Pediatric growth hormone therapy in Greece: analysis of the Hellenic cohort of the GeNeSIS study.

PURPOSE: To describe the data from the Greek cohort of the Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS). METHODS: GeNeSIS was a prospective, open-label, multinational, observational study collecting information on clinical outcomes and treatment safety of children with growth disorders treated with growth hormone (GH), according to national indications. After informed consent, 305 patients (143 females), including 255 patients with growth hormone deficiency (GHD) and 30 with Turner syndrome (TS), from eight investigational sites, were enrolled in Greece. Demographic data, treatment efficacy, and adverse events were reported at the discretion of attending physicians. RESULTS: Treatment with GH was undertaken for 247/255 patients with GHD and 29/30 with TS. The majority of patients treated with GHD (73.7%) and TS (84%) with recorded Tanner stage were prepubertal at enrolment. Among patients treated with GHD and TS, 70.45% and 55% were GH-naïve at study entry, respectively. Height standard deviation score (SDS), height velocity SDS, and height SDS-target height SDS numerically improved during the 4-year observation period. The effect of GH treatment was more prominent in the first year of treatment, especially in the GHD group. CONCLUSIONS: In the Greek cohort of GeNeSIS, GHD is the most frequent indication for GH treatment, followed by TS. While the latter is diagnosed somewhat earlier, GH treatment is not as efficacious as for patients with GHD. No major safety issues were reported during follow-up. The results, which are in accordance with the international literature, should be interpreted in the context of observational studies.

Fracture Incidence, Quality of Life, and Back Pain during 18-Months Treatment with Teriparatide in Greek Postmenopausal Women with Osteoporosis: Results from the European Forsteo Observational Study.

Objective. To evaluate fracture incidence, effects on health-related quality of life(QoL), back pain (BP) occurrence and treatment compliance in Greek post-menopausal osteoporotic women treated with teriparatide (TPTD) for up to 18 months, in a naturalistic setting. Methods. 301 patients provided baseline information on demographic characteristics, fracture history, osteoporosis-related medication and risk factors. During treatment, QoL and BP severity were evaluated. Results. Mean (SD) age was 69.5 (±8.5) years. Fracture history was reported by 92.5% of patients. Incidence of fractures (per 10,000 patients/years) ranged from 402 during 0-6 months of treatment, to 346 during 12-18 months. All 5 dimensions of QoL showed improvement. At baseline and 18 months, BP was reported by 93.2% and 64.2% of patients, respectively. BP and limitation of activities were quantified as moderate or severe by 89.9% and 62.3% of patients at baseline versus 32.4% and 14.8% at 18 months. Patients on treatment at 6, 12, 17, and 18 months were 92.6%, 88.3%, 79.6%, and 36.5%, respectively. Conclusions. In the Greek EFOS study cohort, patients prescribed TPTD were severely osteoporotic, with considerable health-related problems. Significant improvements in QoL and BP together with low fracture rates and high compliance have been recorded during treatment.

Diet, blood lipid profile and physical activity patterns in primary school children from a semi-rural area of Greece.

BACKGROUND: Risk factors for heart disease are becoming increasingly prevalent among young populations. The aim of this study was to assess the cardiovascular risk profile of young adolescents living in a semi-rural area of mainland Greece, Volos. MATERIALS AND METHODS: A total of 198 children (106 females and 92 males) aged 11.6 +/- 0.4 years were randomly recruited. RESULTS: Mean body mass index was 20.4 +/- 3.5 kg m(-2), while 30.3% of children were overweight and 6.7% were obese; no differences were observed between boys and girls. Mean plasma cholesterol (4.93 +/- 0.75 mmol L(-1)), low-density lipoprotein-cholesterol (3.29 +/- 0.64 mmol L(-1)) and triglyceride (0.97 +/- 0.31 mmol L(-1)) concentrations were above age-specific recommended values. On the other hand, mean high-density lipoprotein-cholesterol was acceptable for 92.3% of the children. Self-reported daily energy intake (8.37 +/- 3.06 MJ) was adequate for age, but intake of fat was high (42.0 +/- 9.2% of energy) and that of carbohydrate was relatively low (44.5 +/- 10.0% of energy). Saturated fat consumption was elevated (15.6 +/- 4.3% of energy), while polyunsaturated fat intake fell short (4.8 +/- 1.6% of energy). The study participants spent 9.60 +/- 6.44 h week(-1) on moderate to vigorous physical activities, while they devoted 16.60 +/- 8.81 h week(-1) to sedentary activities. Boys spent significantly more time than girls on both physical (P < 0.001) and sedentary (P = 0.001) activities. No major gender differences were observed in anthropometric, dietary and plasma lipid parameters. CONCLUSION: The findings from the present study support the worrisome trends that have been documented in Greek youngsters elsewhere, and predict an unfavourable cardiovascular risk profile for the Greek population in the foreseeable future.

Urgent thyroidectomy for acute airway obstruction caused by a goiter in a euthyroid pregnant woman.

Pregnancy constitutes a significant factor for thyroid enlargement. However, acute respiratory failure as a result of airway obstruction from an enlarged thyroid gland is an unusual incident. The case presented here concerns a 27-year-old black woman in her 20th gestational week who underwent an urgent operation for removal of a nontoxic, multinodular, mildly substernal goiter that was causing severe upper airway obstruction leading to acute life-threatening respiratory failure. Diagnosis of an extrathoracic tracheal stenosis was based on spirometry with analysis of the flow volume curve and was confirmed by magnetic resonance imaging of the neck. Despite operational risks to the mother as well as the fetus during gestation, an urgent thyroidectomy was carried out successfully. The postoperative period progressed normally and the patient completed her pregnancy with no further respiratory symptoms.