Hippocrates and the medical school of Kos were mainly concerned with the common elements of various diseases and the accurate description of symptoms and signs, as well as their prognostic implications. In contrast, the medical school of Knidos (in neighbouring Asia Minor) and its chief member Euryphon were interested in the systematic classification of diseases according to the systems involved. Galen mentions that Knidian physicians were familiar with four renal diseases, probably the same described in the book About Inner Sufferings, whose author is not known with certainty; most investigators attribute it to the Knidian school (5th century BC), while others consider it to be a Hippocratic work. Both theories are logical and possible, since Hippocrates himself was familiar with the work of the Knidian school and a rival of Euryphon. The first renal disease described in the book is nephrolithiasis with renal colic. Its description is considered a classic one and it is well known for its accuracy and clarity. The second disease corresponds to renal tuberculosis, while the remaining two are somewhat unclear; the third resembles either renal vein thrombosis or bilateral papillary necrosis. The fourth disease, described in the greatest detail of all, corresponds to a chronic suppurative renal infection or a sexually transmitted urethritis, complicated by renal involvement. Some statements concerning treatment follow; they consist of diet modification, physical exercise, ingestion of herbal extracts and surgery, as a last resort. It is therefore evident that Hippocrates is the father of clinical nephrology and that Hippocratic medicine lies at the root of the development of clinical nephrology.
Background
The financial crisis affected several aspects of health. The aim of this study is to explore the impact of the crisis on mortality of mental illnesses in Greece and the socioeconomic determinants of mortality trends.
Methods
Mortality data of 2000–16 were analyzed and sex-and-age-standardized death rates (SDRs) were calculated. The Average Annual Percent Change (AAPC) before and after the time point of slope change was computed. The crisis impact on SDRs was explored with interrupted time series analyses and standardized rate ratios (SRRs). The correlation of mortality with socioeconomic and healthcare-related variables was investigated with correlation and regression analyses.
Results
A significant change in SDR trend was observed after 2012. The AAPC reversed from −2.9% to 94.5%, while the SRR was calculated at 6.1 (5.5–6.7). Income reduction, unemployment rise and health budget cuts were found to be significantly correlated with mortality rise.
Conclusions
Financial crisis had a significant impact on mortality due to mental illnesses, especially in females and elderly. The findings indicate that mortality increase is more driven by socioeconomic and healthcare-related factors that affect access to appropriate healthcare than by morbidity trends. The findings have implications in planning interventions to provide appropriate healthcare to patients living with mental illness.
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