Introduction: Heparin is a sulfated polysaccharide belonging to the glycosaminoglycan family with strong anticoagulant activity. It has been widely used to maintain intravascular catheters in patients requiring intravenous medication. It is believed that heparin prevents thrombus formation in the intravascular catheter, but since the 1980s, the necessity of the heparin solution for peripheral intravenous catheter (PIVC) flushing has been questioned in several clinical trials. According to the Institute for Safe Medication Practices (ISMP), there are four special categories of High Alert Medications (HAMs), including heparin. Aim: The aim of this systematic review was to investigate the efficacy of normal saline versus heparin solution in maintaining the patency and functionality of the PIVC and avoiding complications. Methodology: A systematic review using PubMed and Cochrane Library databases was conducted. Original research studies of hospitalized patients with PIVC, regardless of age, published in English, over the last decade (2009-2019) were eligible for inclusion. Results: The review concluded in 10 studies that met the inclusion criteria. From these studies, it appears that it is not fully documented whether the normal saline (N/S 0,9%) is superior to heparin solution (H/S) in the flushing of the PIVC for maintaining its patency and prevent complications. Researchers tend to support the use of N/S 0,9% due to safety, error avoidance, efficiency, ease of use and cost-effectiveness. Concern about the possible complications of the heparin solution was the cause of guidelines development for N/S 0,9% in countries such as Australia. Conclusions: The use of normal saline seems to outweigh the heparin solution in maintaining the patency of PIVC.

Background: Heterotopic ossification is a musculoskeletal complication in patients in intensive care unit which expects to impair their mobility and quality of life after discharge. The aim of the study was to examine the incidence and the risk factors of heterotopic ossification in critically ill patients. Methods: One hundred-ninety seven consecutive patients evaluated through clinical and laboratory screenings for heterotopic ossification upon admission and discharge and 123 of them were eligible for the study. Symptomatic heterotopic ossification was confirmed to 9 patients (7.31%) by means of ultrasonography and radiography. Many risk factors examined by logistic regression such as age, admission of Glasgow Coma Scale score, length of stay in intensive care unit, duration of mechanical ventilation, duration in Venturi mask and in mask tracheostomy, days in coma, traumatic and non-traumatic brain injury, increased intracranial pressure monitoring, autonomic dysregulation and days in respiratory alkalosis. Results: The risk factors that predict heterotopic ossification were: age, duration of mechanical ventilation, respiratory alkalosis, days in coma, admission of Glasgow Coma Scale score, increased intracranial pressure monitoring, autonomic dysregulation, and non–traumatic brain injury. In multivariate analysis were found significant the autonomic dysregulation, the respiratory alkalosis, the increased intracranial pressure monitoring and the duration of mechanical ventilation (F=17.44, p<0.00).Conclusions: The incidence of symptomatic heterotopic ossification appears to be significant in a general intensive care unit. A few factors seem to predict the occurrence of it, confirming previous studies. Larger studies are needed to be done for better prevention and early identification of this frequent musculoskeletal complication in critical ill patients.

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Introduction: Burn injury is a severe systemic disease with social implications.Aim: The recording of patient’s clinical profile with burn injury worldwide and in Greece, the outcome and impact of the injury on the patient’s mental health and social, professional and family life.Methods: There were collected surveys and reports concerned burn victims, men and women, teenagers and adults of all types and severities of burns in the world and in Greece. The information were been searched in database of Pubmed and websites of international health agencies (American Burn Association-ABA, World Health Organization-WHO , Centers for Diseases Control and Prevention-CDC) and statistical offices (Hellenic Statistical Authority), between the years 1985-2012.Results: In U.S.A. 183.036 burned victims were reported between the years 2002-11 and in Greece 1840 in 1993-2001. The most of studies were showed strong relationship between risk of burn and age, gender, standard of living and education, the place and conditions of the injury, the lack of information and habits of patients. The coexistence of chronic diseases burdened the risk of injury and the outcome. After burn injury, patients had difficulties on professional and social reintegration, because of physical complications and mental disorders. Their psychological condition upon leaving the hospital was important prognostic feature. Researchers suggested the detection of high-risk groups to train them and organized psychosocial reintegration of burned.Conclusion: There is a reciprocal relationship between clinical profile of burned patients before injury and outcome of the disease and their mental health, social, professional and family life. The need for continuous investigation into the profile of burned within multicenter study and organization of network for psychosocial reintegration became evident.