Physicians’ Perceptions and Adherence to Guidelines for the Management of Hypertension: A National, Multicentre, Prospective Study

Background. The aim of the current study was to investigate physicians’ perceptions and adherence to the European guidelines for the management of hypertension. Methods. This is a national, multicentre, prospective, observational study, conducted between November 2007 and June 2008, in Cyprus. Consecutive hypertensive patients have been recruited by a random sample of physicians. The physicians’ recommendations for every single patient have been recorded and compared with the 2007 ESH/ESC guidelines. Results. Of the total of 654 patients, 477 (72.9%) were correctly advised by their physician to receive antihypertensive treatment to control their blood pressure, while 396 (60.5%) correctly got advices to adopt only lifestyle changes. The overall adherence of physicians to the European guidelines (overall agreement rate) was 70.4% (k=0.258, P<0.001). Of the total of 68 physicians, 65 (95.6%) reported that they were aware of some guidelines. There was no statistically significant effect of specific physicians’ characteristics on the overall adherence to guidelines, but there was in the percentage of patients achieving medication guidelines. Conclusions. The study demonstrated that although Cypriot physicians declared that they were aware of the clinical guidelines for the management of hypertension, more than one-fourth of high risk hypertensive patients remained untreated and 40% of low risk patients received inappropriate medication

Epidemiology of acute coronary syndromes in a Mediterranean country; aims, design and baseline characteristics of the Greek study of acute coronary syndromes (GREECS)

BACKGROUND: The present study GREECS was conducted in order to evaluate the annual incidence of acute coronary syndromes (ACS) and to delineate the role of clinical, biochemical, lifestyle and behavioral characteristics on the severity of disease. In this work we present the design, methodology of the study and various baseline characteristics of people with ACS. METHODS/DESIGN: A sample of 6 hospitals located in Greek urban and rural regions was selected. In these hospitals we recorded almost all admissions due to ACS, from October 2003 to September 2004. Socio-demographic, clinical, dietary, psychological and other lifestyle characteristics were recorded. 2172 patients were included in the study (76% were men and 24% women). The crude annual incidence rate was 22.6 per 10,000 people and the highest frequency of events was observed in winter. The in-hospital mortality rate was 4.3%. The most common discharged diagnosis for men was Q-wave MI, while for women it was unstable angina. DISCUSSION: This study aims to demonstrate current information about the epidemiology of patients who suffer from ACS, in Greece

The diagnostic accuracy of a composite index increases as the number of partitions of the components increases and when specific weights are assigned to each component

The aim of this work was to evaluate whether the number of partitions of index components and the use of specific weights for each component influence the diagnostic accuracy of a composite index. Simulation studies were conducted in order to compare the sensitivity, specificity and area under the ROC curve (AUC) of indices constructed using equal number of components but different number of partitions for all components. Moreover, the odds ratio obtained from the univariate logistic regression model for each component was proposed as potential weight. The current simulation results showed that the sensitivity, specificity and AUC of an index increase as the number of partitions of components increases. However, the rate that the diagnostic accuracy increases is reduced as the number of partitions increases. In addition, it was found that the diagnostic accuracy of the weighted index developed using the proposed weights is higher compared with that of the corresponding un-weighted index. The use of large-scale index components and the use of effect size measures (i.e. odds ratios, ORs) of index components as potential weights are proposed in order to obtain indices with high diagnostic accuracy for a particular binary outcome.weights, indices, specificity, AUC, simulations, application,

BULLYING AND SUICIDALITY IN CHILDHOOD AND ADOLESCENCE

Introduction: The episodes of violence and aggression in schools is a common and growing in frequency phenomenon. Research has shown that the engagement with school bullying is a major risk factor as far as suicidal ideation and suicide attempts are concerned. The aim was to review literature about school bullying and cyberbullying as well as the suicidality in children and adolescents. Material and Methods: It was used bibliography search in the databases PubMed and Scopus, reviews of the last five years and some reference textbooks and reports of official government bodies such as the CDC. Results: The brief review has highlighted the scale and the characteristics of the phenomenon of bullying as well as the characteristics of the correlation between bullying and suicidality. The positive correlations of the involvement in both school and cyberbullying with suicidal ideation and suicidal behavior were emphasized. Stronger correlations show the bully/ victims with suicidality. Finally, concomitant victimization by school and cyberbullying increases exponentially the correlations with suicidality. Conclusions: Future research would benefit from the analysis of the longitudinal impact of bullying on young people in terms of suicidal ideation and behaviors towards better understanding of the temporary or permanent establishment of that association. Efforts should continue in identifying and helping those involved with both types of bullying, as well as to establish well functioning prevention and intervention programs

Self-reported prevalence of atherothrombosis in a general population sample of adults in Greece; A telephone survey

Background: The aim of this study was to estimate the prevalence of selected atherothrombotic risk factors and several clinical manifestations of atherothrombosis, as well as the utilization rates of selected vascular interventions in Greece. Methods: During December 2009, 3,007 adults (aged 47 +/- 16 years, 48.3% men and 51.7% women) recruited in a random-digit dialed telephone survey (response rate: 16%). The sample size was selected following a multistage and stratified by gender, age group, and Greek region procedure in order to be more representative. Data regarding medical history and socio-demographic characteristics of the participants were collected. Results: Overall, 6.5%, 17.7% and 14.0% of participants reported that they had been diagnosed with diabetes mellitus, hypertension and hypercholesterolemia, respectively. In the overall sample, 2.5% of participants reported that they had been diagnosed with angina, 2.0% with myocardial infarction, 1.6% with stroke and 2.5% with peripheral artery disease. Overall, 1.5% of participants reported that they had undergone percutaneous coronary intervention, 1.4% coronary artery bypass grafting, 0.6% angioplasty of a peripheral vessel, and 0.7% surgery of a peripheral vessel. Conclusion: Despite the limitations may occur due to the sampling procedure, the findings of the present study indicate that atherothrombosis affects a large portion of the population in Greece and it is expected to impose a significant economic burden. The data of the current study could contribute in obtaining an accurate estimation of the economic burden of atherothrombosis in Greece because people who are aware of their condition/disease are those who use health care resources