Nationwide Study on Practices Related to Screening Among Greek Paediatricians.

OBJECTIVE: The aim of this study was to investigate pediatricians' practices toward screening in Greece. MATERIALS AND METHODS: The survey was conducted within a six month period in a stratified random sample of 371 pediatricians. A questionnaire with three sections was created and pilot tested. Socio-demographic characteristics associated with inappropriate screening were identified using multivariable logistic regression models and latent class analysis. RESULTS: A total of 294 participants completed the telephone survey (response rate 78.6%). The median number of wrong answers to questions related to pediatricians' practice towards screening recommendations was 7±1.57 with minimum 2 and maximum 11 wrong answers. Pediatricians, with less than 15 years of experience, age >50 years old or view more than eighty patients per week, have had significantly higher odds of responding wrong to more than seven questions, hence be less compliant to USPSTF screening guidelines. Latent class analysis has shown that female gender, age <50 years old, and work in the private sector, were associated with a poor practice towards international screening guidelines. CONCLUSION: Our survey found gaps in screening practices among a nationwide sample of Greek pediatricians. Moreover considerable variability in reported practices of screening was noted. There is a need for the development of a national childhood screening program in Greece.

Nationwide Epidemiological Study of Knowledge, Attitudes, and Practices Study of Greek General Practitioners Related to Screening.

BACKGROUND: We aimed to assess general practitioners' (GPs) knowledge, attitudes, and practices (KAPs) toward screening recommendation guidelines of the United States Preventive Services Task Force (USPSTF). METHODS: The survey was conducted during a 6-month period in a stratified random sample of GPs, drawn from a national database of GPs in Greece. Participants were queried about their knowledge, attitudes, and self-reported practice patterns regarding screening in a primary care setting. Sociodemographic characteristics associated with vague screening practicing were identified using multivariable logistic regression models. RESULTS: A total of 299 participants agreed and underwent telephonic survey (response rate: 78.2%). GPs agreed on the key role of population-based screening in improving patient care, and nine out of ten reported that their performance would be improved with the adoption of computer-based support systems in clinical practice. GPs, older than 50 years of age, those who those practicing for more than 15 years and GPs working in private sector, were less likely to comply with screening recommendations. Latent class analysis revealed that male physicians and those working in public sector were more likely to comply with USPSTF recommendations. CONCLUSIONS: Our findings highlight the need of educational intervention programs for GPs in order to promote the implementation of national evidence-based screening recommendation statements in clinical practice.

Myocardial bridge: an unusual cause of asymptomatic ST-elevation during treadmill stress test causing functional ischaemia.

Myocardial bridges are congenital structural abnormalities with debated clinical relevance; they may be traditionally asymptomatic or associated with various clinical manifestations, some of which may be potentially fatal. We report on a 60 years old man, who underwent a follow-up stress/rest myocardial perfusion scintigraphy developing asymptomatic exercise-induced ST-elevation and demonstrating completely reversible ischaemia in the scintigraphic images. Subsequent coronary angiography showed no artery stenosis, but revealed an intramyocardial pathway of the left anterior descending artery throughout a myocardial bridge. In conclusion, to our knowledge, this is the first reported case of asymptomatic exercise-induced ST-elevation secondary to a myocardial bridge.

Apical hypertrophic cardiomyopathy associated with multiple coronary artery-left ventricular fistulae: a report of a case and review of the literature.

We present a rare case of multiple coronary artery-left ventricular (LV) fistulae, associated with apical hypertrophic cardiomyopathy in an 83-year-old woman with electrocardiographic abnormalities and a history of arterial hypertension and paroxysmal atrial fibrillation. In order to evaluate the clinical significance and obtain further insights into this unusual disease, the patient has undergone coronary angiography, left ventriculography, and magnetic resonance imaging which better substantiated the structural abnormalities of the LV and the coronary network.