Chryssa Bakoula

Age at menarche in contemporary Greek girls: evidence for levelling-off of the secular trend

Aim: To examine the secular trend of menarcheal age in Greek girls during the last decade.

Social determinants of self-reported emotional and behavioral problems in Greek adolescents

ObjectiveThis study aimed to assess the social factors associated with self-reported emotional and behavioral problems among Greek adolescents.MethodsAt age 18, a population-based sample of 3373 Greek adolescents completed the Youth Self-Report (YSR) questionnaire.ResultsThe results from the multivariate analysis indicated that both lack of intimate friendships and not having parental monitoring were independently associated with problem behavior among both male and female adolescents. Engagement in sexual activities was significantly associated with higher YSR scores among both genders. Absence of academic motivation was associated with higher YSR scores in girls only.ConclusionsOur results confirm that social factors, including negative family functions, lack of academic motivation and not having close friends, were associated with emotional and behavioral problems among adolescents and imply the need to develop a supportive social network for adolescents.

Breast milk fat concentration and fatty acid pattern during the first six months in exclusively breastfeeding Greek women

Purpose To determine fat and fatty acid (FA) profile of Greek mother’s milk during the first 6 months of exclusive breastfeeding and to examine their correlation with dietary and other maternal characteristics.

Working mothers breastfeed babies more than housewives.

Aim: To examine the prevalence and determinants of breastfeeding and to identify perinatal, sociodemographic, psychosocial and environmental factors associated with maternal infant feeding intention.

Serum amyloid A protein levels as a possible aid in the diagnosis of acute appendicitis in children.

Abstract Hematological and biochemical tests, including white blood cell count (WBC), C-reactive protein (CRP) and other acute-phase reactants, have been used in the diagnosis of acute appendicitis. However, there is controversy among physicians about the value of this practice in children. The objective of our study was to evaluate serum amyloid A protein (SAA) levels in children with confirmed acute appendicitis and to compare the sensitivity and specificity of this marker of inflammation with those for WBC and CRP. A prospective cohort study of 60 children admitted with abdominal pain to rule out appendicitis was used in the study. Of these, 42 underwent surgery, while 18 children who had spontaneous amelioration within 24h of admission were not operated on and served as controls. WBC and serum SAA and CRP levels were obtained preoperatively. Serum concentrations of the analytes were determined with particle-enhanced immunonephelometric methods. Patients with acute appendicitis had WBC, SAA and CRP levels higher than those of the control group (p<0.001). There was no appendicitis patient with a normal SAA value, while 21.4% of the patients had CRP values within the normal range. The performance of each test was measured by receiver-operating characteristic curves. Area under the curve (AUC) values were 0.849 for WBC, 0.868 for CRP and 0.964 for SAA. The sensitivity and specificity of these methods were 76% and 75% for WBC>10.0×10 9/L, 62% and 94% for CRP>10mg/L and 86% and 83% for SAA >45.0 mg/L, respectively. Circulating SAA levels have better discriminatory value than WBC or CRP in the assessment of acute appendicitis in children. Thus, this test appears to be of higher value than the current standards of care in the diagnosis of this condition.

Relationship between Eating Behavior, Breakfast Consumption, and Obesity Among Finnish and Greek Adolescents

OBJECTIVE To investigate the relationship between eating-related behaviors, particularly breakfast consumption, and weight status in Finnish and Greek adolescents. METHODS A total of 6,468 16-year-old Finnish adolescents and 2,842 17- and 18-year-old Greek adolescents, based on the latest follow-up of 2 population-based cohorts, were studied. Univariate analysis examined the associations between breakfast consumption, family meals, emotional eating, bingeing, and weight status in both populations. Multiple logistic regression models focused on the relationship between breakfast consumption and overweight/obesity taking potential confounders into account. RESULTS Daily breakfast consumption was associated with lower levels of overweight/obesity among Finnish and Greek boys, but not among girls. Adjusting for confounders did not change the result among Greek boys, but adjustment for fathers body mass index, weight control, and fear of getting fat attenuated the association among Finnish boys. CONCLUSIONS AND IMPLICATIONS This study highlights the importance of breakfast consumption, particularly among male adolescents, in obesity prevention programs.

The Effect of Weather Variability on Pediatric Asthma Admissions in Athens, Greece

The aim of this study was to determine whether there is any association between weather variability and asthma admissions among children in Athens, Greece. Medical data were obtained from hospital registries of the three main Childrens Hospitals in Athens during the 1978–2000 period; children were classified into two age groups: 0–4 and 5–14 years. The application of Generalized Linear Models with Poisson distribution revealed a significant relationship among asthma hospitalizations and the investigated parameters, especially for the children aged 0–4 years. Our findings showed that Hospital admissions for childhood asthma in Athens, Greece, is negatively correlated with discomfort index, air temperature and absolute humidity whereas there is a positive correlation with cooling power, relative humidity and wind speed.

Can we be optimistic about asthma in childhood? A Greek cohort study.

Objective. To examine the prevalence and natural course of asthma from childhood to adolescence in a population-based, Greek birth cohort and to identify associated factors. Methods. Longitudinal information on asthma symptoms, physician diagnosed and treated, was available for 2133 children at 7 and 18 years of age. Results. The prevalence of current asthma was 9.0% and 5.0% at 7 and 18 years, respectively. The prevalence of lifetime asthma was 26.3% at 18 years. More than half of the children (58.2%) with early onset asthma were asymptomatic at 7 years and only 7.6% continued to have symptoms during adolescence. However, in 48.2% of those with late onset asthma, symptoms persisted up to 18 years. Logistic regression analyses showed that male gender, family history of atopy, active adolescent smoking and maternal smoking were significantly positively associated with lifetime asthma at 18 years. In addition, smoking during pregnancy was associated with an increased risk for persistence of asthma symptoms at 18 years. Asthma during childhood and active adolescent smoking were positively associated, and daily consumption of fruit and vegetables was negatively associated with current asthma at 18 years of age. Finally, children who were breastfed had a lower risk for lifetime asthma at 7 years. Conclusion. The prevalence of asthma symptoms at 7 and 18 years of age was low throughout Greece. Our results suggest that, among others, nutrition is an important correlate of asthma in Greek children.

Parental stress affects the emotions and behaviour of children up to adolescence: a Greek prospective, longitudinal study.

Systematic research about the continuity of mental health problems from childhood to adolescence is limited, but necessary to design effective prevention and intervention strategies. We used a population-based representative sample of Greek adolescents, followed-up from birth to the age of 18 years, to assess early influences on and the persistence of mental health problems in youth. We examined the role of peripartum, early development and parental characteristics in predicting mental health problems in childhood and adolescence. Results suggest a strong relationship between behavioural problems in childhood and adolescence for both genders, while emotional problems were more likely to persist in boys. Age and sex-specific models revealed significant positive associations between higher scores on the behavioural and emotional problems scales and higher frequency of accidents in preschool years, physical punishment in early childhood, lack of parental interest in childs school and activities, and perceived maternal stress in all children. Perceived paternal stress was associated with higher scores on the Total and Internalizing problems scales in the total population. Our results suggest that early interventions are necessary as mental health problems strongly persist from childhood to late adolescence. The adverse effects of parental stress and poor care-giving practices on childs psychopathology need to be recognised and improved.

Transient Hypophosphataemia Associated with Acute Infectious Disease in Paediatric Patients

The aim of this study was to investigate the prevalence of hypophosphataemia in children with acute infection and the relationship between serum phosphate and C-reactive protein (CRP) concentration. Serum phosphate and CRP levels were measured on admission in 238 patients (aged 1 month to 14 y) with: pneumonia (n = 51), upper respiratory tract-related bacterial infection (n = 70), urinary tract infection (n = 50) and viral infection (n = 67). Patients were classified according to CRP value (0-50, 51-100, 101-150, ≥ 151 mg/l) and type of infection. The prevalence of hypophosphataemia was calculated for each group. 30 children with hypophosphataemia on admission had serial measurements of serum phosphate and CRP levels. A significant negative correlation between serum phosphate and CRP levels was found (r = -0.41, p < 0.0001). Patients with CRP ≥ 151 mg/l on admission had a lower mean serum phosphate value than those with CRP ≤⃒ 50 mg/l (1.17 vs 1.50 mmol/l, p < 0.0001). The overall prevalence of hypophosphataemia for patients with pneumonia, upper respiratory tract bacterial infection, urinary tract and viral infections was 45%, 35.7%, 18% and 4.4%, respectively. Hypophosphataemia occurred during the phase of rising of CRP level and resolved soon after CRP reached a plateau. In conclusion, hypophosphataemia is a relatively frequent but transient phenomenon in children with acute infectious disease. It is associated with an increase in CRP concentration and resolves before the normalization of CRP levels.