced from 0.34 ± 0.06 to 0.32 ± 0.05, p < 0.005). There was a positive correlation between mitral and tricuspid E/A ratio both at baseline and at month nine after treatment ( r = 0.661, p < 0.001 and r = 0.503, p < 0.005 respectively). LV mass index and interventricular septum thickness were decreased after treatment. No correlation was found between MPI improvement and blood pressure reduction. Conclusions: RAS inhibition in patients with mild hypertension results in an improvement of RV global function which is unrelated to the reduction in blood pressure. </jats:p
e-SCP-ECG+ Protocol: An Expansion on SCP-ECG Protocol for Health Telemonitoring—Pilot Implementation
No full textStandard Communication Protocol for Computer-assisted Electrocardiography (SCP-ECG) provides standardized communication among different ECG devices and medical information systems. This paper extends the use of this protocol in order to be included in health monitoring systems. It introduces new sections into SCP-ECG structure for transferring data for positioning, allergies, and five additional biosignals: noninvasive blood pressure (NiBP), body temperature (Temp), Carbon dioxide (CO2), blood oxygen saturation (SPO2), and pulse rate. It also introduces new tags in existing sections for transferring comprehensive demographic data. The proposed enhanced version is referred to as e-SCP-ECG+ protocol. This paper also considers the pilot implementation of the new protocol as a software component in a Health Telemonitoring System
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Pheochromocytoma crisis presenting with cardiogenic shock
No full textPheochromocytoma is a catecholamine-secreting tumor of the adrenal glands whose typical presentation includes the triad of headache, palpitations, and diaphoresis. Pheochromocytoma crisis is an urgent medical condition whose diagnosis and management constitute a challenge for physicians. We present the case of a 55-year-old man who developed cardiogenic shock in the setting of a pheochromocytoma crisis. After stabilizing blood pressure with combined administration of α- and β-blockers, the tumor was surgically removed. Our diagnostic and therapeutic challenges are discussed
