Introduction: Chronic lung aspiration is not that uncommon in infancy, resulting in chronic or re... more Introduction: Chronic lung aspiration is not that uncommon in infancy, resulting in chronic or recurrent respiratory symptoms. Occasionally aspiration can be silent, without acute reflexive cough or any other sign of distress. Fiberoptic endoscopic evaluation of swallowing (FEES) is an alternative to videofluoroscopy swallow study (VFSS), with no barium or radiation. We aimed to present our experience as a pragmatic study on the clinical utility of FEES in infants with persistent respiratory symptoms. Methods: Infants presented with chronic/recurrent wet cough and/or noisy breathing in our clinic during the period 2013-2017, were examined for silent aspiration. Subjects with other diagnoses such as neurologic disorders, prematurity, genetic disorders, tonsillar hypertrophy, structural airway abnormalities or symptomatology suggestive of gastroesophageal reflux disease were excluded. Aspiration was investigated with fiberoptic endoscopic evaluation of swallowing (FEES), during milk formula consumption. Results: All together 19 infants (M/F 11/8) were examined for silent aspiration with FEES. The median age of evaluation was 4.2 months (range 1-10.5 months). The test showed profound deep larynx penetration and/or aspiration of milk formula in 6 infants (31.6%) (1-5 month-old) (p= 0.008), establishing the diagnosis of silent aspiration. Conclusion: Silent aspiration is a quite common contributing factor in infants with chronic/recurrent wet cough and/or noisy breathing and can be easily detected with FEES. This may help to avoid more complex and unnecessary or expensive examinations.cv
Background: We investigated the relationship between parental smoking and prevalence of childhood... more Background: We investigated the relationship between parental smoking and prevalence of childhood asthma during a 15-year period. Methods: In four identical questionnaire surveys conducted in 1998 (n=3076), 2003 (n=2725), 2008 (n=2688) and 2013 (n=2554) we recorded parental smoking habits and the prevalence of doctor-diagnosed current asthma among 8-9-year old children in Patras, Greece. The time-trends of parental smoking and those of childhood asthma were compared by cross-sectional analysis. Results: There was a continuous decrease in parental smoking during the study period. The prevalence of asthma increased from 6% in 1998 to 6.9% in 2003, remained stable between 2003 and 2008 (6.9%), and decreased to 5.2% in 2013 (Figure 1A). Among asthmatic children, there was a continuous decrease in the percentage of fathers smoking indoors since 1998 (Figure 1B); conversely, the percentage of mothers smoking indoors decreased only after 2008 (Figure 1C). Cross-sectional analysis revealed that only the time trends of maternal smoking was correlated to the prevalence trends of childhood asthma (maximum significant correlation coefficient at time lag 0 – Figure 1D and 1E). Conclusions: The time-trends of indoors maternal smoking are strongly correlated with the prevalence trends of childhood asthma, thus showing the close relation between household tobacco smoke exposure and development of asthma symptoms in children.
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expand... more Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical exp...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2018
The diagnosis of asthma is currently based on clinical history, physical examination and lung fun... more The diagnosis of asthma is currently based on clinical history, physical examination and lung function, and to date, there are no accurate objective tests either to confirm the diagnosis or to discriminate between different types of asthma. This consensus exercise reviews the state of the art in asthma diagnosis to identify opportunities for future investment based on the likelihood of their successful development, potential for widespread adoption and their perceived impact on asthma patients. Using a two-stage e-Delphi process and a summarizing workshop, a group of European asthma experts including health professionals, researchers, people with asthma and industry representatives ranked the potential impact of research investment in each technique or tool for asthma diagnosis and monitoring. After a systematic review of the literature, 21 statements were extracted and were subject of the two-stage Delphi process. Eleven statements were scored 3 or more and were further discussed a...
Endocrine, metabolic & immune disorders drug targets, Mar 31, 2017
Food protein-induced proctocolitis (FPIP) is the most common colonic manifestation of food allerg... more Food protein-induced proctocolitis (FPIP) is the most common colonic manifestation of food allergy in infants, accounting for up to 60% of exclusively breast-fed children. The causative foods derive from the mother's diet that are then excreted in her milk. The suggested risk factors for the development of FPIP are an immature immune system, altered intestinal permeability and other factors that activate local immune function, such as genetic susceptibility in combination with particularly sensitizing foods. FPIP is an enhanced immune responsiveness of some infants to very small amounts of food antigens, inducing an inflammatory mucosal response, mediated by T cells.
β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. ... more β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. Increased β-glucuronidase activity in the cerebrospinal and peritoneal fluid has been shown to be a useful marker of bacterial inflammation. We explored the role of β-glucuronidase in the detection of bacterial infection in bronchoalveolar lavage fluid (BALF) of paediatric patients. In this case-control study, % polymorphonuclear cell count (PMN%), β-glucuronidase activity, interleukin-8 (IL-8), tumour necrosis factor-α (TNF-α) and elastase were measured in culture-positive (≥10(4) cfu/mL, C+) and -negative (C-) BALF samples obtained from children. A total of 92 BALF samples were analysed. The median β-glucuronidase activity (measured in nanomoles of 4-methylumbelliferone (4-MU)/mL BALF/h) was 246.4 in C+ (interquartile range: 71.2-751) and 21.9 in C- (4.0-40.8) (P < 0.001). The levels of TNF-α and IL-8 were increased in C+ as compared with C- (5.4 (1.7-12.6) vs 0.7 (0.2-6.2) pg/mL, P...
In Greece recently, higher-valent pneumococcal conjugate vaccines (PCVs) replaced the 7-valent (P... more In Greece recently, higher-valent pneumococcal conjugate vaccines (PCVs) replaced the 7-valent (PCV7); the 10-valent (PCV10) became available in May 2009 and the 13-valent (PCV13) in June 2010. We investigated the nasopharyngeal colonization with Streptococcus pneumoniae in day-care center attendees in Athens and the prefecture of Viotia. Between December 2010 and June 2011, nasopharyngeal cultures were obtained 4 times, at enrollment and then every 6 to 8 weeks. Among the 233 children, 225 (96.6%) had been vaccinated with ≥1 dose of PCV7. One tenth of the PCV7 vaccinated attendees had also received ≥1 dose of PCV13 or PCV10. During the 4 samplings, 358 isolates were recovered from a total of 874 samples. Of the 233 children, 183 (78.5%) were found to carry S. pneumoniae at least once. The overall serotype distribution among carriers was similar regardless of the time lapsed since the last PCV7 dose. A high frequency of 19A (17.1%) coincided with a low frequency of 19F (1.4%). Non-PCV13 serotypes accounted for 73.1% of the isolates; 23B, 15B/C, 16F, 21, 11A, 15A, 6C, 10A, 22F and 23A were the most common. Among attendees aged 24-59 months (median age 42 months), prolonged carriage of a non-PCV13 serotype was relatively common, mainly for 21 and 16F. One out of 4 cases of colonization with the prevalent non-PCV13 serotypes was followed by persistent carriage for 5 to 14 weeks. During this period of transition to the higher-valent PCVs in the day-care center setting, non-PCV13 serotypes dominated and exhibited prolonged colonization. The frequency and the duration of prolonged carriage tends to be increased, if sampling frequency increases and the carriage time before and after positive cultures is taken into consideration. Further studies regarding the fitness of the colonizing non-PCV13 serotypes will likely to be seen in the future.
The prevalence of allergic rhinitis, hay fever and eczema has risen worldwide during the last fou... more The prevalence of allergic rhinitis, hay fever and eczema has risen worldwide during the last four decades but may have reached a plateau in some westernized societies. We examined time trends in the prevalence of childhood chronic or recurrent rhinitis, rhinoconjunctivitis and eczema in urban Greece. Using identical methodology, three population-based cross-sectional parental questionnaire surveys on current (last two years) and lifetime allergic symptoms of the nose, eyes and skin were performed among 8-10-yr-old children in 1991, 1998 and 2003 in Patras, Greece. Exactly 2417, 3006 and 2725 questionnaires were completed in 1991, 1998 and 2003, respectively. Prevalence rates of current (lifetime) symptoms of chronic or recurrent rhinitis were 5.1% (6.0%) for 1991, 6.5% (8.0%) for 1998 and 8.0% (9.8%) for 2003. Respective values for rhinoconjunctivitis were 1.8% (2.1%), 2.7% (3.4%) and 3.6% (4.6%) and for eczema 2.5% (4.5%), 3.4% (6.3%) and 5.0% (9.5%) (p for trend &amp;amp;amp;amp;lt;0.001). Among current asthmatics there was an increase in lifetime rhinitis (p = 0.038), current (p = 0.025) and lifetime rhinoconjunctivitis (p = 0.007) and current (p = 0.001) and lifetime eczema (p &amp;amp;amp;amp;lt; 0.001); male predominance increased throughout the study. The proportion of atopic asthma (current asthma with chronic or recurrent rhinitis and/or rhinoconjunctivitis and/or eczema) increased during the same period (p &amp;amp;amp;amp;lt; 0.001). In conclusion, there is a continuous increase in the prevalence of allergic manifestations among preadolescent children in Patras, Greece during the period 1991-2003. In our population, boys have contributed to this increase more than girls and the increase of atopy is, at least partially, responsible for the increase of asthma.
Aim: To determine maturational tempo differences related to the timing of pubertal onset in girls... more Aim: To determine maturational tempo differences related to the timing of pubertal onset in girls.Methods: We studied longitudinally 307 prepubertal Greek schoolgirls. Age at onset of puberty (B2), peak height velocity (PHV) and age at menarche were recorded. Age at onset of puberty quartiles were determined in order to define girls as early maturers (<9.2 years) and late maturers (>10.6 years). Due to dropout from the study, results for menarche are reported for 182 girls.Results: Median (1st–3rd quartile) time span from B2 to PHV was longer for early maturers than for average and late maturers, 1.6 (1.0–2.2) years, 1.1 (0.7–1.7) years and 0.9 (0.3–1.1) years, respectively, p < 0.001). There was no significant difference in PHV, in the time interval from PHV to menarche and in adult height (for 75 girls) with respect to whether girls matured early, average or late.Conclusion: A compensatory delay in the maturational tempo in early‐maturing girls and a catch‐up mechanism in...
Background/Aims : Tracheomalacia is not an unusual diagnosis in pediatric respiratory clinics. We... more Background/Aims : Tracheomalacia is not an unusual diagnosis in pediatric respiratory clinics. We tried to find the most suitable approach to the evaluation and diagnosis of “brassy”,“ barking” cough. Methods: We performed a dynamic helical CT scan (HCT) in 15 patients (aged 5 to 14 years) suspected of tracheomalacia on the grounds of clinical symptoms (barking cough ± recurrent chest infections). All patients underwent flexible bronchoscopy (FB) under deep sedation and spontaneously breathing. Four children who suffered from various parenchymal lung diseases but no “ barking” cough were used as controls. The ratio of anteroposterior/tranverse diameter was measured in the thoracic inlet and the carina level, in full inspiration and end expiration. Results: Flexible bronchoscopy confirmed the existence of tracheomalacia in all patients; in 5 out of 15, lesions were located in the upper part of the trachea as shown by FB. HCTs showed localized narrowing of the intrathoracic trachea in...
The objective of this study was to assess the knowledge on pulse oximetry among health care profe... more The objective of this study was to assess the knowledge on pulse oximetry among health care professionals involved in pediatric care. A multiple-choice questionnaire was distributed to 505 pediatric health care professionals from 19 hospitals and health centers throughout Greece. Exploratory factor analysis was performed to identify underlying factors that could explain most of the variance of the responses. The mean test and factor scores were calculated and compared between clinical settings. The mean test score was 61.9+/-18.1%. After factor analysis, 2 distinct groups of deficits in knowledge regarding pulse oximetry were identified: 1 was interpreted as relating to practical knowledge and the other to theoretical knowledge. The mean score of the items that assessed practical knowledge was 82.7+/-12.5% and of those that assessed theoretical knowledge was 44.2+/-21.7%. Pediatricians and family practitioners, participants from level 3 institutions, and health care professionals wo...
Introduction: Chronic lung aspiration is not that uncommon in infancy, resulting in chronic or re... more Introduction: Chronic lung aspiration is not that uncommon in infancy, resulting in chronic or recurrent respiratory symptoms. Occasionally aspiration can be silent, without acute reflexive cough or any other sign of distress. Fiberoptic endoscopic evaluation of swallowing (FEES) is an alternative to videofluoroscopy swallow study (VFSS), with no barium or radiation. We aimed to present our experience as a pragmatic study on the clinical utility of FEES in infants with persistent respiratory symptoms. Methods: Infants presented with chronic/recurrent wet cough and/or noisy breathing in our clinic during the period 2013-2017, were examined for silent aspiration. Subjects with other diagnoses such as neurologic disorders, prematurity, genetic disorders, tonsillar hypertrophy, structural airway abnormalities or symptomatology suggestive of gastroesophageal reflux disease were excluded. Aspiration was investigated with fiberoptic endoscopic evaluation of swallowing (FEES), during milk formula consumption. Results: All together 19 infants (M/F 11/8) were examined for silent aspiration with FEES. The median age of evaluation was 4.2 months (range 1-10.5 months). The test showed profound deep larynx penetration and/or aspiration of milk formula in 6 infants (31.6%) (1-5 month-old) (p= 0.008), establishing the diagnosis of silent aspiration. Conclusion: Silent aspiration is a quite common contributing factor in infants with chronic/recurrent wet cough and/or noisy breathing and can be easily detected with FEES. This may help to avoid more complex and unnecessary or expensive examinations.cv
Background: We investigated the relationship between parental smoking and prevalence of childhood... more Background: We investigated the relationship between parental smoking and prevalence of childhood asthma during a 15-year period. Methods: In four identical questionnaire surveys conducted in 1998 (n=3076), 2003 (n=2725), 2008 (n=2688) and 2013 (n=2554) we recorded parental smoking habits and the prevalence of doctor-diagnosed current asthma among 8-9-year old children in Patras, Greece. The time-trends of parental smoking and those of childhood asthma were compared by cross-sectional analysis. Results: There was a continuous decrease in parental smoking during the study period. The prevalence of asthma increased from 6% in 1998 to 6.9% in 2003, remained stable between 2003 and 2008 (6.9%), and decreased to 5.2% in 2013 (Figure 1A). Among asthmatic children, there was a continuous decrease in the percentage of fathers smoking indoors since 1998 (Figure 1B); conversely, the percentage of mothers smoking indoors decreased only after 2008 (Figure 1C). Cross-sectional analysis revealed that only the time trends of maternal smoking was correlated to the prevalence trends of childhood asthma (maximum significant correlation coefficient at time lag 0 – Figure 1D and 1E). Conclusions: The time-trends of indoors maternal smoking are strongly correlated with the prevalence trends of childhood asthma, thus showing the close relation between household tobacco smoke exposure and development of asthma symptoms in children.
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expand... more Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical exp...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2018
The diagnosis of asthma is currently based on clinical history, physical examination and lung fun... more The diagnosis of asthma is currently based on clinical history, physical examination and lung function, and to date, there are no accurate objective tests either to confirm the diagnosis or to discriminate between different types of asthma. This consensus exercise reviews the state of the art in asthma diagnosis to identify opportunities for future investment based on the likelihood of their successful development, potential for widespread adoption and their perceived impact on asthma patients. Using a two-stage e-Delphi process and a summarizing workshop, a group of European asthma experts including health professionals, researchers, people with asthma and industry representatives ranked the potential impact of research investment in each technique or tool for asthma diagnosis and monitoring. After a systematic review of the literature, 21 statements were extracted and were subject of the two-stage Delphi process. Eleven statements were scored 3 or more and were further discussed a...
Endocrine, metabolic & immune disorders drug targets, Mar 31, 2017
Food protein-induced proctocolitis (FPIP) is the most common colonic manifestation of food allerg... more Food protein-induced proctocolitis (FPIP) is the most common colonic manifestation of food allergy in infants, accounting for up to 60% of exclusively breast-fed children. The causative foods derive from the mother's diet that are then excreted in her milk. The suggested risk factors for the development of FPIP are an immature immune system, altered intestinal permeability and other factors that activate local immune function, such as genetic susceptibility in combination with particularly sensitizing foods. FPIP is an enhanced immune responsiveness of some infants to very small amounts of food antigens, inducing an inflammatory mucosal response, mediated by T cells.
β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. ... more β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. Increased β-glucuronidase activity in the cerebrospinal and peritoneal fluid has been shown to be a useful marker of bacterial inflammation. We explored the role of β-glucuronidase in the detection of bacterial infection in bronchoalveolar lavage fluid (BALF) of paediatric patients. In this case-control study, % polymorphonuclear cell count (PMN%), β-glucuronidase activity, interleukin-8 (IL-8), tumour necrosis factor-α (TNF-α) and elastase were measured in culture-positive (≥10(4) cfu/mL, C+) and -negative (C-) BALF samples obtained from children. A total of 92 BALF samples were analysed. The median β-glucuronidase activity (measured in nanomoles of 4-methylumbelliferone (4-MU)/mL BALF/h) was 246.4 in C+ (interquartile range: 71.2-751) and 21.9 in C- (4.0-40.8) (P < 0.001). The levels of TNF-α and IL-8 were increased in C+ as compared with C- (5.4 (1.7-12.6) vs 0.7 (0.2-6.2) pg/mL, P...
In Greece recently, higher-valent pneumococcal conjugate vaccines (PCVs) replaced the 7-valent (P... more In Greece recently, higher-valent pneumococcal conjugate vaccines (PCVs) replaced the 7-valent (PCV7); the 10-valent (PCV10) became available in May 2009 and the 13-valent (PCV13) in June 2010. We investigated the nasopharyngeal colonization with Streptococcus pneumoniae in day-care center attendees in Athens and the prefecture of Viotia. Between December 2010 and June 2011, nasopharyngeal cultures were obtained 4 times, at enrollment and then every 6 to 8 weeks. Among the 233 children, 225 (96.6%) had been vaccinated with ≥1 dose of PCV7. One tenth of the PCV7 vaccinated attendees had also received ≥1 dose of PCV13 or PCV10. During the 4 samplings, 358 isolates were recovered from a total of 874 samples. Of the 233 children, 183 (78.5%) were found to carry S. pneumoniae at least once. The overall serotype distribution among carriers was similar regardless of the time lapsed since the last PCV7 dose. A high frequency of 19A (17.1%) coincided with a low frequency of 19F (1.4%). Non-PCV13 serotypes accounted for 73.1% of the isolates; 23B, 15B/C, 16F, 21, 11A, 15A, 6C, 10A, 22F and 23A were the most common. Among attendees aged 24-59 months (median age 42 months), prolonged carriage of a non-PCV13 serotype was relatively common, mainly for 21 and 16F. One out of 4 cases of colonization with the prevalent non-PCV13 serotypes was followed by persistent carriage for 5 to 14 weeks. During this period of transition to the higher-valent PCVs in the day-care center setting, non-PCV13 serotypes dominated and exhibited prolonged colonization. The frequency and the duration of prolonged carriage tends to be increased, if sampling frequency increases and the carriage time before and after positive cultures is taken into consideration. Further studies regarding the fitness of the colonizing non-PCV13 serotypes will likely to be seen in the future.
The prevalence of allergic rhinitis, hay fever and eczema has risen worldwide during the last fou... more The prevalence of allergic rhinitis, hay fever and eczema has risen worldwide during the last four decades but may have reached a plateau in some westernized societies. We examined time trends in the prevalence of childhood chronic or recurrent rhinitis, rhinoconjunctivitis and eczema in urban Greece. Using identical methodology, three population-based cross-sectional parental questionnaire surveys on current (last two years) and lifetime allergic symptoms of the nose, eyes and skin were performed among 8-10-yr-old children in 1991, 1998 and 2003 in Patras, Greece. Exactly 2417, 3006 and 2725 questionnaires were completed in 1991, 1998 and 2003, respectively. Prevalence rates of current (lifetime) symptoms of chronic or recurrent rhinitis were 5.1% (6.0%) for 1991, 6.5% (8.0%) for 1998 and 8.0% (9.8%) for 2003. Respective values for rhinoconjunctivitis were 1.8% (2.1%), 2.7% (3.4%) and 3.6% (4.6%) and for eczema 2.5% (4.5%), 3.4% (6.3%) and 5.0% (9.5%) (p for trend &amp;amp;amp;amp;lt;0.001). Among current asthmatics there was an increase in lifetime rhinitis (p = 0.038), current (p = 0.025) and lifetime rhinoconjunctivitis (p = 0.007) and current (p = 0.001) and lifetime eczema (p &amp;amp;amp;amp;lt; 0.001); male predominance increased throughout the study. The proportion of atopic asthma (current asthma with chronic or recurrent rhinitis and/or rhinoconjunctivitis and/or eczema) increased during the same period (p &amp;amp;amp;amp;lt; 0.001). In conclusion, there is a continuous increase in the prevalence of allergic manifestations among preadolescent children in Patras, Greece during the period 1991-2003. In our population, boys have contributed to this increase more than girls and the increase of atopy is, at least partially, responsible for the increase of asthma.
Aim: To determine maturational tempo differences related to the timing of pubertal onset in girls... more Aim: To determine maturational tempo differences related to the timing of pubertal onset in girls.Methods: We studied longitudinally 307 prepubertal Greek schoolgirls. Age at onset of puberty (B2), peak height velocity (PHV) and age at menarche were recorded. Age at onset of puberty quartiles were determined in order to define girls as early maturers (<9.2 years) and late maturers (>10.6 years). Due to dropout from the study, results for menarche are reported for 182 girls.Results: Median (1st–3rd quartile) time span from B2 to PHV was longer for early maturers than for average and late maturers, 1.6 (1.0–2.2) years, 1.1 (0.7–1.7) years and 0.9 (0.3–1.1) years, respectively, p < 0.001). There was no significant difference in PHV, in the time interval from PHV to menarche and in adult height (for 75 girls) with respect to whether girls matured early, average or late.Conclusion: A compensatory delay in the maturational tempo in early‐maturing girls and a catch‐up mechanism in...
Background/Aims : Tracheomalacia is not an unusual diagnosis in pediatric respiratory clinics. We... more Background/Aims : Tracheomalacia is not an unusual diagnosis in pediatric respiratory clinics. We tried to find the most suitable approach to the evaluation and diagnosis of “brassy”,“ barking” cough. Methods: We performed a dynamic helical CT scan (HCT) in 15 patients (aged 5 to 14 years) suspected of tracheomalacia on the grounds of clinical symptoms (barking cough ± recurrent chest infections). All patients underwent flexible bronchoscopy (FB) under deep sedation and spontaneously breathing. Four children who suffered from various parenchymal lung diseases but no “ barking” cough were used as controls. The ratio of anteroposterior/tranverse diameter was measured in the thoracic inlet and the carina level, in full inspiration and end expiration. Results: Flexible bronchoscopy confirmed the existence of tracheomalacia in all patients; in 5 out of 15, lesions were located in the upper part of the trachea as shown by FB. HCTs showed localized narrowing of the intrathoracic trachea in...
The objective of this study was to assess the knowledge on pulse oximetry among health care profe... more The objective of this study was to assess the knowledge on pulse oximetry among health care professionals involved in pediatric care. A multiple-choice questionnaire was distributed to 505 pediatric health care professionals from 19 hospitals and health centers throughout Greece. Exploratory factor analysis was performed to identify underlying factors that could explain most of the variance of the responses. The mean test and factor scores were calculated and compared between clinical settings. The mean test score was 61.9+/-18.1%. After factor analysis, 2 distinct groups of deficits in knowledge regarding pulse oximetry were identified: 1 was interpreted as relating to practical knowledge and the other to theoretical knowledge. The mean score of the items that assessed practical knowledge was 82.7+/-12.5% and of those that assessed theoretical knowledge was 44.2+/-21.7%. Pediatricians and family practitioners, participants from level 3 institutions, and health care professionals wo...
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