Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study

<p>Abstract</p> <p>Background</p> <p>Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece.</p> <p>Methods</p> <p>The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years), who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire.</p> <p>Results</p> <p>Use of antibiotics within the past 12 months was reported by 888 participants (77.9%). 508 individuals (44.6%) reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%). The antibiotics most frequently used for self-medication were amoxicillin (18.3%), amoxicillin/clavulanic acid (15.4%), cefaclor (9.7%), cefuroxim (7.9%), cefprozil (4.7%) and ciprofloxacin (2.3%). Fever (41.2%), common cold (32.0%) and sore throat (20.6%) were the most frequent indications for the use of self-medicated antibiotics.</p> <p>Conclusion</p> <p>In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold.</p

Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic

Background: Human papillomavirus (HPV) infection is a causative factor for cervical cancer. Early detection of high risk HPV types might help to identify women at high risk of cervical cancer. The aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynecological outpatient clinic and to explore the determinants of the infection.Methods: A total of 225 women were studied. All women underwent a regular gynecological control. 35 HPV types were studied; 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 62, 66, 68, 70, 71, 72, 73, 81, 82, 83, 84, 85 and 89. Also, basic demographic information, sociodemographic characteristics and sexual behavior were recorded.Results: HPV was detected in 22.7% of the study population. The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). 66.2% of the study participants had a Pap test during the last year without any abnormalities. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P = 0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P < 0.001), and negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P = 0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P = 0.01).Conclusion: The prevalence of HPV in women attending an outpatient clinic is high. Number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income

Prevalence of HPV infection among greek women attenoing a gynecological outpatient

Background : The presence of human Papillomavirus and its infection has been shown that causes cervical cancer. High-risk HPV types are present in over 99% of cervical cancers and in the vast majority of cases of high grade cervical intraepithelial neoplasia. Worldwide, approximately, 70% of cervical cancers are due to HPV types 16 and 18. Women with normal cervical cytology who are infected with high risk HPV type have an approximately 100-fold increased risk of developing cervical cancer compared to uninfected women. Aim of Study : Τhe aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynaecological outpatient clinic and to investigate possible determinants of the infection. Methods : A total of 225 women were studied. All women underwent a regular gynaecological control as attending a gynaecological outpatient clinic during October 2007 to May 2008. Basic demographic information, sociodemographic characteristics and sexual behaviour were also recorded. The examine of the HPV prevalence and its subtypes in cervical smears was done with PCR . Statistical analysis was preformed using programs available in the SPSS statistical package (SPSS 15.0, Chicago, USA). Results : HPV infection was detected in 22.7% of the study population. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P=0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P<0.001), while it was related negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P=0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P=0.01). Conclusion: In conclusion, the prevalence of HPV in women attending an outpatient clinic is high. The number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income. The frequency of the subtypes of HPV 16 and 53 was 5,3% and 4,9% respectively. The combination of Vaccination against human papillomavirus on one hand and the gynaecologic cancer screening in young people on the other, could lead to effective prevention of cervical cancer.Εισαγωγή: Η παρουσία του Ιού των Ανθρωπίνων Θηλωμάτων και της HPV λοίμωξης που προκαλεί έχει δειχθεί ότι αποτελεί προδιαθεσικό παράγοντα ανάπτυξης καρκίνου του τραχήλου της μήτρας. Οι ογκογόνοι υπότυποι του ιού των ανθρώπινων θηλωμάτων σχετίζονται με το 99% του συνόλου των καρκίνων του τραχήλου της μήτρας καθώς και με την πλειονότητα των υψηλού βαθμού ενδοεπιθηλικών αλλοιώσεων. Το 70% των τραχηλικών καρκίνων οφείλεται στους ογκογόνοιυς υπότυπους HPV- 16,18. Παγκοσμίως, περίπου το 70% των περιπτώσεων καρκίνου του τραχήλου της μήτρας οφείλονται στους υπότυπους HPV 16 και 18. Σκοπός: Σκοπός της παρούσας μελέτης ήταν η εκτίμηση του επιπολασμού της λοίμωξης των ανθρώπινων θηλωμάτων σε δείγμα ελληνίδων γυναικών, οι οποίες παρακολουθούνταν σε τακτικά εξωτερικά ιατρεία Δημόσιου Μαιευτηρίου της Αθήνας, καθώς και η διερεύνηση πιθανών συσχετίσεων με παράγοντες κινδύνου από το ατομικό ιστορικό και τα δημογραφικά χαρακτηριστικά των ατόμων της μελέτης. Mέθοδος: Διεξήχθηκε περιγραφική μελέτη συσχετίσεως με συγχρονικές συγκρίσεις, σε τυχαίο δείγμα γυναικών αναπαραγωγικής ηλικίας. Μελετήθηκαν συνολικά 225 γυναίκες, οι οποίες υποβλήθηκαν σε πλήρη γυναικολογική εξέταση και τεστ Παπανικολάου κατά τη χρονική περίοδο Οκτωβρίου 2007 έως Μαΐου 2008, στα τακτικά ιατρεία δημόσιου μαιευτηρίου της Αττικής. Η ανίχνευση του ιού και των υποτύπων του πραγματοποιήθηκε με την εφαρμογή της μεθόδου της αλυσιδωτής αντίδρασης πολυμεράσης στο τραχηλικό επίχρισμα. Η στατιστική ανάλυση έγινε με τη χρήση του στατιστικού προγράμματος SPSS stat istical package (SPSS 15.0, Chicago, IL, ΗΠΑ). Αποτελέσματα: Η λοίμωξη από τον ιό HPV ανιχνεύτηκε στο 22,7% του πληθυσμού της μελέτης. Ο HPV-16 ήταν ο πιο συνηθισμένος υπότυπος που ανιχνεύτηκε (5,3%), ακολουθούμενος από τον HPV-53. Το ποσοστό των γυναικών που διαγνώστηκαν για πρώτη φορά με HPV λοίμωξη ήταν 17,3%. Η HPV λοίμωξη συσχετίσθηκε θετικά με την κατανάλωση αλκοόλ (OR: 2,19, 95% CI: 1,04-4,63, P=0,04) και τον αριθμό των ερωτικών συντρόφων (OR: 2,16, 95% CI: 1,44-3,25, P<0.001), ενώ συσχετίσθηκε αρνητικά με την ηλικία (OR: 0,93, 95% CI: 0,87-0,99, P=0,03) και το μηνιαίο εισόδημα (OR: 0,63, 95% CI: 0,44-0,89, P=0,01). Συμπέρασμα: Ο επιπολασμός της HPV λοίμωξης σε γυναίκες αναπαραγωγικής ηλικίας είναι υψηλός. Ο αριθμός των ερωτικών συντρόφων και η κατανάλωση αλκοόλ φαίνεται να αποτελούν τους πλέον σημαντικούς παράγοντες κινδύνου της HPV λοίμωξης, ενώ ακολουθούν η νεαρή ηλικία και το χαμηλό οικογενειακό εισόδημα. Η συχνότητα των υποτύπων HPV-16 και 18 ήταν 5,3% και 4,9% αντίστοιχα. Ο εμβολιασμός έναντι του ιού των ανθρωπίνων θηλωμάτων, σε συνδυασμό με το γυναικολογικό έλεγχο και το τεστ Παπανικολάου σε άτομα νεαρής ηλικίας, θα μπορούσαν να οδηγήσουν σε αποτελεσματική πρόληψη της νόσου

Emerging infectious diseases

The field of infectious disease is vast, complex and rapidly expanding. New advances in diagnostic testing, the development of new antimicrobial therapies and even the emergence of novel infectious diseases require diligent study by medical practitioners to remain current. International travelling can pose various risks to health, depending on the characteristics of both the traveller and the travel. Travellers may encounter sudden and significant changes in altitude, humidity, microbes and temperature, which can result in ill-health. In addition, serious health risks may arise in areas where accommodation is of poor quality, hygiene and sanitation are inadequate, medical services are not well developed and clean water is unavailable. The purpose of this paper is to highlight the details and impact of 4 significant diseases that pose a threat to public health. Specifically issues are such as the cause, transmission, geographical distribution, nature of disease and precautions of SARS, influenza, chikungunya and avian flu

Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic

Background: Human papillomavirus (HPV) infection is a causative factor for cervical cancer. Early detection of high risk HPV types might help to identify women at high risk of cervical cancer. The aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynecological outpatient clinic and to explore the determinants of the infection.Methods: A total of 225 women were studied. All women underwent a regular gynecological control. 35 HPV types were studied; 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 62, 66, 68, 70, 71, 72, 73, 81, 82, 83, 84, 85 and 89. Also, basic demographic information, sociodemographic characteristics and sexual behavior were recorded.Results: HPV was detected in 22.7% of the study population. The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). 66.2% of the study participants had a Pap test during the last year without any abnormalities. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P = 0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P < 0.001), and negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P = 0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P = 0.01).Conclusion: The prevalence of HPV in women attending an outpatient clinic is high. Number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income

Knowledge regarding assessment of sepsis among Greek nurses

The aim of the present survey was to evaluate nurses' knowledge regarding sepsis in Greece. A total of 835 registered nurses (125 males/710 females) from tertiary hospitals in Greece were interviewed from April 2008 to December 2009. All participants completed a self-completed questionnaire about assessment of sepsis (see Figure 1). Basic demographic information was recorded. The protocol and questionnaire were approved by the Ethics Committees of participating hospitals. The majority of the participants answered correctly regarding awareness of systemic inflammation - 83.5% regarding the role of temperature in the definition of systemic inflammation; 81.3% regarding the importance of white blood cell count; and 49.9% and 46.3% regarding the role of tachycardia and tachypnoea, respectively. The same pattern was observed regarding the answers about the assessment of sepsis - 79.4% of the nurses answered correctly about the role of blood pressure; 70.9% about the role of urine volume; and 43.5% about the importance of oxygen saturation. Finally, 57.2% of the participants confirmed that in practice they followed the current guidelines for the diagnosis and treatment of patients with sepsis. The study has established baseline data with which future studies can be compared