PRVI SLUČAJ PAGOFAGIJE: BIZANTSKI CAR TEOFIL (829.–842.)

The Byzantine Emperor Theophilus (829-842 AD) died from dysentery, the exact nature of which is unknown. However, based on the original Greek texts of the Byzantine historians and chroniclers of that era, the possible cause of death may be connected to Theophilus’ pagophagia (snow eating), in order to relieve the symptoms of gastric inflammation. Additionally to the symptoms from the gastro-intestinal system, the Emperor seemed suffering from depress after the defeat of his army and the loss of territories, among whom his native town, Amorion. The current study supports the theoretical possibility that the case of pagophagia in the 9th century AD, so well described by a great number of historians because of the sufferer’s royal identity, extends in the past the knowledge on pica, still attracting the medical interest.Bizantski car Teofil (829.–842.) umro je od dizenterije, čija je točna narav nepoznata. Kako bilo, na temelju originalnih grčkih tekstova bizantskih povjesničara mogući se uzrok smrti može povezati s Teofilovom pagofagijom (jedenjem snijega), kako bi olakšao simptome upale želuca. Uz simptome u gastrointestinalnom sustavu, čini se da je car patio od depresije nakon poraza njegove vojske i gubitka teritorija, između ostaloga i njegova rodnog grada Amoriona. Ova studija potvrđuje teorijsku mogućnost da je slučaj pagofagije u 9. stoljeću tako dobro opisan kod velika broja povjesničara zbog bolesnikova kraljevskog identiteta, proširujući znanje o piki (pikacizmu) u prošlost, poremećaju koji i dalje privlači medicinsku pažnju

PRVI SLUČAJ PAGOFAGIJE: BIZANTSKI CAR TEOFIL (829.–842.)

The Byzantine Emperor Theophilus (829-842 AD) died from dysentery, the exact nature of which is unknown. However, based on the original Greek texts of the Byzantine historians and chroniclers of that era, the possible cause of death may be connected to Theophilus’ pagophagia (snow eating), in order to relieve the symptoms of gastric inflammation. Additionally to the symptoms from the gastro-intestinal system, the Emperor seemed suffering from depress after the defeat of his army and the loss of territories, among whom his native town, Amorion. The current study supports the theoretical possibility that the case of pagophagia in the 9th century AD, so well described by a great number of historians because of the sufferer’s royal identity, extends in the past the knowledge on pica, still attracting the medical interest.Bizantski car Teofil (829.–842.) umro je od dizenterije, čija je točna narav nepoznata. Kako bilo, na temelju originalnih grčkih tekstova bizantskih povjesničara mogući se uzrok smrti može povezati s Teofilovom pagofagijom (jedenjem snijega), kako bi olakšao simptome upale želuca. Uz simptome u gastrointestinalnom sustavu, čini se da je car patio od depresije nakon poraza njegove vojske i gubitka teritorija, između ostaloga i njegova rodnog grada Amoriona. Ova studija potvrđuje teorijsku mogućnost da je slučaj pagofagije u 9. stoljeću tako dobro opisan kod velika broja povjesničara zbog bolesnikova kraljevskog identiteta, proširujući znanje o piki (pikacizmu) u prošlost, poremećaju koji i dalje privlači medicinsku pažnju

HEALTH CARE FOR REFUGEE CHILDREN DURING THE GREEK CIVIL WAR (1946-1949)

U ovom se članku govori o fizičkim i psihičkim traumama djece tijekom i nakon Građanskog rata u Grčkoj (1946.-1949.). Organizirane su dvije velike evakuacije djece: jednu je organizirala Grčka komunistička partija, raseljavajući djecu u sedam zemalja istočne Europe, a drugu grčka vlada i Kraljica Frederica, smještajući djecu u domove (paidopoleis) unutar zemlje. U članku se raspravlja o tome da su djeca trpjela ratne strahote i nasilje, dobrovoljno ili nasilno odvajanje od obitelji i institucionalizaciju na kraće ili duže vrijeme te da su obje strane pokušavale pružiti siguran smještaj, hranu i medicinsku i psihološku skrb žrtvama rata.This paper focuses on physical and psychological traumas of children during and after the Greek Civil War (1946-1949). There were two evacuation programmes: one organised by the Greek Communist Party to seven countries of Eastern Europe and the other by the Greek government and Queen Frederica to children’s homes (paidopoleis) in the country. The paper also argues that Greek refugee children experienced war terror and violence, voluntary or forced separation from their families, and institutionalisation for a shorter or longer time, and that both sides sought to provide shelter, food, medical treatment, and psychological support to the victims

Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

BACKGROUND: Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. PURPOSE: To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. METHODS: A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). RESULTS: The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. CONCLUSIONS: PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes

Dromokaition Psychiatric Hospital of Athens: from its establishment in 1887 to the era of deinstitutionalization

Dromokaition Psychiatric Hospital opened its doors in 1887, following the donation made by Zorzis Dromokaitis from the island of Chios. Private donations and all forms of charities had contributed to a large extent in the establishment of hospitals across Greece, during the late 19th and the early 20th century. Dromokaition was one of them but it was also unique, as it was the first psychiatric hospital in Athens, admitting patients from every part of the country. This paper aimed at highlighting the long service of the institution through the different historical periods the country went through. We present the chronicle of its foundation, the development of its inner structure, and the medical and organizational influences which it received, along the way. The therapeutic methods used during the first decades of its operation reflected the corresponding European standards of the time. As a model institution from its foundation, it followed closely the prevailing European guidelines, throughout its historical path, either as an independent institution or as an integrated one within the National Health Service

Doctors' Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece

There is limited information about doctors' communication behaviors and their salient beliefs with regard to bad news disclosure in Greece. In this qualitative study we investigated the self-reported practices of doctors on breaking bad news, their perceptions about the factors affecting the delivery of such news, and their beliefs about the most appropriate disclosure manner. A focus group discussion and individual interviews were conducted. Twenty-five resident and specialist doctors from primary health care and hospital settings participated. We analyzed the collected data with content analysis techniques. Participants were found to acknowledge the importance of appropriate and effective delivery of bad news; however, none of them reported the implementation of empirically informed communication practices. They described communication patterns mainly formed by their work experience and often guided by the patient's family requests. Doctor, patient, and family characteristics and organizational features and resources were reported to affect the delivery of bad news. Participants perceived the most appropriate disclosure manner as an individualized approach to each patient's unique needs. They suggested an interdisciplinary, collaborative management of the delivery process and the establishment of formal supportive services. These findings may provide useful information for the development of tailored, empirically informed curriculum interventions and educational programs in order to address several barriers to communication. Sociocultural characteristics that influence the disclosure practice, as well as physicians' perceptions that are consistent with the optimal information delivery, should be taken into account. System-level strategies that focus on the development of patient-centered communication also need to be prioritized