Outcomes of cardiopulmonary resuscitation efforts in a Greek tertiary hospital.

INTRODUCTION: In-hospital cardiac arrest is a leading cause of death and despite recent advances in cardiopulmonary resuscitation, the survival to hospital discharge is poor. The aim of our study was to evaluate the success of resuscitation efforts in a tertiary hospital. PATIENTS AND METHODS: We retrospectively collected and analysed data on all patients in whom cardiopulmonary resuscitation was attempted after in-hospital cardiac arrest in one-year period. RESULTS: 96 cardiac arrest victims were studied. Sustained return of spontaneous circulation was achieved in 15 (15.6%) patients, while all of them survived for 24 h. Training in cardiopulmonary resuscitation, initiation of resuscitation efforts in less than 5 min, and intubation time < 1 min after team arrival were predictive factors associated with restoration of spontaneous circulation. Non-certified residents resuscitated 87 (90.6%) patients with 6 (6.8%) of them achieving return of spontaneous circulation and surviving for 24 h. On the contrary, certified ward residents resuscitated nine (9.3%) patients with 100% immediate and 24-h survival. CONCLUSION: In our hospital, certified providers had remarkably higher successful resuscitation rates for in-hospital cardiac arrest than non-certified providers. This finding suggests that training in cardiopulmonary resuscitation, continuing medical education, and implementation of the existing legislation will result in increased survival.

Severe sepsis and septic shock due to Plasmodium vivax infection.

Plasmodium vivax malaria is typically characterized by a mild and benign clinical course. Organ dysfunction is rarely seen, whereas acute lung injury has been found to occur after starting antimalarial treatment. We present an unusual case of severe sepsis and septic shock due to Plasmodium vivax monoinfection.

Evaluation of the willingness for cadaveric donation in Greece: a population-based study.

Despite the importance of body donation for medical education and the advancement of medical science, cadaveric donation remains suboptimal worldwide. The purpose of this study was to evaluate the willingness of body donation in Greece and determine the characteristics of donors. This cross-sectional questionnaire survey was conducted from January to June 2011. A specially designed questionnaire was distributed to 1,700 individuals who were randomly selected from five major Greek cities. It was found that higher educational levels (P = 0.002), annual family income below 30,000 Euros (P = 0.001), guaranteed employment status (P = 0.02), and the presence of comorbid conditions (P = 0.004) seemed to affect potential donors' willingness for cadaveric donation. Those with strong religious beliefs were found to be unwilling to donate their bodies to medical science. Interestingly, the majority of participants who believed that hospitalized patients are deceived or are used for harmful experiments were willing to become whole body donors (P = 0.043). In Greece, the rate of body donation to medical science remains low, and most Greek citizens are not willing to become body donors. Efforts to encourage discussions about whole body donation should be implemented in order to improve current low levels of donation.

Patients with colorectal cancer are characterized by increased concentration of fecal hb-hp complex, myeloperoxidase, and secretory IgA.

OBJECTIVES: The aim of our study was to evaluate the use of fecal hemoglobin-haptoglobin (Hb-Hp) complex, myeloperoxidase (MPO), and secretory IgA as potential diagnostic markers for the screening of colorectal cancer. METHODS: Our study consisted of 190 participants (150 patients and 40 healthy individuals) aged 40 to 70 years who underwent complete colonoscopy. From each participant, a stool sample was collected 1 day before colonoscopy. The patients were instructed to collect another sample after the fourteenth postoperative day. No special diet was recommended. RESULTS: In the control group, all fecal markers were within normal values in most participants. Colorectal tumors were accompanied by a highly significant increase in all markers. The median value of Hb-Hp complex was 23.22±10.02 (P<0.0001) whereas the median values of MPO and sIgA were 14936.43±9580.83 (P<0.0001) and 6503.38±2794.87 (P<0.0001), respectively. The sensitivity and specificity of Hb-Hp complex, MPO, and sIgA are 95.3% and 87.5%, 96% and 87%, and 90.8% and 85%, respectively. The difference of preoperative and postoperative values of the patients was statistically significant for all markers. After surgical intervention, the value of Hb-Hp complex was normalized in 133 of the 150 patients (88.7%). The postoperative values of MPO were within normal limits in 131 patients (87.3%), whereas those of secretory IgA were within normal limits in 103 of the 150 patients (68.5%). CONCLUSION: Fecal Hb-Hp complex, MPO, and sIgA can effectively be used as screening tools for the early diagnosis of colorectal cancer, and for the postoperative follow-up of patients.