Primary syphilis in HIV-negative patients is on the rise in Greece: epidemiological data for the period 2005-2012 from a tertiary referral centre in Athens, Greece.

BACKGROUND: Epidemiological data on primary syphilis in Greece are limited. OBJECTIVE: The purpose of the present study was to investigate the trends of the disease in Greece during the last few years and whether they are in accordance with the trends in other European countries and the United States of America. METHODS: We conducted a retrospective analysis based on records of patients who visited the Sexually Transmitted Infections Unit of 'A. Sygros' Hospital in Athens, Greece, during the period 2005-2012. Our hospital is a tertiary referral centre for sexually transmitted infections covering an area of more than four million people, which is almost half the population of Greece. We documented the total annual number of patients, the male to female ratio, sexual orientation, patients' ethnic origin and education level. RESULTS: We reviewed the records of 1185 patients with a confirmed diagnosis of primary syphilis. The total number of patients with primary syphilis has risen from 111 in 2005 to 158 in 2012, an increase of 42.3%. The mean annual number is 148. The mean male to female ratio is 4.76 : 1, with a peak value of 8.50 : 1 in 2011. The majority of patients are of Greek origin, ranging from 67.4% to 87.2%. Within the male patients group, it seems that the percentage of men having sex with men has risen steadily from 2005 (20.7%) up to 2010 (59.1%) with a decline in 2012 (46.0%). The mean value over 8 years is 45.0%. CONCLUSION: Primary syphilis in Greece is on the rise. Τhe majority of our patients are Greek, despite immigrant influx. Men clearly outnumber women, representing more than 80% of the total number of patients. Furthermore, there seems to be a trend towards predominance of men having sex with men as the core group among male patients.

Correlation of antibodies against desmogleins 1 and 3 with indirect immunofluorescence and disease status in a Greek population with pemphigus vulgaris.

BACKGROUND: The use of ELISA testing of antibodies to desmogleins 1 and 3 (anti-Dsg1 and anti-Dsg3) and indirect immunofluorescence (IIF) has been strongly supported for the serologic diagnosis of pemphigus. The purpose of this study was to correlate anti-Dsg1 and anti-Dsg3 with IIF values, disease localization, treatment and clinical course in Greek patients with pemphigus vulgaris (PV). METHODS: A total of 54 patients with PV had ELISA serum testing for the presence and titers of anti-Dsg1, anti-Dsg3 and IIF. Anti-Dsg1, anti-Dsg3 and IIF were correlated with treatment and disease localization. For 40 patients, titers of anti-Dsg1 and anti-Dsg3 were assessed in relation to treatment and clinical course after 12 months. RESULTS: Anti-Dsg3 and anti-Dsg1 positivity in patients with negative IIF was 70.6% and 58.8%, respectively. Anti-Dsg1 and anti-Dsg3 were positive in 89.3% and 100% of patients with mucocutaneous disease, respectively, 88.9% and 66.7% of patients with skin limited disease, respectively and 52.9% and 76.5% of patients with mucosal limited disease, respectively. Both antibody titers showed significant correlation with IIF and treatment status. Improvement of clinical status was associated with significant decrease of both anti-Dsg1 and anti-Dsg3 after 12 months. CONCLUSIONS: Serum testing of anti-Dsg1 and anti-Dsg3 in PV patients not only provides significant correlations with IIF, treatment and disease type, but may serve as a monitoring tool for clinical course and treatment guidance.

Adolescents' self-reported suicide attempts, self-harm thoughts and their correlates across 17 European countries.

BACKGROUND: Suicide is a leading cause of death among adolescents in Europe. Self-harm thoughts and behaviours are documented precursors of completed suicide. It is therefore of great importance to investigate the prevalence of suicide thoughts and attempts and their correlates, with the aim of preventing this major life-threatening public health problem. This study provides cross-national European data on self-reported suicidal thoughts and attempts among adolescents. METHODS: Data were obtained from 45,806 high school students aged 15-16 years from 17 countries that participated in the European School Survey Project on Alcohol and Other Drugs (ESPAD) 2007 school survey. The standardised methods of the ESPAD survey ensure comparability across countries. Students completed an anonymous questionnaire in their classrooms. The prevalences of suicidal thoughts and attempts are reported as well as their sociodemographic and psychosocial correlates identified in logistic regression. RESULTS: The median prevalence of any lifetime self-reported suicide attempt was 10.5% across the participating countries (range 4.1%-23.5%). The median of frequent self-harm thoughts (at least five times) was 7.4% (range 2.1%-15.3%). Suicidal behaviour and thoughts had significant associations with gender, substance use, family integrity and socioeconomic status. Countries with higher prevalence of substance use tended to have a weaker association between substance use and self-reported suicide attempts. CONCLUSION: Although self-reported self-harm thoughts and suicide attempts vary in prevalence within Europe, there are common correlates across countries. These have an important impact on understanding the phenomenon of suicide among young people and in guiding prevention.

Effectiveness of topical calcineurin inhibitors as monotherapy or in combination with hydroxychloroquine in cutaneous lupus erythematosus.

BACKGROUND: Calcineurin inhibitors show potent anti-inflammatory effects and favorable safety profile when used in the treatment of cutaneous lupus erythematosus (CLE). OBJECTIVE: The present study investigates the change in clinical parameters of erythema, desquamation and edema, when calcineurin inhibitors are used as monotherapy or in combination with hydroxychloroquine in CLE for a period of 60 days. METHODS: 18 patients were treated with topical tacrolimus and 20 patients with topical pimecrolimus, as monotherapy or in combination with hydroxychloroquine. Clinical parameters of erythema, desquamation and edema were assessed on a scale from 0 to 3 for erythema and edema and 0 to 2 for desquamation. RESULTS: Statistically significant improvement in erythema, desquamation and edema was observed in patients on monotherapy with calcineurin inhibitor and combination treatment with hydroxychloroquine, regardless of disease type. Combination treatment resulted in improvement of edema in 100% of patients, while monotherapy did so in 75% of patients. CONCLUSIONS: Topical calcineurin inhibitors enhance the therapeutic effect of systemic agents in cutaneous lupus erythematosus, and result in improvement of the clinical parameters studied.