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Purpose: This study aims to explore experiences and views of 15 year old adolescents on primary health care services in large cities in Greece, and make policy and practice recommendations. Methods: A representative sample of 15 year old students, living in large cities of Greece, was selected using stratified cluster sampling. Information was collected using a structured questionnaire. Results: The questionnaire was completed by 2019 of the 2342 students in the school classes selected (response rate 86%). Girls were 54%; 92% were born in Greece. Half of the students (50%) reported having communication problems with the physician(s) they usually visit. Reasons of communication problems included: a/organizational problems, e.g. inadequate consultation time (17%); b/privacy and confidentiality issues, e.g. not having the opportunity to be alone with the doctor (36%), lack of confidence that their discussion with the doctor will not be disclosed to their parents (46%); c/lack of understanding their perspective, e.g. the doctor “is not interested in my problems” (15%), he/ she “does not treat me with respect” (13%). The gender of the physician is important for about one third of the students of the study sample (girls 48%, boys 23%) and girls tend to prefer a female doctor (54%). Conclusion: Adolescents in this study pointed out that they need doctors who are aware of their way of thinking and problems and can communicate effectively with them; they require more consultation time, continuity of care, confidentiality and privacy. Service provision should be accordingly modified.

Objectives The purpose of this study was to compare the results of magnetic resonance angiography (MRA) with X-ray coronary angiography (XCA) in a pediatric population. Background Coronary artery abnormalities in Kawasaki disease (KD) develop in about 15% to 25% of young patients, mostly in the form of aneurysms. Methods Thirteen patients (12 male), age three to eight years, were studied. The maximal diameter and length of the aneurysm were recorded. Coronary MRA was performed using a 1.5 T Philips Intera CV magnetic resonance scanner with an electrocardiographically triggered pulse sequence. It was a three-dimensional segmented k-space gradient–echo sequence (TE = 2.1 ms, TR = 7.5 ms, flip angle = 30°, slice thickness = 1.5 mm) employing a T2-weighted preparation pre-pulse and a frequency selective fat-saturation pre-pulse. Data acquisition was performed in mid-diastole. All scans were carried out with the patient free breathing using a two-dimensional real-time navigator beam. All patients underwent XCA within a week. Results In six patients, aneurysms of the coronary arteries were identified, while coronary ectasia alone was present in the remaining seven patients. Magnetic resonance angiography and XCA diagnosis of coronary artery aneurysm agreed completely. Maximal aneurysm diameter and length and ectasia diameter by MRA and XCA were similar. No stenotic lesion was identified by either technique. Conclusions In conclusion, MRA is a reliable diagnostic tool, equivalent to XCA for coronary artery aneurysm identification in patients with KD. Magnetic resonance angiography may prove to be of great value for the serial non-invasive evaluation of these patients.

OBJECTIVE: To study bone density in healthy Greek girls going through puberty and determine the influence of developmental and hormonal factors. DESIGN: Sixty healthy female adolescents (average age of 13.88±2.53 years) were included. Bone mineral density (BMD) was measured at the hip by DXA (dual energy X-ray absorptiometry). Pubertal stage was determined by Tanner's criteria. Creatinine, calcium, phosphorus, parathyroid hormone, calcitonin and 25-OH-vitamin D levels were measured in blood samples. The European physical fitness test battery (EUROFIT) was used to assess the parameters of physical fitness that are related to strength. RESULTS: Adolescent girls had a mean (±SD) BMD value of 0.947±0.144 g/cm2 at the total hip (total hip BMD). Tanner's stage for pubic hair and body mass index (BMI) constituted significant, positive and independent predicting factors for bone density of total hip. Deficiency of 25OH-vitamin D was a negative predicting factor of bone density. Blood levels of calcium and phosphorus, the hours that adolescents devoted to sports, and handgrip strength, were independent predicting factors of bone density at the hip. CONCLUSIONS: Bone density and consequently bone health is determined by factors that can be modified in order to achieve optimal bone growth and reduce the risk of fractures and osteoporosis in later life.