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Women were allowed to practice the medical profession during the Byzantine Empire. The presence of female physicians was not an innovation of the Byzantine era but actually originated from ancient Greece and Rome. The studies and the training of women doctors were apparently equivalent to those of their male colleagues. The principal medical specialties of the female doctors were gynecology and midwifery. Byzantine legislation treated relatively equally both female and male doctors. For this reason, it can be assumed that the presence of female doctors was correlated with the position of women in Byzantine society. However, there is not sufficient information in the literature to clarify whether female and male doctors used to earn equal payment for the same service.

Aim: Female genital mutilation (FGM) is a common practice especially performed in women with no anaesthesia or antibiotics and in absence of aseptic conditions. The aim of this systematic review is to explore and analyze for first time in the current literature, the clinical evidence related to the presence of infections in the practice of FGM., Method: A systematic search of PubMed and Scopus was performed. A combination of the terms "female circumcision", "genital mutilation", "genital cutting" and "infection" were used. Studies reporting data on the infections related to patients with FGM were included., Results: A total of 22,052 patients included, in the study, from African countries. The age ranged from 10 days to 20 years. The procedure was done by physicians, paramedical staff, and other specialties. Type I FGM was performed in 3,115 women while 5,894, 4,049 and 93 women underwent Type II, Type III and unknown type of FGM, respectively. Different types of infections were identified including UTIs, genitourinary tract infections, abscess formation and septicemia or even HIV infection. Moreover, most infections were identified in Type III FGM. The isolated pathogens in the different type of infections, were HIV, Clostridium tetani, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Candida albicans, Trichomonas vaginalis, HSV-2, Pseudomonas pyocyanea, Staphylococcus aureus. The univariate risk of infection ranged from 0.47 to 5.2., Conclusion: A variety of infections can occur after FGM. The management of these complications in a low-income economy can be a great burden for the families.

The objective of this investigation was to document clinicians' awareness regarding the incidence and severity of Clostridium difficile-associated diarrhea (CDAD). An international electronic survey was conducted among corresponding authors of articles indexed by PubMed and published during the last 10 years in 'Core Clinical Journals'. A total of 1,163 clinicians answered (response rate 59%); most of the responses were submitted from North America (54.6%), Europe (32.2%), and Asia/Pacific (11.6%). Only 2.2% of the participants answered correctly all four questions, while 14.1% answered all questions incorrectly. Regarding each question, 10.8% of the participants correctly estimated current CDAD treatment failure or recurrence rates to be around 40%, 33.4% correctly estimated the ratio of antibiotic-associated colitis attributed to C. difficile to be around 60%, 72.7% correctly responded that almost all antibiotics are associated with CDAD, and 41.7% correctly responded that any patient is at risk for CDAD. Almost half (44.4%) of the respondents considered CDAD to be underestimated. Participants from North America scored higher than those from Europe or Asia/Pacific (p < 0.001). Participants considering CDAD to be overestimated (3.4%) had the lowest mean score of correct answers. Among a clinically diverse international sample of physicians with academic expertise, there was an inadequate level of awareness of the magnitude and clinical importance of CDAD.

Background: The impact factors of biomedical journals tend to rise over time. We sought to assess the trend in the impact factor, during the past decade, of journals published on behalf of United States (US) and European scientific societies, in four select biomedical subject categories (Biology, Cell Biology, Critical Care Medicine, and Infectious Diseases)., Methods: We identified all journals included in the above-mentioned subject categories of Thomson Reuters Journal Citation Reports® for the years 1999, 2002, 2005, and 2008. We selected those that were published on behalf of US or European scientific societies, as documented in journal websites., Results: We included 167 journals (35 in the subject category of Biology, 79 in Cell Biology, 27 in Critical Care Medicine, and 26 in Infectious Diseases). Between 1999 and 2008, the percentage increase in the impact factor of the European journals was higher than for the US journals (73.7±110.0% compared with 39.7±70.0%, p = 0.049). Regarding specific subject categories, the percentage change in the factor of the European journals tended to be higher than the respective US journals for Cell Biology (61.7% versus 16.3%), Critical Care Medicine (212.4% versus 65.4%), Infectious Diseases (88.3% versus 48.7%), whereas the opposite was observed for journals in Biology (41.0% versus 62.5%)., Conclusion: Journals published on behalf of European scientific societies, in select biomedical fields, may tend to close the "gap" in impact factor compared with those of US societies. WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?: The impact factors of biomedical journals tend to rise through years. The leading positions in productivity in biomedical research are held by developed countries, including those from North America and Western Europe. WHAT DOES THIS ARTICLE ADD?: The journals from European biomedical scientific societies tended, over the past decade, to increase their impact factor more than the respective US journals.

Objectives: Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics., Study Design: Observational study in the greater metropolitan area of Athens, Greece., Methods: Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software., Results: Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (P<0.001) was found between private and public hospitals using the Flesch-Kincaid and SMOG readability scales. Pamphlets from private hospitals were one grade more difficult than those from public hospitals., Conclusion: Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population., (Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)