Background: While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice.Aims: Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made. Method:Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on.Results: There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its' total loss, while it can disturb patient-doctor relationship.

Background:Considerable studies directly connect the complications in diabetic patients, and especially peripheral neuropathy, with the emergence of depression. Neuropathetic pain may deteriorate the general health status of the diabetic patient and glycaemic regulation.Purpose:The purpose of this study was to investigate the appearance and degree of diabetic peripheral neuropathy and its correlation with depression, with other parameters of the disease and also duration.Methods:57 diabetic patients participated with diagnosed diabetic peripheral neuropathy (male n=27, female n= 30, mean of age 72.7±6.35 years). The first part of Michigan Neuropathy Screening Instrument and the Zung Depression Rating Scale were used as tools for our study. Data was analysed with the SPSS 18.0 statistic program.Results:57.9% of the patients were overweight, 35.1% were obese and only 7% were within normal weight range. The BMI findings between the two genders indicate that male participants are more often obese than females. Women surpassed men in the category of overweight patients (p<0.05). The score based on MNSI was high and between 3 to 12 (mean average of 8.19±2.60 with 8 as intermediate rate). Almost 60% of patients had severe neuropathy, only 2 were found with mild symptoms and the rest had moderate neuropathtic symptoms, based on the score summary from the questionnaire. Investigating in detail the relation of diabetic neuropathy and depression, it derives that a high degree of diabetic neuropathy is related with high score of depression [F(3.160)=9.821, p=0.001]. Moderate and severe neuropathy was found with almost the same levels of depression.Conclusions:The correlation between diabetic neuropathy and depression is confirmed, while a very high depression rate was found in patients with severe neuropathy. The issue needs further study by using common instruments to obtain comparative results from the scientific community.

BACKGROUND: Needs assessment of patients with advanced cancer (ACPs) is essential for optimal care. This study evaluated the psychometric properties of the Needs Evaluation Questionnaire (NEQ) and assessed the supportive care needs of hospitalized ACPs with solid tumors.METHODS: The validated Greek version of the NEQ along with demographic and clinical data of 95 consecutive breast, colon and lung ACPs hospitalized in the University Hospital of Heraklion, Crete, Greece, were used to assess their supportive care needs. The NEQ score was subsequently rescaled to 0-100.RESULTS: NEQ displayed adequate psychometric properties in validity and reliability tests. The average number of needs reported was 8.4(4.1). Female and younger patients reported a higher score of unmet needs than their male (40.3 versus 30.0, p=0.005) and elder (40.1 versus 29.2, p=0.001) counterparts. Patients reported higher needs in receiving information about their future (73.7%), treatments (56.8%), examinations (51.6%) and for the need "to speak with people who had the same experience" (53.7%). In contrast, lower scores were observed in the assistance and treatments needs regarding intimacy (11.6%), "better attention from nurses" (15.8%), "more help with eating, dressing, and going to the bathroom" (18.9%). Lung ACPs reported more assistance and treatment needs than colon and breast ACPs (p<0.05).CONCLUSIONS: ACPs reported many unmet needs, mainly informational, that were related to gender, age, and type of cancer. NEQ is a useful tool in everyday clinical practice for obtaining information for supportive care needs. Health care personnel has to address these needs for implementing effective patient-centered care.

Background: The early birth of a newborn and the hospital care in the intensive care causes stress to parents. Objective: The main objective of this study was to investigate preterm parents’ level of stress and which coping strategies do they use in a Neonatal Intensive care Unit in a University Hospital of Central Greece. Methods: This cross-sectional study used a group of 82 preterm parents in the Neonatal Intensive care unit in a University Hospital of Central Greece. They were asked to answer a questionnaire with the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU), Coping Orientation to Problems Experienced (BRIEF/COPE), Daily Spiritual Experience Scale (DSES). The McNemar test was used to compare fathers ‘and mothers’ views on psychological support. The paired t-test or the Wilcoxon-signed rank test was used to compare scores between fathers and mothers. The levels of importance are bilateral and the statistical importance was defined as 0.5. For the analysis SPSS 22.0 was used. Results: The most common cause of admission to NICU was low birth weight. The severity of the preterm’s condition was found to be independently correlated with PSS-NICU score due to “sights and sounds” and due to “Infant Appearance and behaviour” in the NICU. The severity of the child’s condition and the parents’ DSES score were found to be independently correlated to the stress score due to their “parent-infant relationship”. Mothers ‘and fathers’ scores on the dimensions of the Brief-COPE Questionnaire were similar, suggesting a similar way of managing stress. Substance use, religion, humor were found to correlate with total score of PSS-NICU. More specifically PSS-NICU correlated negatively with substance use (r=-0.30 p=0.009) and humor (r=-0.28 p=0.016) while it correlated positively with religion (r=0.29 p=0.011). Conclusion: Mothers and fathers of preterm need support. Spirituality and religion, helps then face the challenges of having their baby hospitalized in a NICU.

Background: Atherosclerosis is the most important cardiovascular disease across the globe with a large proportion of associated morbidity and mortality. The aim of this study is to detect the presence of atherosclerosis-like lesions in the three segments of the thoracic aorta (ascending aorta, aortic arch and descending aorta) of 50 unselected adult cadavers of all ages. Methods: An autopsy analysis was performed using 50 unselected adult cadavers (37 male, 13 female -mean age 64.2 years; age range 19-90 years). Macroscopic dissection of the three segments of the thoracic aorta was performed and the presence of atherosclerosis-like lesions was evaluated according to the subjects' demographic and clinical characteristics. Results: Atherosclerotic lesions in at least one of the three aortic segments were identified in 82% of cadavers, 83.78% of male and 76.92% of female. Of 50 subjects, 30% had an atherosclerotic lesion in the ascending aorta, 48% in the aortic arch and 44% in the descending aorta. No aneurysmal changes were detected. Smoking, hypertension, diabetes, hypercholesterolemia, obesity and coronary disease were the risk factors correlated most with the presence of atherosclerosis. Conclusions: Atherosclerosis-like lesions in the thoracic aorta are prevalent in adults of all ages. Obesity is a major risk factor regarding the development of atheromas. This cadaveric study comes to underline the necessity of further similar studies in order to evaluate the presence of atherosclerosis in the thoracic aorta, and also helps to assess the risk of major cardiovascular events in the general population.