Pediatric Residents Knowledge of Penicillin Allergy.

Penicillin allergy knowledge has not been evaluated specifically in the pediatric resident population. An anonymous electronic survey was distributed to all the pediatric residents in a single residency program to ascertain knowledge of penicillin allergies and allergy history taking skills. Responses among each resident class were compared using the Fisher exact test, 2-tailed. A total of 46 (52%) of 88 pediatric residents completed the survey. Only 63% reported to have had prior penicillin allergy education. All residents incorrectly identified low-risk symptoms as high-risk symptoms. The knowledge of penicillin allergy was poor across all training levels with no improvement over the duration of training. There is large support in the literature for de-labeling penicillin allergy in patients. Pediatric residents evaluate patients in childhood when most of the allergy labeling occurs. We need to consider strategies for incorporating penicillin allergy education in pediatric residency training.

Diagnosis, treatment and quality of life in patients with cancer-related lymphedema.

Cancer-related lymphedema is the result of surgical operation or radiation therapy of the corresponding lymph nodes and is due to the obstruction of the lymphatic drainage in the affected area. In lymphedema the lymphatic stasis causes an inflammatory reaction that leads to the proliferation of adipose tissue and fibrosis, resulting in mild to severe permanent swelling of the affected part of the body. It is more often found in the upper extremities of women with breast cancer. It may, however, appear at one or more extremities and may include the corresponding quadrant of the trunk. It may also affect head and neck, breast, genitals and lower extremities, depending on the surgery the patient has undergone. It is often associated with obesity (BMI>40). Early diagnosis and treatment of lymphedema is related with better therapeutic outcome. Women with breast cancer confront more problems with lymphedema than with mastectomy. Its effect on patients' quality of life is relevant to changes in body image, self-esteem, feelings of weakness, fear and anxiety about disease progression, financial costs, and reduced limb function. More recent studies support the effectiveness of contemporary surgical techniques in lymphedema's treatment. In conservative management, CDT remains the treatment of choice and in combination with exercise, weight control programs and self-care training seems to significantly improve patients' quality of life.

A cross-sectional study for assessing perceived symptoms, depression and quality of life in advanced lung cancer patients.

PURPOSE: The purpose of the present study was to assess the perceived symptoms, depression and quality of life (QoL) in advanced lung cancer patients undergoing chemotherapy. METHODS: The study was cross sectional and was conducted in the oncology department of General Hospital "George Papanikolaou", Thessaloniki, Greece. The sample was convenient and consisted of 76 advanced lung cancer patients. A questionnaire including instruments such as Center for Epidemiologic Studies Depression Scale- CES-D, Revised Edmonton Symptom Assessment Scale r-ESAS, EORTC QLQ-C30 and demographic and clinical information was used to collect data. RESULTS: The most frequently observed symptoms were tiredness, shortness of breath, anxiety and well-being. The vast majority of patients (75.3%) had total score in CES-depression higher than 16. The type of residence affected ESAS emotional score (p=0.010). Gender affected the level of depression (p=0.014) and the type of lung cancer affected depression (p=0.036). The type of residence affected emotional functioning (p=0.010), the type of treatment influenced the score of global health status (p=0.007), the role functioning (p=0.032) and social functioning (p=0.024). Multivariate regression analysis was conducted to identify the predictors of overall QoL and depression. The statistically significant factors for QoL were pain (p<0.001) and tiredness (p=0.003), while the type of lung cancer (p<0.007), the type of insurance (p<0.025) and the type of treatment (p<0.041) influenced depression as well. CONCLUSIONS: Advanced lung cancer patients experienced moderate level in QoL and mild levels of symptoms. Demographic and clinical characteristics influenced depression and QoL.

Assessment of oncology patients' satisfaction from intravenous chemotherapy.

PURPOSE: To assess patient satisfaction from chemotherapy and investigate the effect of demographic factors, disease symptoms and treatment on satisfaction. METHODS: A non-randomized cross-sectional survey was conducted on a sample of 100 patients undergoing chemotherapy at "Metaxa" Cancer Hospital, Piraeus, Greece for 6 months. A demographic data questionnaire, a Cancer Treatment Satisfaction Questionnaire (CTSQ) and visual analog scales were used to evaluate pain, anxiety, fatigue, and nausea while presence or absence of vomit were also assessed. RESULTS: The majority of the patients in the sample were men (51%), with a mean age of 58.5 ± 10.82 years. The mean value of expectations from treatment was 60.55, from treatment's satisfaction was 75.86 and from feelings about treatment's side effects was 44.56. The most serious symptoms were fatigue and anxiety (7.2 ± 1.95 and 6.71 ± 2.5, respectively). Statistical tests have shown that sub-dimensions of CTSQ are associated with pain, anxiety, fatigue, and nausea. CONCLUSIONS: Generally, chemotherapy meets patients' expectations with cancer. Symptoms such as fatigue, anxiety, pain, and nausea affect their satisfaction. Treatment's satisfaction can be improved by evaluating symptoms, which will lead to appropriate interventions.

Managing the Intervention Costs of Musculoskeletal Disorders in the Hospital Workplace.

OCCUPATIONAL APPLICATIONSThis study demonstrates the applicability of multicriteria tools to solve occupational health and safety (OSH) problems related to cost management in the healthcare sector. To the best of our knowledge, this is the first work in which linear programming and established methods for risk assessment of work-related musculoskeletal disorders (i.e., the Key Item Method) have been combined with the knowledge and experience of the corresponding safety engineer (or OSH auditor or consultant). The ease of implementation of the whole process facilitates its future utilization in working practice without adding an undue burden on existing OSH practices.

TECHNICAL ABSTRACTBackground: Managing the intervention costs of musculoskeletal disorders (MSDs) through the optimal use of the resources and the evaluation of interventions is a cornerstone in Occupational Safety and Health (OSH) management in the healthcare sector.Purpose: We aim to create a practically useful tool for the allocation of work-related MSDs intervention costs and the support of relevant OSH decisions in the hospital workplace.Methods: A legally established risk assessment method was combined with the widely applied Key Item Method and linear programming to develop a functional cost allocation tool for allocating the work-related MSDs intervention costs in the hospital workplace. The proposed tool indicates where investments should be made in an intervention or combination of interventions, to jointly achieve minimization of the risk and maximization of convenience with the minimum possible cost. The primary goal of our study was to evaluate interventions indicated by the tool, in terms of reducing the risk values related to MSDs. The sample studied consisted of 15 female nurses of "Metaxa" Cancer Hospital (Greece). The main selected interventions were related to ergonomic training, improving work conditions, tidiness, and equipment.Results: Implementing these interventions over a two-month period (September to November 2019) led to a significant reduction in employees' risk of strain.Conclusions: The proposed tool can be practically useful in allocating OSH intervention costs for a certain safety investment.

Sexuality and quality of life of patients with hematologic malignancy and hematopoietic stem cell transplantation: a critical review.

PURPOSE: This systematic review aims to investigate the relationship between sexuality and quality of life (QoL) of patients with hematological malignancies that underwent hematopoietic stem cell transplantation (HSCT). METHODS: A bibliographic search was carried out through PubMed database with the following terms for the years 2008 to 2019: sexuality, sexual function, quality of life, hematopoietic stem cell transplantation. RESULTS: Fourteen studies were included in the review. They present heterogeneity regarding measurement tools, time of measurement and type of HSCT. The common theme that emerged from most studies is that sexual dysfunction is reported after years of HSCT and it negatively impacts QoL. Women and allogenic HSCT with its consequences (graft versus host disease) were risk factors for sexual dysfunction. Sexual activity of HSCT patients was decreased at first but resumed after the first year. The most common sexual problems reported were erectile dysfunction for men and lack of desire for women. In the majority of studies the amelioration of physical, psychological symptoms and sexual function lead to improvement in QoL over time. CONCLUSIONS: Sexuality and QoL of patients are affected by HSCT in varying degrees, and seems to be a significant and positive correlation between sexuality and QoL. However, with weaknesses and shortcomings in the revised studies' methodology (sample sizes, type of HSCT, attrition rates etc.), results are difficult to generalize.

Intervention for symptom management in patients with malignant fungating wounds - a systematic review.

PURPOSE: To identify the latest data on interventions in the management of malignant fungating wounds (WFWs). METHODS: A systematic review has been conducted to explore the original research about symptom management of malignant fungating wounds. Keywords and time constraints were used for the period 2008-2017 using the online Medline database (NCBI) with combined inclusion and exclusion criteria. RESULTS: Eleven original research studies met the inclusion criteria. Nine of them referred to the use of materials and methods for managing the main symptoms which are malodour, exudate, pain and bleeding. An improvement in symptoms was observed in the involving intervention studies. According to the results, odor and exudates were significantly decreased by the use of honey and silver dressings. Wound cleaning with saline or tap water and the use of metronidazole had also positive results. Pain management was performed by the systematic use of opioids and the administration of an additional dose prior to the dressing change. CONCLUSION: Patients with MFWs need a holistic treatment approach. They often seek late for health services and professional help. The disease is already locally advanced and a variety of symptoms leads to suffering and low quality of life. The effective management of symptoms by health professionals is vital to support patients in advanced disease. The need for constant briefing and updating of knowledge is imperative.