Clinics In Greece Research Articles

Power matters: Posthuman entanglements in a social solidarity clinic

This paper develops a materialist and performative conception of power, proposing a theoretical framework that bridges Barad’s intra-active agential ontology and Foucault’s microphysics of power. The article uses empirical data collected from a social clinic in Greece where the traditional apparatus of the clinic is contested and experimentally reconfigured. We focus on three overlapping themes and reflect on how power relations materialize themselves through everyday practices and multiple entanglements between human and non-human agents. We argue that these entanglements constitute the dynamic matter of power: their performative reiteration determines how power matters. By showing how power materially exceeds the manifest intentions of human agents, our case study aims to contribute to an idea of alternative organising that accounts for the materiality of mundane posthuman entanglements within an antagonistic understanding of power.

Statin-associated side effects in patients attending a lipid clinic: evidence from a 6-year study.

IntroductionThere is conflicting evidence regarding the actual incidence of statin-associated side effects in clinical practice. We aimed to record the incidence of statin-associated side effects in the setting of a lipid clinic. We focused on clinically relevant liver enzyme increase and statin-associated muscle symptoms (SAMS).Material and methodsThis was a retrospective study including adult patients with dyslipidemia followed up for ≥ 3 years in a university hospital lipid clinic in Greece. We recorded the incidence of clinically relevant liver enzyme increase (> 3 × upper limit of normal (ULN) on 2 occasions) and SAMS (muscle crumps, creatine kinase (CK) increase > 10 × ULN and rhabdomyolysis) during follow-up.ResultsAmong study participants (n = 1,334), 3.1% and 2.8% presented with clinically relevant liver enzyme increase and SAMS at least once during a median follow-up of 6 years (4–10). Only 11% (n = 5) of subjects with a clinically relevant liver enzyme increase and 6% (n = 2) of those with SAMS did not tolerate any statin at any dose. Most subjects with a history of a clinically relevant liver enzyme increase or SAMS were eventually treated with a moderate- or high-intensity statin (76% and 80%, respectively) or with combination treatment of a statin plus another lipid-lowering drug (15% and 36%, respectively). No risk factors for these statin-associated side effects were identified.ConclusionsThe incidence of statin-associated side effects is low in the setting of a lipid clinic. The vast majority of these individuals were still able to tolerate statin treatment.

The effect of a physiotherapy intervention on disability decrease and on the perceived health-related quality of life in patients with musculoskeletal disorders

IntroductionTo evaluate the effect of a physiotherapy intervention on disability decrease and the perceived health-related quality of life (HRQoL) in patients with musculoskeletal disorders.MethodsThe interventional study involved 150 patients of a public hospital and 3 private physiotherapy clinics in Greece. The study lasted 5 months (December 2016–April 2017). A composite questionnaire was used, including sociodemographic/medical data, Oswestry Disability Index (ODI), and EQ-5D-3L. The main intervention consisted in 10 physiotherapy sessions including transcutaneous electrical nerve stimulation, short-wave diathermy, high-frequency ultrasound, hand massage, and strengthening/stretching exercises. Questionnaires were completed before the first session and then after the tenth session. Analysis was performed with SPSS v. 21.0.ResultsHalf of the participants (50%) were treated in a state hospital, while the rest (50%) in a private clinic. The patients had problems in their spine and neck in the same percentage (44.7%). There was a significant decrease (mean: 19.33, SD: 13.71) in ODI score after the intervention. The decrease differed significantly depending on age, marital status, and problem location (spine, neck, chest). A significant improvement in EQ-5D-3L and visual analogue scale scores was recorded after treatment (<i>p</i> = 0.001). The EQ-5D-3L score change differed significantly depending on age, marital status, educational level, problem location, and previous physiotherapy treatment. There was a significant positive correlation between changes in EQ-5D-3L and ODI (<i>r</i> = 0.48, <i>p</i> < 0.001).ConclusionsThe physiotherapy intervention was beneficial for patients with musculoskeletal disorders and improved their perceived HRQoL. Several demographic and medical characteristics affected the improvement.

Neonatal Birth Weight of the Woman as a Risk Factor for Breast Cancer in her Life: a Case-Control Bicentric Study.

Background:It is a global fact that the birth weight is increasing during the years around the world and for this reason it is very important to be examined as a potential risk factor for breast cancer. According to data from World Health Organization, breast cancer is the second most frequent malignancy across the world, after lung cancer, in Europe including Greece in incidence and mortality for women between the ages 0-85 years old.Objective:The aim of this study was to investigate a possible association between neonatal birth weight of the women and breast cancer risk in Greek women. Although that many studies concluded that birth weight is positively related with breast cancer reinforcing the theory that breast cancer may originate in utero, some studies found no association. Moreover, the results from previous studies are inconsistent maybe due to several factors such as the study design and the number of cases.Methods:This study was a case-control retrospective bicentric study. The case group included 238 women with breast cancer, while the control group included 153 women without breast cancer who consulted in two breast clinics in Greece. In all women, a clinical examination and breast ultrasound were achieved. Moreover, digital bilateral mammography was performed in patients older than 40 years.Results:According to Fisher’s exact analysis, there is a statistically significant relationship between the higher women’s neonatal birth weight and the risk for breast cancer (p<0.001). More specifically in the group of women with breast cancer, 61% of them had more than 3500 grams birth weight, in contrast with 7.8 % in the control group. In our cohort, women who had birth weight more than 3500 grams are more likely to develop breast cancer in their life.Conclusion:Our study trend to show that the increased neonatal birth weight may influence future risk of breast cancer. However, further studies with larger number of participants are needed in order to clarify the role of birth weight as a complementary risk factor of breast cancer.

PCSK9 inhibitors: The breakthrough lipid-lowering treatment at real-life setting. A 2-year regional lipid clinic experience

Background and Aims: Data on clinical implementation of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in real-life setting is limited. Thus, we report 2-year experience with PCSK9 inhibitors in clinical practice at a University Hospital Lipid Clinic in Greece.

Comparison of the Greek Version of the Quick Mild Cognitive Impairment Screen and Standardised Mini-Mental State Examination.

Short cognitive screening instruments (CSIs) are widely used to stratify patients presenting with cognitive symptoms. The Quick Mild Cognitive Impairment (Qmci) screen is a new, brief (<5mins) CSI designed to identify mild cognitive impairment (MCI), which can be used across the spectrum of cognitive decline. Here we present the translation of the Qmci into Greek (Qmci-Gr) and its validation against the widely-used Standardised Mini-Mental State Examination (SMMSE). Consecutive patients aged ≥55years presenting with cognitive complaints were recruited from two outpatient clinics in Greece. All patients completed the Qmci-Gr and SMMSE and underwent an independent detailed neuropsychological assessment to determine a diagnostic classification. In total, 140 patients, median age 75years, were included; 30 with mild dementia (median SMMSE 23/30), 76 with MCI and 34 with subjective memory complaints (SMC) but normal cognition. The Qmci-Gr had similar accuracy in differentiating SMC from cognitive impairment (MCI & mild dementia) compared with SMMSE, area under the curve (AUC) of 0.84 versus 0.79, respectively; while accuracy was higher for the Qmci-Gr, this finding was not significantly different, (p=.19). Similarly, the Qmci-Gr had similar accuracy in separating SMC from MCI, AUC of 0.79 versus 0.73 (p=.23). The Qmci-Gr compared favorably with the SMMSE. Further research with larger samples and comparison with other instruments such as the Montreal Cognitive Assessment is needed to confirm these findings but given its established brevity, it may be a better choice in busy clinical practice in Greece.

How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists?

Psoriasis (Pso) and psoriatic arthritis (PsA) are chronic and debilitating diseases which often develop in the same patient and are linked to a wide range of comorbid conditions. Dermatologists and rheumatologists need to cooperate in combined clinics, especially when they deal with severe, recalcitrant disease, and multiple comorbidities. The clinical and research benefits of this collaboration have been previously described to contribute to a better and more sustainable health care system. To apply a more holistic approach of patients with Pso and PsA, we established the first dual care clinic in Greece, for Pso and PsA patients, based at Attikon General University Hospital. Hereby, we describe the infrastructure and operation of a combined Pso and PsA clinic (PPAC), in the national health care system of Greece, and its impact on the management of Pso and PsA. The PPAC is a single-day joint clinic, held once a week, which consists of three dermatologists and three rheumatologists. We present the results of 185 newly diagnosed patients between December 2018 and January 2019. Mean age of onset of Pso was 34 ± 16 years old and 47 ± 12 years old for PsA. Most patients suffered from severe plaque Pso (144/185, 78%) and asymmetric oligoarticular arthritis (59/185, 32%), for which they were receiving treatment with biologic agents (105/185, 57%). Many required monitoring for hypertension (74/185, 40%), dyslipidemia (69/185, 37%), diabetes (17/185, 9%), and depression (20/185, 11%). Patients reported high levels of care satisfaction (visual analogue scale: 86 ± 11.5), using the PPAC facility, compared to different referrals between specialties. This is the first joint dermatology-rheumatology clinic in Greece, providing comprehensive care in patients with Pso and PsA. Our results support the concept of combined clinics delivering better integrated care for such patients.

Assessment of patient satisfaction of certified and non-certified private dental clinics in Athens

Background: In recent years, the issue of quality assurance in health services has emerged in the forefront, with strong research and practical interest. In addition, there is a number of changes to health service users who nowadays have higher expectations of satisfaction, efficiency and quality of health services.Aim: The aim of the present study is to assess the satisfaction of patients and, by extension, the quality of the services provided both in certified and non-certified private dental practices in Athens, to highlight the difference in the services provided and the areas in which it appears.Methods: This is a quantitative study of dental patients’ satisfaction in Athens using an anonymous and self-completed questionnaire. The aggregate sample collected is 317 patients within three months of the questionnaire being shared. In particular, the sample for certified dental places was 176 patients, while the sample of non-certified dental places was 141 patients. For the statistical analysis, the SPSS program for Windows version 25 was used, and the tables were created with Microsoft Excel 2010 based on the SPSS analysis data.Results: The results showed differences between the social level of patients, the permanent residence of the participants as well as differences in the reason for choice and visit to each dental place, while on the questions about the satisfaction of the services the differences were little. The questions with the most shared responses were those in the financial basis. Correlation coefficients did not show any statistically significant relationship between demographic characteristics and satisfaction, with the exception of the level of education of patients in certified dental clinics.Conclusions: Although the results of the research showed little differences in the satisfaction of the patients between certified and non-certified dental clinics, these results are quite limited due to the small number of certified dental clinics in Greece. Further research is needed to produce safer conclusions.

Children’s Emotional Needs Regarding Contact with their Parents during their Placement: Professionals Perceptions

ABSTRACT This study concerns the exploration of the perceptions of professionals working in residential child care and in child psychiatric clinics in Greece regarding family visits during child placement. The participants were fourteen people working in residential child care and child psychiatric clinics. A qualitative approach was chosen. The method of thematic analysis was used to analyze the interview data. Five main categories emerged from the analysis, which led to a more thorough understanding of the participant’s perceptions. The findings of this study demonstrate the importance of connecting youth with their story and their parents. Emphasis is placed on the protective and supportive role of the institution (and the people who actually form it) and their ability to provide a safe environment that can maintain boundaries and in which they are emotionally available to the children and resilient.

A Greek registry of current type 2 diabetes management, aiming to determine core clinical approaches, patterns and strategies

BackgroundTo analyze data in terms of the glycaemic control and therapeutic regimens used for Type-2 Diabetes Mellitus (T2DM) management in Greece, identify factors that influence clinical decisions and determine the level of compliance of T2DM management with the latest international and local guidelines.Methods‘AGREEMENT’ was a national-multicenter, non-interventional, cross-sectional disease registry. A total of 1191 adult T2DM patients were enrolled consecutively from 59 sites of the National Health System (NHS) or University Hospitals, representing the majority of Diabetes centers or Diabetes outpatient clinics in Greece with a broad geographic distribution. Patients were stratified by gender and analysis was done according to 3 treatment strategies: A (lifestyle changes or use of one oral antidiabetic agent), B (up to 3 antidiabetic agents including injectables but not insulin) and C (any regimens with insulin).ResultsMean (±SD) HbA1c % of the total population was 7.1 (±1.2) while mean (±SD) FPG (mg/dl) was measured at 136 (±42). The proportion of patients who achieved HbA1c < 7% was 53% and ranged from 74.2% for group A, to 60.6% for group B and 35.5% for group C. Median age of the studied population was 65.0 year old (Interquartile Range-IQR 14.0) with an equal distribution of genders between groups. Patients on insulin therapy (treatment strategy C) were older (median age: 67 years vs 63 or 65 for A and B, respectively) with longer diabetes duration (mean duration: 15.3 years vs 5.2 and 10.1 for A and B, respectively). Patients who received insulin presented poor compliance. There was a consensus for a series of decision criteria and factors that potentially influence clinical decisions, used by physicians for selection of the therapeutic strategy among the three groups. Compliance with international and Greek guidelines received a high score among groups A, B and C. No significant differences were presented as per sites’ geographic areas, NHS or University centers and physicians’ specialty (endocrinologists, diabetologists and internists).ConclusionsThe presented findings suggest the need for improvement of the glycaemic control rate, especially among insulin treated patients as this group seems to achieve low glycaemic control, by setting appropriate HbA1c targets along with timely and individualised intensification of treatment as well as post-therapy evaluation of the compliance with the proposed treatment.

Insertion of long-term tunneled cuffed hemodialysis catheters via the external jugular vein by using a simple, safe and reliable surgical technique.

Description of our technique for the insertion of long-term tunneled cuffed hemodialysis (HD) catheters via the external jugular vein. From December 1999 to August 2006, 357 long-term tunneled cuffed HD catheters were inserted in 308 patients, who were referred to us from various hospitals and clinics in Greece. About half of them (168, or 47%) were inserted via the external jugular vein. We describe our surgical technique for the insertion of long-term tunneled cuffed HD catheters via the external jugular vein. During our study, there was a gradual increase in using the external jugular vein as a method for the insertion of permanent HD catheters. In all cases, the intraoperative catheter blood flow was measured >300 ml/min. No major complications occurred. Long-term tunneled cuffed HD catheters can be inserted via the external jugular vein by using an easy, simple, safe surgical technique. This procedure provides the possibility of using the internal jugular vein in the future.

Solidarity outpatient clinics in Greece: a survey of a massive social movement

ObjectiveUntil 2016, around 3 million persons had limited access to health care in Greece due to the economic crisis. We describe a massive solidarity movement of community clinics and pharmacies in Greece. MethodWe conducted a survey in 2014-15 and describe the characteristics of community clinics and pharmacies spontaneously established all over Greece after 2008. ResultsA characteristic of the 92 active solidarity clinics is autonomous collective functioning, free services, and funding from non-governmental sources. The largest clinics examined more than 500 uninsured or partly insured patients per month. Clinics covered a wide range of clinical and preventive services. Funding, availability of drugs, vaccines, medical material and their legal status were the main problems identified. The solidarity movement involved thousands of health professionals covering essential population needs. ConclusionsThe community outpatient clinics were an outstanding example of solidarity and temporarily alleviated the health needs of a large part of the population.

Antibiotic resistance profiles from isolated bacteria in outpatient infertility clinic in Greece

Aim: To investigate the prevalence of common aerobic gram positive and gram negative bacteria, Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis in symptomatic and asymptomatic Greek patients and to determine antibiotic resistance profiles. Methods: This retrospective study included a total of 316 adult men examined at the Assisted Reproduction Department of IASO- Obstetrics and Gynecology clinic in Athens, Greece. Sperm have been collected and proceed to culture and antibiotic sensitivity at the Central Laboratories following a standard protocol. Results: Twelve inappropriate out of 316 samples were excluded from the study. Out of the remaining 304 sperm samples 111 (37.5 %) were positive. Antibiotic sensitivity testing detected resistances to some commonly used antibiotics such as b-lactams and the quinolones. Ureaplasma urealyticum and Mycoplasma hominis were the most frequently isolated bacteria (45%), followed by Enterobacteriaceae (40%) and Enterococci 12.6%. The majority of 45 Enterobacteriaceae isolates, were Escherichia coli (31 strains/68%) corresponding to 27.9% of the total number of positive cultures. One infection to Chlamydia trachomatis was detected by an immunochromatic rapid test, one Candida sp, one Pseudomonas aeruginosa, two M. hominis and three Streptococcus group B. Escherichia coli were resistant to b lactams in about 38.7% due to b-lactamase, and 22.5%, 9.6%, 6.4%, were resistant to nitrofurantoin, sulfamethoxazole and ciprofloxacin respectively. Enterococci have shown resistance due to b-lactamase and PBP 5 alteration/hyperproduction. Ureaplasmas were resistant to the fluoroquinolones tested ciprofloxacin and ofloxacin, at 72.2% and 62.3% respectively. Conclusion: Carriage of bacteria in sperm is controversial for its contribution in sperm quality and fertility. In our IVF unit, we follow a protocol of isolation and antibiotic profiling of bacteria from sperm culture regardless of their concentration in sperm and giving the numbers/ml. This helps doctors to distinguish carriage or infection and to decide about potential therapy. Given the antibiotic resistances shown by this study, the importance of culture against empiric therapy in assisted reproduction patients is also clearly demonstrated.

Factors associated with HCV test uptake in heroin users entering substitution treatment in Greece.

People who inject drugs (PWID) represent the main risk group for hepatitis C virus (HCV) infection in most middle and high-income countries. Testing PWID is considered as an important prevention measure. Identification of PWID characteristics associated with HCV testing may contribute to strategies targeting the containment of the HCV and HIV epidemics in Greece. Anonymous behavioural data from 2747 heroin users were collected upon entry in 38 opioid substitution treatment (OST) clinics in Greece during the period 2013-2015. HCV test uptake was the dependent variable while covariates included sociodemographic and addiction-related variables, mostly derived from the EMCDDA treatment demand indicator protocol. Among 2299 cases with complete data on HCV testing, 83.5% reported any HCV testing uptake, with 61.2% reporting a recent test (<12months). In the multivariate analyses, any previous HCV testing uptake was associated with age ≥25years, past drug treatment attempt, injecting or sniffing the primary substance, injection history ≥5years, and syringe sharing earlier than the past 12months. Past HCV test uptake was higher among those reporting full-time employment and 2-4years injecting histories, and lower among residents of Athens. Recent testing was positively associated with female gender and polysubstance use. Any previous HCV testing uptake is high among PWID entering OST in Greece and is associated with older age, longer injecting histories and past drug-related treatment attempts. Efforts to prevent and mitigate the ongoing HCV test epidemic among PWID in Greece should combine treatment with scaling up of screening, targeting especially those younger than 25years and at the beginning of their hazardous use.

Continuous intraoperative recurrent laryngeal nerve monitoring during thyroid surgery. The Greek experience

Introduction: Recurrent laryngeal nerve injury is a serious complication of thyroid surgery. The anatomic dissection and visual identification of the inferior laryngeal nerve is the standard of care to avoid this complication. The intermittent intraoperative nerve stimulation technique has failed to improve nerve safety. The continuous recurrent laryngeal nerve monitoring is a promising new technique, currently under study to evaluate its feasibility and safety outcomes. We present our experience of applying this method in a private thyroid surgery clinic in Greece

Investigation of the association between quality of life and depressive symptoms during postpartum period: a correlational study

BackgroundThe onset of a major depressive episode is experienced by a large number of women in the weeks or months following delivery. Postpartum depression may deem those women experiencing it incapable of taking care for themselves, their family and their infants, while at the same time it could negatively affect their quality of life. The present study assessed the quality of life of a sample of mothers in Greece, in order to investigate the association between postpartum depression and quality of life (QoL).Methods145 women in a Private-General Obstetrics and Pediatric Clinic in Greece completed the Edinburgh Postnatal Depression scale (EPDS) and SF-36 questionnaire on the third and fourth day after delivery (caesarean or normal childbirth). The data were analyzed using SPSS version 17.0. Linear and logistic regression analysis was performed in order to find the independent factors related to the quality of life and postpartum depression symptoms.Results9.9% of the participants experienced postpartum depression symptoms. Significant associations were found between the place of residence and symptoms of postpartum depression, and more specifically, women outside of Attica indicated higher levels of postpartum depression symptoms (p = 0.008) than women living in Attica. The level of education was also found to be significantly associated with postpartum depression symptoms, since women with Primary and Secondary education experienced higher levels of postpartum depression symptoms (p = 0.005) than those with a tertiary education. Concerning quality of life, women with postpartum depression symptoms scored 24.27 lower in «Role-Physical», 15.60 lower in «Bodily pain», 11.45 lower in «General Health», 14.18 lower in dimension of «Vitality», 38.25 lower in Role – Emotional and 16.82 lower in dimension of mental health, compared to those without depression symptoms.ConclusionPostpartum depression symptoms are associated with the quality of life of women after pregnancy, and therefore constitute a powerful predictor of the quality of life. Health care professionals should provide individualized care for the prevention and treatment of Postpartum Depression symptoms in order to help women improve their quality of life.

PP.05.15] THE IMPACT OF SWITCHING FROM PROTOTYPE TO GENERIC ATORVASTATIN ON PERSISTENCE AND COMPLIANCE IN GREECE

Objective: To investigate the effect of switching from prototype to generic atorvastatin on adherence in hypercholesterolemic patients newly treated with atorvastatin under real life clinical conditions. Design and method: We conducted a non-interventional, ambispective, single-center, cohort study in Greece between May 2015 and October 2016. All adult hypercholesterolemic patients from the largest hypertension clinic in Greece with a documented first prescription with a prototype atorvastatin during a 6-month index period were screened retrospectively. Patients that either received a second prescription of prototype atorvastatin or switched to a generic version of atorvastatin were identified as the potential study pool. A random sample of 190 patients equally split in two cohorts comprised the study population, and were followed up prospectively. Persistence to treatment was assessed by time to discontinuation. Compliance was assessed by both the proportion of days covered (PDC) through the official Governmental e-prescribing system and the self-administered Morisky Medication Adherence Scale (MMAS-4). Finally, treatment satisfaction was measured with the self-administered Treatment Satisfaction Questionnaire for Medication (TSQM). Results: As per protocol 190 patients were enrolled in the study, 95 in each cohort. There were no statistically significant differences between cohorts regarding baseline characteristics, while all patients were hypertensive. The 18-month survival probability estimates were 90.2% and 76.4% for the non-switch and switch cohort respectively (HR = 0.574, p = 0.1627). Non-switchers were more compliant than switchers as measured by both PDC (79.1% vs. 73.0%, p < 0.001) and MMAS-4 scale (percent reporting high adherence: 73.7% vs. 26.3%, p < 0.001) and presented better results in TSQM dimensions (convenience: 65.9 vs. 62.3, p < 0.001, effectiveness: 68.2 vs. 62.9, p < 0.001, side effects: 98.7 vs. 98.4, p = 0.945, global satisfaction: 67.5 vs. 57.5, p < 0.001). Conclusions: Switching from a prototype to generic atorvastatin was associated with impaired persistence, compliance and treatment satisfaction in newly treated hypercholesterolemic patients. This new data provide a basis for further research to better understand adherence behavior.

John C. Carapanayiotis (1909-1999): the Greek radiologist and pioneer of physiatry in Greece

John C. Carapanayiotis was specialized in physical medicine and rehabilitation in the USA in 1948, at a time when the medical world in post-war Greece was ignorant of this specific medical specialty, and the political, economic and social backdrop was incapable of accepting and understanding the wealth of scientific knowledge that he was trying to introduce. At this point it should be noted that the specialty of Physical Medicine and Rehabilitation was established in Greece in 1973. John C. Carapanayiotis was a member of the American Congress of Physical Medicine during the 1950's. In the same period, he expressed interest, on behalf of the New York University, in the establishment of a Physical Therapy Clinic in Greece, which would be granted unlimited funding by the Marshal Plan. His efforts clashed constantly with the backward mentality of his time, with the entrenched conservatism and with the bureaucratic red tape. Unfortunately, he was far ahead of his time and was condemned to the same fate as all other visionaries and pioneers in the way that his knowledge and scientific background were not put into practice for decades to come.

LOW BACK PAIN: POSITIVE CORRELATION OF LOW SOCIOECONOMIC STATUS AND PAIN INTENSITY. A CROSS-SECTIONAL STUDY

Purpose: To record the incidence of low back pain in pain clinics in Greece and to determine whether patients’ demographic and socioeconomic characteristics affect the intensity of pain and their emotional situation. Methods: A cross-sectional study of patients complaining about low back pain was conducted at six different pain clinics. Multiple linear regression analysis in a stepwise method was used. Statistical significance was set at [Formula: see text] and analyses were conducted using SPSS statistical software. Results: Most of the patients were women (69.7%), over 60 years old (64.2%) and had low income (76.2%). University alumni and patients with postgraduate studies having less intense pain than primary/middle school and high school graduates ([Formula: see text]; [Formula: see text]; [Formula: see text] and [Formula: see text]; [Formula: see text]; [Formula: see text], respectively). Female sex ([Formula: see text]; [Formula: see text]; [Formula: see text]), painkillers use ([Formula: see text]; SE [Formula: see text]; [Formula: see text]) and increased pain score ([Formula: see text]; [Formula: see text]; [Formula: see text]) were associated with greater negative emotions. Age ([Formula: see text]; SE [Formula: see text]; [Formula: see text] for patients 60–69 years old and [Formula: see text]; SE [Formula: see text]; [Formula: see text] for patients over 70) and marital status ([Formula: see text]; [Formula: see text]; [Formula: see text]) were associated with more positive emotions. Conclusions: Many patients visit pain clinics complaining about low back pain. Their demographic and socioeconomic characteristics seem to affect their pain and their emotional situation.

The Implementation of Global Asthma Management Guidelines in Two General Respiratory Outpatient Clinics in Greece

BACKGROUND: The implementation of global guidelines for asthma management aims at asthma control. The aim of this study was to investigate the implementation of asthma management guidelines by both patients and physicians in two general pulmonary outpatient clinics in Greece. METHODS: Two questionnaires were administered to pulmonologists (n=43) and patients (n=181) separately. Asthma control was assessed by Asthma Control Test. RESULTS: All physicians informed their patients about asthma and suggested regular visits. The vast majority educated their patients to recognize symptom deterioration (n=42, 97.7%) and asthma triggers (n=41, 95.3%), to readjust treatment (n=41, 95.3%) and use correctly the inhaler devices (n=40, 93%). Greek pulmonologists suggested physical activity (n=40, 93%), peak flow meter use (n=13, 30.2%) and asthma physiotherapy (n=10, 23.3%), while 13 (30.2%) provided a written action plan. Among 181 participants with asthma, 41 (22.7%) had hyperventilation, while 117 (64.6%), mostly young men, had controlled asthma with high FEV1% predicted and without hyperventilation. Only 21 (11.6%) visited the emergency room in the past 6 months, while 98 (54.1%) had regular follow-up. They had developed a partnership with their physician (n=151, 83.4%) and confirmed their response to education on asthma triggers (n=156, 86.2%), symptom deterioration (n=171, 94.5%), inhaler medication technique (n=168, 92.8%) and peak flow meter use (n=40, 22.1%). Moreover, 118 (65.2%) patients recognized medication categories and 34 (18.8%) had a written action plan. They complied with physical activity suggestion (n=141, 77.9%), while 11 (6.1%) have performed breathing exercises. CONCLUSION: The recommendations for asthma management are significantly integrated into clinical practice in Greece, leading to high prevalence of asthma control.