A study of time-place clustering in anencephaly and spina bifida.
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Biomedical subjects
Publications and source records attributed to D Trichopoulos.
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The prevalence of salmonellas in drain swabs from three abattoirs of Athens was studied with the use of conventional methods of Salmonella isolation as well as with a new procedure which involves secondary enrichment from the usual selenite broth or Muller-Kauffmann's tetrathionate broth in Rappaport's medium slightly modified.In all groups studied the secondary enrichment in Rappaport's medium led to an increase in the number of positive swabs, in the number of Salmonella serotypes, and in the total number of strains isolated.The frequency of Salmonella isolations was higher in samples from abattoirs killing only pigs and lower in samples from abattoirs killing only cattle or only sheep.The predominant serotype in abattoirs dealing with cattle was Salmonella tennessee, and S. typhimurium in abattoirs dealing with sheep. No predominant serotype was found in samples from abattoirs dealing mostly with pigs.S. abony, S. drypool, S. emek, S. indiana, S. muenchen and S. tennessee were isolated for the first time in Greece.
An international collaborative study has been carried out to test the hypothesis that prolonged lactation protects women against cancer of the breast. While pregnancy itself seemed to confer some protection against breast cancer in all areas studied, no consistent differences in duration of lactation were found between breast cancer patients and unaffected women, once the fact that breast cancer patients have fewer pregnancies had been allowed for. Even in areas where some women had lactated for a total of 5 years or more, such women occurred proportionately no less frequently among breast cancer patients than among unaffected women. In the light of this and other recent evidence, it is unlikely that lactation has any protective effect against breast cancer in women, and other explanations must be sought for the remarkable international differences in the frequency of this disease.
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BACKGROUND: We have evaluated high-risk behavior of adolescents 12 to 17 years of age on the basis of seven binomial psychosocial variables in order to assess whether there is a tendency of these variables to cluster in the same individuals and to identify socioeconomic covariates of risky behavior. METHODS: Study participants were 547 adolescents from four high schools in Greece: two in rural areas, one in an upper-medium socioeconomic class areas, and one in a low-to-medium socioeconomic class area of Athens. Clustering was assessed by evaluating concordance of high-risk attributes examined in pairs, and was expressed as a series of odds ratios (ORs) as well as by factor analysis. RESULTS: All but one OR were higher than the null value, but they were particularly high with respect to smoking and nonuse of safety belts (OR = 3.2, P < 10(-4)), smoking and binge drinking (OR = 3.3, P < 10(-4)), smoking and riding with a drunk driver (OR = 5.3, P = 10(-4)), smoking and driving under the influence of alcohol (OR = 9.7, P < 10(-4)), nonuse of oral contraceptives and riding a car with a drunk driver (OR = 15.4, P = 0.002), and driving under the influence of alcohol and riding with a drunk driver (OR = 18.6, P < 10(-4)). Factor analysis indicated that risky behavior could be explained in terms of two component factors, namely carelessness in the context of self interest and irresponsible sexual behavior. A composite index integrating information of all seven high-risk indicators regressed on sociodemographic characteristics showed that risky behavior increased sharply with age and was concentrated strongly in the low-education families and the lower income areas. CONCLUSIONS: Several aspects of high-risk behavior tend to aggregate in the same individuals, and the clustering pattern has already been developed by late adolescence, mostly among the less privileged families and population groups. It appears that socioeconomic class health differentials may have strong roots in late adolescence.
BACKGROUND: We have attempted to summarize the evidence concerning the association of olive oil intake with cancer risk in humans. METHODS: We reviewed all the studies that met the following criteria: (1) they have directly examined olive oil in the context of an extensive food frequency questionnaire or have evaluated the role of monounsaturated fat in populations of Mediterranean countries where a large fraction of monounsaturated fat originates from olive oil and (2) they have analyzed the data with explicit or implicit control for energy intake to accommodate the likely confounding influence of caloric consumption and to account to a certain extent for differential completeness of reporting between cases and controls. Ecologic studies were also considered and relevant experimental data were invoked. RESULTS: With respect to breast cancer, there is converging evidence for a protective effect, although the data are not definitive. For other cancer types, the overall epidemiologic evidence, although promising, is quantitatively limited and qualitatively suboptimal. CONCLUSIONS: The issue is of major public health importance and deserves additional study.
BACKGROUND: Several variables have been established as risk factors for osteoporosis: it is more common among women and the gender difference increases with age and with years since menopause. Estrogens, androgens, physical activity, and body mass index have been previously shown to be positively associated with bone mineral density and inversely with risk for fractures. METHODS: To assess the effect on bone mineral content of energy-generating nutrients, healthy men (n = 36) and women (n = 118) ages 25-69 years were interviewed among visitors and staff of the University of Athens Department of Medical Physics. Bone mineral density (BMD) was measured by single photon absorptiometry. RESULTS: Demographic and lifestyle variables were not significantly related to BMD in this study, although the patterns were consistent with those previously reported by other investigators. Total energy intake, which also reflects energy expenditure through physical activity, was positively associated with BMD among both men (P = 0.003) and women (P = 0.04). After adjustment for nonnutritional variables and energy intake, monounsaturated fat, which in the Greek population is mostly derived from olive oil, was associated with BMD. The association was positive among both men (P = 0.01) and women (P = 0.03). There was evidence for an inverse association between carbohydrate intake and BMD, but the association was significant only with respect to mono- and disaccharides. CONCLUSIONS: In this population, consumption of monounsaturated fat and physical activity were predictive of bone mineral density, but larger studies are needed.
Ten years ago the incidence of diphtheria was relatively high in Greece and a survey of school children had revealed a carrier prevalence of non-toxigenic Corynebacterium diphtheriae of 3,4%. A similar survey undertaken now has revealed that the disease seems to be disappearing. Among 895 school children (6-13 years-old) in seven primary schools of different socioeconomic levels, only seven were carriers of non-toxigenic C. diphtheriae strains, corresponding to a prevalence of 0.8%. Toxigenic strains were not found. All carriers were pupils of the same school, and the carrier state was more frequent during the first three school years. All the carriers were found in a school serving a socioeconomically deprived area. A statistically significant association was found between the prevalence of C. diphtheriae and of other non-pathogenic Corynebacteria.
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Studies have demonstrated repeatedly that air pollution in Athens is associated with a small but statistically significant increase in mortality. Extremely high air temperatures can also cause excess mortality. This study investigated whether air pollution and air temperature have synergistic effects on excess mortality in Athens. Data concerning the increased number of deaths in July 1987 (when a major "heat wave" hit Greece) were compared to the deaths in July of the 6 previous years. This comparison revealed a greater increase in the number of deaths in Athens (97%), compared to all other urban areas (33%) and to all non-urban areas (27%). Data on the daily levels of smoke, sulfur dioxide, and ozone; the number of deaths that occurred daily; and meteorological variables were collected for a 5-y period. The daily value of Thom's discomfort index was calculated. Multiple linear regression models were used to investigate main and interactive effects of air temperature and Thom's discomfort index and air pollution indices. The daily number of deaths increased by more than 40 when the mean 24-h air temperature exceeded 30 degrees C. The main effects of an air pollution index are not statistically significant, but the interaction between high levels of air pollution and high temperature (> or = 30 degrees C) are statistically significant (p < .05) for sulfur dioxide and are suggestive (p < .20) for ozone and smoke. Similar results were obtained when the discomfort index was used, instead of temperature in the models.
Blood samples were taken from, and interviews were conducted with, 76 persons injured in motor vehicle crashes, and from 126 controls with a home and leisure injury. The analysis was undertaken by modelling the data through conditional logistic regression, controlling for gender- and age-matched variables and other potentially confounding variables, including education and visual acuity. Detectable alcohol levels were associated with a 4.9 relative risk (95% confidence intervals 1.4 to 16.8). The population attributable fraction was about 10% with wide confidence intervals. There was no evidence for a safe threshold in these data. The increased injury risk associated with detectable blood-alcohol levels was disproportionally, albeit non-significantly, elevated among occasional drinkers in comparison to regular drinkers. We conclude that alcohol intake is an important cause of road traffic injuries even in the context of the Mediterranean countries where alcohol is taken in moderation and mainly in the form of wine during meals.
One hundred and twenty children first diagnosed as having acute leukemia between 1988 and 1992 in Athens, Greece, were followed until May 15, 1993. The socioeconomic status of the children's families was assessed by means of paternal occupation, paternal schooling, maternal schooling, ownership of a car, ability to choose a private medical facility and freedom in the choice of the attending physician. The analysis was done by proportional-hazards modelling, controlling for age and gender. All six socioeconomic indicators, alternatively evaluated, showed that fatality rates were higher in the lower socioeconomic groups, although nominal statistical significance was reached for only one of them. With respect to family ownership of a private car, the fatality rate ratio between children of families who own a car and children of families who do not was 0.29 with a 95% confidence interval of 0.13-0.62 (p = 0.002). These results suggest that in Greece, socially disadvantaged children have a less favorable survival from childhood leukemia.