Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program.

AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer (CRC) screening program using fecal immunochemical test (FIT). METHODS: All employees of "Attikon" University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT (DyoniFOB(®) Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test. RESULTS: Among our target population consisted of 211 employees, 59 (27.9%) consented to participate, but only 41 (19.4%) and 24 (11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation (P = 0.005) and test completion - first and second round - (P = 0.004 and P = 0.05) rates, respectively. Physician's (13.5% vs 70.2%, P < 0.0001) participation and test completion rates (7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated (25.8% vs 70.2%, P = 0.0002) and completed the first test round (19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later. CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.

Long-term patient satisfaction of gastrointestinal endoscopic procedures.

BACKGROUND: We prospectively assessed patient satisfaction in a Greek Academic endoscopy facility. METHODS: Consecutive outpatients filled a satisfaction questionnaire right after their endoscopy (D1), 3 days (D3) and 3 months (M3) later. Overall patient satisfaction was measured by their willingness to repeat endoscopy in our facility and to further recommend it. Participant satisfaction regarding pre-procedural, procedural and post-procedural issues was measured using a five-step Likert scale in 19 items with 4 and 5 scores indicating favorable responses. Pareto analysis was used to determine service issues requiring improvement. Late adverse events were recorded at D3 and M3 assessments. RESULTS: Over six months, 501 patients participated (89.4% and 87.8% response rate at D3 and M3 assessments, respectively). More than 97% of the participants would repeat the procedure in our facility and would recommend our endoscopy service, at all three assessments. Pareto analysis identified waiting time until the appointment and on the day of the examination, discomfort during and after the endoscopy, time to obtain the pathology report and overall management of the patient problems as the issues requiring improvement. No predictor of high satisfaction score has been identified. No serious late adverse events were reported. CONCLUSION: Despite the overall high levels of patient satisfaction, management of patient discomfort and organizational issues need improvement.

Skin disease after occupational dermal exposure to coal tar: a review of the scientific literature.

For about a century, coal tar has been used in industry and has been applied in the therapeutic management of several skin diseases. However, in the last decades the benefits of coal tar exploitation for humans could not outweigh its harmful effects on health. The aim of this study is to present the main adverse effects of coal tar on skin, with the emphasis on occupational exposure. The scientific literature indicates that dermal exposure to coal tar and coal tar pitches can be the cause of phototoxic reactions, irritation and burn, allergic dermatitis, folliculitis, occupational acne, atrophy of the epidermis, and hyperpigmentation. Moreover coal tar has been implicated in tumorigenesis, a relationship shown in numerous studies but not confirmed yet as the mechanism has not been fully clarified. A common finding in most studies is that exposure over a long period is the main risk factor for malignancy development, even in low exposure levels. Additional prospective, well-designed studies need to be performed to confirm the validity of the carcinogenic, mutagenic, and cytotoxic potential of coal tar on skin.