Papers by Theodoros Xanthos
Healthcare, Jun 21, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Acta Obstetricia et Gynecologica Scandinavica, 2012
International Journal of Molecular Sciences
Breast cancer and cardiovascular diseases (CVD) represent significant global health challenges, w... more Breast cancer and cardiovascular diseases (CVD) represent significant global health challenges, with CVD being the leading cause of mortality and breast cancer, showing a complex pattern of incidence and mortality. We explore the intricate interplay between these two seemingly distinct medical conditions, shedding light on their shared risk factors and potential pathophysiological connections. A specific connection between hypertension (HTN), atrial fibrillation (AF), myocardial infarction (MI), and breast cancer was evaluated. HTN is explored in detail, emphasizing the role of aging, menopause, insulin resistance, and obesity as common factors linking HTN and breast cancer. Moreover, an attempt is made to identify the potential impact of antihypertensive medications and highlight the increased risk of breast cancer among those women, with a focus on potential mechanisms. A summary of key findings underscores the need for a multisystem approach to understanding the relationship betw...
Resuscitation, Oct 1, 2012
Aim: Although researchers in several countries have investigated patients' points of view regardi... more Aim: Although researchers in several countries have investigated patients' points of view regarding cardiopulmonary resuscitation, there has been no research investigating this issue in Greece. The present study aimed at identifying the attitude of older Greek patients regarding cardiopulmonary resuscitation. Methods: One basic questionnaire consisting of 34 questions was used in order to identify patients' opinions regarding cardiopulmonary resuscitation in five different hospitals from June to November 2011. Results: In total, 300 questionnaires were collected. Although patients' knowledge regarding cardiopulmonary resuscitation was poor, most of them would like to be resuscitated in case they suffered an in-hospital cardiac arrest. Also, they believe that they should have the right to accept or refuse treatment. However, the legal and sociocultural norms in Greece do not support patients' choice for the decision to refuse resuscitation. The influence of several factors, such as their general health status or the underlying pathology, could lead patients to give a "do not attempt resuscitation" order. Conclusions: The attitudes of older Greek patients regarding resuscitation are not different from others', whereas the legal and sociocultural norms in Greece do not support patient choice in end-of-life decisions, namely the decision to refuse resuscitation. We advocate the introduction of advanced directives, as well as the establishment and implementation of specific legislation regarding the ethics of resuscitation in Greece. Geriatr Gerontol Int 2014; 14: 874-879.
Journal of Plastic Reconstructive and Aesthetic Surgery, Jul 1, 2021
IGI Global eBooks, 2022
Advances in neonatology enabled significant improvements in neonatal survival, often at the expen... more Advances in neonatology enabled significant improvements in neonatal survival, often at the expense of long-term morbidity. End-of-life decisions concern neonatal patients with fatal congenital anomalies, severe neurological deficits, and extreme prematurity at the limits of viability, presenting a complex issue for both healthcare professionals and parents. Since newborns cannot express their wishes or claim their rights, physicians and parents carry the responsibility to decide in their best interests, considering their future quality of life. Harmonization of scientific progress and legislation defining clear rules is necessary so neonatologists can proceed to such agonizing decisions. Greece lacks both specific legislation regarding such decisions and medical training on handling respective ethical dilemmas. Thus, guidelines improving such decisions are closely related to the quality of the healthcare system and should be established along with the legal system's adaptation.
BMC Medical Ethics, Nov 23, 2020
Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise... more Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians' profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians' attitude and views ranging from value of life to quality of life approach (scale 1-5). Results: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians' educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p < 0.001) were factors that affected the attitude score. Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.
Pharmaceuticals, May 7, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Pharmaceuticals, May 7, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Resuscitation, Jun 1, 2011
Family presence during resuscitation and invasive procedures (FPDRAIP) has been a frequent topic ... more Family presence during resuscitation and invasive procedures (FPDRAIP) has been a frequent topic of debate among healthcare personnel worldwide. This paper determines the knowledge, experiences and views of Greek physicians and nurses on FPDRAIP and examines possible correlations and factors promoting or limiting the implementation of the issue. The data for this descriptive questionnaire study were collected between March and June 2009. The study population consisted of 44 physicians and 77 nurses working in neonatal-pediatric departments and intensive care units in Patras, Greece, who answered an anonymous questionnaire. The majority of the participants (73.6%) were not familiar with FPDRAIP, were neither educated (72.7%) nor did they agree with the issue (71.9%). No written policy on FPDRAIP existed in the hospitals surveyed. Participants who were familiar with existing guidelines on the issue, or those who had relevant personal experience (76.9%), were positive for practising it as well. The degree of invasiveness of the medical intervention was the major determinant for healthcare personnel to consent for FPDRAIP. Finally, 43.2% of physicians believed that the decision of allowing FPDRAIP should be made only by them, whereas, 40.3% of nurses thought it should be a joint one. This study reveals that healthcare personnel in Greece are not familiar with the issue of FPDRAIP. In view of the increasing evidence on the advantages of this practice, we recommend implementation of relevant educational programs and institutional guidelines and policies.
Resuscitation, Jun 1, 2011
Family presence during resuscitation and invasive procedures (FPDRAIP) has been a frequent topic ... more Family presence during resuscitation and invasive procedures (FPDRAIP) has been a frequent topic of debate among healthcare personnel worldwide. This paper determines the knowledge, experiences and views of Greek physicians and nurses on FPDRAIP and examines possible correlations and factors promoting or limiting the implementation of the issue. The data for this descriptive questionnaire study were collected between March and June 2009. The study population consisted of 44 physicians and 77 nurses working in neonatal-pediatric departments and intensive care units in Patras, Greece, who answered an anonymous questionnaire. The majority of the participants (73.6%) were not familiar with FPDRAIP, were neither educated (72.7%) nor did they agree with the issue (71.9%). No written policy on FPDRAIP existed in the hospitals surveyed. Participants who were familiar with existing guidelines on the issue, or those who had relevant personal experience (76.9%), were positive for practising it as well. The degree of invasiveness of the medical intervention was the major determinant for healthcare personnel to consent for FPDRAIP. Finally, 43.2% of physicians believed that the decision of allowing FPDRAIP should be made only by them, whereas, 40.3% of nurses thought it should be a joint one. This study reveals that healthcare personnel in Greece are not familiar with the issue of FPDRAIP. In view of the increasing evidence on the advantages of this practice, we recommend implementation of relevant educational programs and institutional guidelines and policies.
Resuscitation, Jun 1, 2007
Background: Ventricular fibrillation remains the leading cause of death in western societies. Int... more Background: Ventricular fibrillation remains the leading cause of death in western societies. International organizations publish guidelines to follow in case of cardiac arrest. The aim of the present study is to assess whether the newly published guidelines record similar resuscitation success with the 2000 Advanced Life Support Guidelines on Resuscitation in a swine model of cardiac arrest. Methods and results: Nineteen landrace/large white pigs were used. Ventricular fibrillation was induced with the use of a transvenous pacing wire inserted into the right ventricle. The animals were randomized into two groups. In Group A, 10 animals were resuscitated using the 2000 guidelines, whereas in Group B, 9 animals were resuscitated using the 2005 guidelines. Both algorithms recorded similar successful resuscitation rates, as 60% of the animals in Group A and 44.5% in Group B were successfully resuscitated. However, animals in Group A restored a rhythm, compatible with a pulse, quicker than those in Group B (p = 0.002). Coronary perfusion pressure (CPP) was not adversely affected by three defibrillation attempts in Group A. Conclusions: Both algorithms' resulted in comparable resuscitation success, however, guidelines 2000 resulted in faster resuscitation times. These preliminary results merit further investigation.
Resuscitation, Jun 1, 2007
Background: Ventricular fibrillation remains the leading cause of death in western societies. Int... more Background: Ventricular fibrillation remains the leading cause of death in western societies. International organizations publish guidelines to follow in case of cardiac arrest. The aim of the present study is to assess whether the newly published guidelines record similar resuscitation success with the 2000 Advanced Life Support Guidelines on Resuscitation in a swine model of cardiac arrest. Methods and results: Nineteen landrace/large white pigs were used. Ventricular fibrillation was induced with the use of a transvenous pacing wire inserted into the right ventricle. The animals were randomized into two groups. In Group A, 10 animals were resuscitated using the 2000 guidelines, whereas in Group B, 9 animals were resuscitated using the 2005 guidelines. Both algorithms recorded similar successful resuscitation rates, as 60% of the animals in Group A and 44.5% in Group B were successfully resuscitated. However, animals in Group A restored a rhythm, compatible with a pulse, quicker than those in Group B (p = 0.002). Coronary perfusion pressure (CPP) was not adversely affected by three defibrillation attempts in Group A. Conclusions: Both algorithms' resulted in comparable resuscitation success, however, guidelines 2000 resulted in faster resuscitation times. These preliminary results merit further investigation.
Resuscitation, Oct 1, 2013
coronary perfusion pressure (CPP) calculated. CBF was continuously monitored by a transonic flow ... more coronary perfusion pressure (CPP) calculated. CBF was continuously monitored by a transonic flow probe. VF was electrically induced and PEA produced by delivering electrical countershock(s). CPR, including mechanical chest compression and ventilation, was then initiated and continued for 15 min. Epi (20 g/kg) was administered into the right atrium after 2 min of CPR and repeated every 3 min thereafter. If animals were resuscitated, the study sequence was repeated after 30 min of recovery. Results: A total of 19 experimental cycles were completed with a mean of 2 ± 1 cycles/pig. CPP significantly increased from 14 ± 6 mmHg before epi to a peak of 32 ± 13 mmHg (p < 0.01) at 1 min after epi administration. Concurrent with CPP increases, CBF decreased from 46 ± 19 mL/min before epi to the lowest value of 22 ± 18 mL/min (p < 0.01) at 30 s after epi (Fig. 1). Both increase in CPP and decrease in CBF persisted beyond 3 min after epi. However, while CPP already decreased to 24 ± 12 mmHg, CBF persisted with a low flow of 25 ± 12 mL/min 3 min after epi. Conclusions: In this model, administration of epi significantly increased CPP during CPR. Increases in CPP, however, were not accompanied by increases in CBF, which was markedly reduced following epi.
Resuscitation, Oct 1, 2013
coronary perfusion pressure (CPP) calculated. CBF was continuously monitored by a transonic flow ... more coronary perfusion pressure (CPP) calculated. CBF was continuously monitored by a transonic flow probe. VF was electrically induced and PEA produced by delivering electrical countershock(s). CPR, including mechanical chest compression and ventilation, was then initiated and continued for 15 min. Epi (20 g/kg) was administered into the right atrium after 2 min of CPR and repeated every 3 min thereafter. If animals were resuscitated, the study sequence was repeated after 30 min of recovery. Results: A total of 19 experimental cycles were completed with a mean of 2 ± 1 cycles/pig. CPP significantly increased from 14 ± 6 mmHg before epi to a peak of 32 ± 13 mmHg (p < 0.01) at 1 min after epi administration. Concurrent with CPP increases, CBF decreased from 46 ± 19 mL/min before epi to the lowest value of 22 ± 18 mL/min (p < 0.01) at 30 s after epi (Fig. 1). Both increase in CPP and decrease in CBF persisted beyond 3 min after epi. However, while CPP already decreased to 24 ± 12 mmHg, CBF persisted with a low flow of 25 ± 12 mL/min 3 min after epi. Conclusions: In this model, administration of epi significantly increased CPP during CPR. Increases in CPP, however, were not accompanied by increases in CBF, which was markedly reduced following epi.
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Papers by Theodoros Xanthos