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The accelerated rate of pharmaceutical innovation and the resulting increase in pharmaceutical spending constitute a challenging problem for the health administration and its policy, and for the scientific community. In Greece, in particular, since budgetary surveillance was imposed on Greece, because of the absence of an appropriate infrastructure for negotiations on reimbursed prices (a structure that would have the ability to control and restrict pharmaceutical spending), an upper obligatory budget limit on pharmaceutical public spending has been legally established. The legally established upper limit has been implemented through two obligatory infrastructures, the volume discounts (rebate) in the first place, and ultimately the automatic returns adjustments (claw back). It is a common, publicly declared estimate that the level of the legally established upper limit to public pharmaceutical spending is quite low, given the needs of the Greek population. Hence, the resulting level of automatic returns has been quite high for the pharmaceutical industry. The main aim of this paper is to contribute to a much-needed public debate about the adequate level of the upper limit of public pharmaceutical spending, adjusted to the population needs, along with fairer distribution of the claw back, while the need for an upper limit is present, with breakdown of this upper limit into an ATC4 multi-level, and with population needs defined more accurately. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is the most prevalent cause of death both in Greece and worldwide. In this paper, the fatal cardiovascular events which are described in the Bible, Old and New Testament, are presented and interpreted. [ABSTRACT FROM AUTHOR]

Persons with disabilities constitute a vulnerable population group in Europe, systematically exposed to high levels of poverty and social exclusion, with adverse effects on their health and well-being. This paper analyzes the legal scope of equal treatment and non-discrimination of persons with disabilities in healthcare settings from the human rights perspective. Disability constitutes a multidimensional concept and, as such, it must be approached not only from the public health perspective, but also from the human rights perspective. In this analysis, the case of Greece is examined, to identify the extent to which there is a sense of state responsibility towards ensuring and, ultimately, implementing the equal treatment of persons with disabilities in healthcare settings. Finally, the full participation of persons with disabilities, and disability mainstreaming in the design and implementation of interventions, are proposed as practical ways for eliminating the inequalities in health care currently experienced by persons with disabilities. [ABSTRACT FROM AUTHOR]

OBJECTIVE Medical education (ME), as a specific field of knowledge related to the processes of medical teaching and learning, is gradually gaining ground in Greece. It does not need to start from scratch, as relevant papers have been already published in the Greek medical literature. The aim of this paper was to list all the articles that refer to ME, published in the journals of the Athens Medical Society: Archives of Hellenic Medicine (AHM) and Archives of Medical Societies (AMS). METHOD Every single published issue was indexed. After the 4th issue of the 16th volume of ??? (July--August 1999) all articles are available on the web (http://www.mednet.gr/archives/). The earlier issues were found either in the Library of Health Sciences of the National and Kapodistrian University of Athens or in the Library of the Athens Medical Society. In both cases, the table of contents was first checked, either electronically since July- August 1999 or manually for all previous issues. The abstracts of all articles that initially considered relevant were read and the irrelevant ones were excluded. RESULTS The first issue of AMS was published in the first trimester of the year 1975. The first issue of AHM, the sequel to AMS, was published in February 1984. Having indexed 36 volumes, 47 articles on ME were found (1.28 per year). The first such article was in the 2nd issue of the 5th volume of AMS (1979) and the last in the 3rd issue of the 27th volume of AHM (2010). During its 9-year period of publication, AMS hosted 16 ME articles (1.8 per year), while A?M journal has hosted 31 ME articles in its 26 years of publication (1.2 per year). All papers relevant to ME are listed here, including the 6 that have been recently accepted (2010) but not yet published. CONCLUSIONS Although AMS and AHM are medical and not medical-education journals, ME has found its way into their pages. The listing of ME articles could be helpful to those who intend to work in the field of education of medical students and doctors. The expansion of this indexing to include all other medical journals would contribute to the whole picture of the relevant to Greek bibliography on ME, which should not be ignored by those interested in ME in Greece. [ABSTRACT FROM AUTHOR]

OBJECTIVE Exenatide BID, in head-to-head Phase III clinical trials with insulin, provided similar glycemic control in patients whose diabetes mellitus (DM) was uncontrolled by oral antidiabetic medications (OADs). A variety of criteria appeared to influence the critical decision to move towards an injectable DM therapy. CHOICE is a multinational, prospective, non-interventional, observational study designed to assess the time to change to injectable glucoselowering therapy (exenatide or insulin) among adults with type 2 DM, and the factors associated with the choice. This paper describes baseline data from Greek patients in the study. METHOD In the course of routine clinical care, the demographic/clinical characteristics and healthcare resource use of patients initiating injectable antidiabetic therapy were analyzed, using univariate tests to quantify differences between cohorts on either exenatide or insulin. RESULTS Of 807 eligible patients (52.5% men, mean age 63±11 years), 318 (39.4%) initiated exenatide and 489 (60.6%) insulin, according to protocol-defined criteria. Patients initiating exenatide were younger than those initiating insulin (59±10 vs 65±11 years, p<0.0001), with a higher proportion of women than men (54.4% vs 42.9%, p<0.01), a higher mean body mass index (BMI; 34.4±7 vs 28.7±5 kg/m2; p<0.0001) and waist circumference (112±15 vs 99±14 cm; p<0.0001). They also had lower mean levels of glycated hemoglobin (HbA1c) in the 3 months prior to initiation of injectable therapy (8.4±1.5% vs 9.3±1.9%, p<0.0001), and lower mean blood levels of low-density lipoprotein cholesterol, creatinine and both fasting and random glucose and less often had microalbuminuria. In addition, those initiating exenatide reported a shorter mean duration of DM (9±6 vs 12±8 years, p<0.001) with fewer macrovascular (21.4% vs 28.2%, p<0.05) or microvascular (10.4% vs 17.2%, p<0.01) complications. Of all the participants 45 (5.6%) reported ⩾1 episode of hypoglycemia in the 3 months prior to initiation of injectable therapy, 15 (4.7%) initiating exenatide and 30 (6.1%) initiating insulin. More patients initiating exenatide had been given dietary and exercise advice (77.7% vs 68.9%, p<0.05). At the time of initiation of injectable therapy, 32% of patients initiated with insulin and 10% of those initiated with exenatide did not report taking any OAD therapy. CONCLUSIONS Patients initiating exenatide rather than insulin as injectable therapy for DM in Greece were on average younger and more obese, with lower HbA1c, a shorter duration of DM, and fewer macro- and microvascular comorbitities, while more had received diet and exercise instructions. The percentage of patients in the insulin group reporting no OAD use at the time of initiation of injectable therapy was 3 fold that in the exenatide group. [ABSTRACT FROM AUTHOR]