Low Reported Adherence to the 2019 American Diabetes Association Nutrition Recommendations among Patients with Type 2 Diabetes Mellitus, Indicating the Need for Improved Nutrition Education and Diet Care.

Patient adherence to guidelines is important for improved outcomes and prognosis. Nevertheless, many patients with type 2 diabetes mellitus (T2DM) do not comply with the recommendations regarding medication, physical activity, diet or self-care. The present cross-sectional study aimed to assess the level of adherence to the dietary recommendations issued by the American Diabetes Association (ADA) among patients with T2DM in Komotini, Greece. A total of 162 adults with T2DM (64.7 ± 10.6 years old), of which 41.4% were men, were recruited from the Sismanoglio Hospital and participated in the study. The level of adherence to individual recommendations issued by the ADA was assessed using yes/no questions. The overall adherence rate to the guidelines was low (41.2%). According to the multivariable analysis, age and medication therapy were identified as contributors to the compliance rate. No differences were noted in the total compliance rate between patients of different religious denominations (Muslims/Christians). Patients on oral antidiabetic agents (OAA) were more adherent compared with those on insulin therapy. A mere 3.7% of the participants had received nutrition education by a registered dietitian, 9.9% were following an individualized diet plan to improve glycemia, and 3.1% had set specific energy goals to reduce body weight. These findings are indicative of the need for the delivery of improved nutrition education.

Family caregiver beliefs and barriers to effective pain management of cancer patients in home care settings.

PURPOSE: Pain is one of the most common symptoms in cancer patients, and its management is a significant goal in supportive care. Many barriers interfere with its effective control. Nowadays, with a shift in care from the hospital to the home, there is an increasing tendency to involve family caregivers in pain management. Their beliefs may act as barriers to effective pain management in these homecare settings. This study aimed to validate and explore these beliefs using Barriers Questionnaire II (BQ II). METHODS: A cross-sectional survey of 202 individuals from a cohort of family caregivers in Greece. RESULTS: The reliability index Cronbach, a value for the translated version of the BQ II, calculated >0.9. Most participants reported worries about the side effects of analgesics. They often assumed these effects were irreversible, and equally, there were concerns about addiction to these drugs. They agreed on the effectiveness of analgesics in treating cancer pain but disagreed that reporting pain is a distracting factor in active cancer treatment. CONCLUSIONS: This is the first time BQ II has been used in this population. The results are consistent with the international academic studies in this area, but more research is needed. BQ II was found to be a valid and reliable scale for defining caregiver attitudes and barriers to effective pain management in homecare settings. Health professional training, interventions targeted to caregivers and trained home care teams may improve the quality of cancer care in these settings.

Breaking bad news in cancer patients.

OBJECTIVE: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. MATERIALS AND METHODS: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. RESULTS: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. CONCLUSIONS: There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines.

A prospective study of acute poisonings in a sample of Greek patients.

OBJECTIVES: Acute poisoning is one of the most common situations managed in the emergency department. Significant differences have been reported concerning the prevalence and etiology of poisoning. This study aims to present the epidemiologic and clinical characteristics of poisonings in the region of Thrace in Northern Greece, where no similar studies have been performed. METHODS: A prospective study was carried out in our hospital's emergency department during 4 years (1999-2003). Atotal of 223 adult patients were admitted with acute poisoning, 87 males (39%) and 136 females (61%). RESULTS: Mean age of male and female patients was 37.1 years (standard deviation 16.1) and 33.4 years (standard deviation 14.5), respectively. Intoxications were more common in summer (34.1%). The median time between poisoning and presentation was 4 hours. Poisonings were more common in the urban population (64.1%). Psychotropes were the leading cause of poisoning in patients with a psychiatric disease (74.1%) and analgesics in all the other patients groups (34.8%). The clinical status on admission was: conscious (45.7%), confused (35.4%), precoma/coma (18.9%). Haemodialysis was performed only in one patient and respiratory support was necessary in 10 patients. An antidote was administrated in 73 patients. Median hospital stay was 1 day. Two patients died (0.9%). CONCLUSIONS: Poisoning's aetiology varies significantly in different countries. Previous suicide attempts are common in these patients. Precipitating factors can be major depressive, or dysthymic disorders. The mortality rate is low.

Prevalence of hemochromatosis gene (HFE) mutations in Greece.

The frequencies of the hereditary hemochromatosis gene (HFE) mutations C282Y and H63D vary between different populations. There are a limited number of reports regarding the frequency of these mutations in populations of southeastern Europe. Two hundred and sixty-four adult individuals of Greek origin were examined for the C282Y and H63D mutations to determine the allele and genotype frequencies. The HFE gene region of DNA samples extracted from peripheral leukocytes was amplified by the polymerase chain reaction. Restriction enzyme analysis was performed using RSAI for C282Y and MBOI for H63D. None of the 264 individuals carried the mutation C282Y. Forty-three individuals (16.2%) were heterozygous carriers of the H63D allele and 2 were homozygous for this mutation (0.75%). The overall H63D allele prevalence is thus estimated at 8.9%. HFE mutation frequencies were low in the population studied and this may explain, in part, the relative rarity of clinical cases of hereditary hemochromatosis in Greece.