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PubMed2001

Microscopy, PCR and ELISA applied to the epidemiology of amoebiasis in Greece.

Detection and differentiation between Entamoeba histolytica and E. dispar are of great importance both for diagnosis and epidemiological studies. The present study was aimed to estimate the prevalence of these species in Greece and to assess the performance of microscopy, ELISA and PCR in the field. Our results indicate that the prevalence of these parasites is very low in Greece and that PCR and ELISA are by far better than microscopy. When it comes to the choice between ELISA and PCR, it seems that in real situations the advantages of PCR are outweighed by those of ELISA.

Animals↗
PubMed2003

Staffing and organisation of nursing care in cardiac intensive care units in Greece.

PURPOSE: To explore staffing and organisational characteristics of nursing care in cardiac intensive care units (CICUs) in Greece. METHODOLOGY: An exploratory descriptive survey design with additional cross-sectional comparisons was employed. A specifically developed survey-type questionnaire, addressed to nurse managers, was distributed to all CICUs in Greece. RESULTS: The response rate was 76.2% (N=32 units). Nursing staff per bed ratios over 24 h (whole-time equivalent) were very low and exhibited a mean of 1.25 (+/-0.53). The total registered nurse to assistance nurse (RN/AN) ratio was 2.74, but a lot of variability was observed and in many units ANs operated in RNs positions. Only 42% of the nurses had participated at in-service continuing education programs and a systematic training program in cardio pulmonary resuscitation (CPR) was provided in only 12 (37.5%) units. The reported frequencies at which specific technical tasks were performed autonomously by nurses varied substantially and reflected a medium to low level of practice autonomy; the most frequently reported tasks were: peripheral IV line insertion, CPR chest compression, titration of vasoactive drugs and administration of analgesics. Higher percentages of nurses had received in-service training associated with the likelihood of performance of several technical tasks (P<0.03). CONCLUSIONS: Future studies need to explore the effect of these organisational characteristics on patient outcomes. The endorsement of nation-wide standards for nursing staffing and training in CICUs is imperative.

Adult↗
PubMed1999

Food and nutrient intakes of Greek (Cretan) adults. Recent data for food-based dietary guidelines in Greece.

The present study aimed to estimate current nutrient intake levels and food group consumption patterns in Greece using cut-off levels derived from the results of dietary recall interviews with 470 Cretan adults. It was found that the present-day Greek diet contains, in the main, adequate levels of fibre. In comparison with the traditional diet, however, the levels of saturated fat in the diet have greatly increased, particularly in younger adults. An association was found between low fruit and vegetable and low fibre intake and a fat intake that was mainly in the form of saturated fat, this being particularly evident in female subjects. Given the wide availability of olive oil, fish, fresh fruit and vegetables in Greece, the development of national dietary guidelines would be of great potential benefit, particularly to the younger generations.

Adult↗
PubMed1997

Desiccation survival of populations of the entomopathogenic nematodes Steinernema feltiae and Heterorhabditis megidis from Greece and the UK.

The desiccation survival and ability to control water loss during drying of individual infective juveniles (IJs) of populations of Steinernema feltiae and Heterorhabditis megidis from Greece and the UK were examined at different relative humidities. Survival at all relative humidities was for minutes only and there was no evidence of enhanced survival of the populations of either species from Greece compared with those from the UK. The survival of individuals of both populations of H. megidis was superior to that of S. feltiae and the rate of drying of H. megidis was significantly slower. The sheath surrounding the IJs of H. megidis appears to be involved in slowing the rate of water loss of the enclosed nematodes.

Animals↗
PubMed2000

Health technology assessment in Greece.

In 1983 a health reform aimed to assure universal coverage and equity in the distribution of services in Greece. The reform implied state responsibility for the financing and delivery of services and a reduction of the private sector. The model was a Bismarckian scheme for social insurance. However, healthcare delivery remains fragmented and uncoordinated and the private sector is getting stronger. The dominant payment system is fee-for-service for the private sector and administered prices and salaries for public hospitals and social insurance funds. The many insurers have their own eligibility requirements, validation procedures, etc. Coverage of services by social security funds, probably among the most comprehensive in Europe, is determined more on historical and political grounds than on efficiency or cost-effectiveness. The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management, poor incentives in the public sector, open-ended financing, inefficient use of hospital beds, and lack of cost-effectiveness. There are no specific legal provisions for the control of health technology. Technologies are introduced without standards or formal consideration of needs. There are no current efforts to control health technology in Greece. However, health technology assessment (HTA) has gained increasing visibility. In 1997 a law provided for a new government agency responsible for quality control, economic evaluation of health services, and HTA. The hope is that the new law may introduce evaluation and assessment elements into health policy formulation and assure that cost effectiveness, quality, and appropriate use of health technology will receive more attention.

Delivery of Health Care↗
PubMed2001

Health technology assessment in the area of prevention: selected screening cases in Greece.

OBJECTIVE: To explore the impact of health technology assessment (HTA) on health policy and practice in Greece through selected screening case studies in the prevention area. The three cases studied were mammography screening, PSA screening, and routine ultrasonography in normal pregnancy. METHODS: Official policy recommendations or reports, a literature review of Greek published research as well as gray literature from various sources, and interviews with specialists and medical associations were performed, and their impact on health policy formulation was examined. RESULTS: The implementation of the screening tests does not take the form of structured mass screening programs. Almost all physicians (urologists-pathologists, gynecologists) apply PSA and routine ultrasonography in normal pregnancy respectively with the purpose of either prevention or diagnosis. Mammography is applied generally for prevention or diagnosis, but there are some mass screening programs at a local level. In addition, the results show no evidence that the efficacy and the cost-effectiveness of the three screening programs have been a matter of serious concern and investigation for the purposes of policy formulation in Greece. CONCLUSION: The results point to a need for the implementation of HTA methods on mass screening preventive programs in which real value and cost remain unclear and whose use is based on empirical and personal assessments.

Adult↗
PubMed2005

Epidemiology of human brucellosis in a defined area of Northwestern Greece.

Despite a European co-financial programme for control and eradication of brucellosis in Southern Europe, there is evidence that foci of brucellosis still exists in Greece and other Southern European countries. Human brucellosis cases are probably underreported in these countries. A local surveillance system was implemented in a defined region of Northwestern Greece, in order to record and study all human brucellosis cases, using several sources of retrieval. A total of 152 newly diagnosed cases were recorded during a 2-year study period (from 1 April 2002 to 31 March 2004). The age- and sex-adjusted mean annual incidence rate for the population of the study area was 17.3 cases/10(5) inhabitants. Incomplete application of the control and eradication programme in livestock, and the possible illegal trafficking of animals and their products across the Greek-Albanian border could be responsible for the persistence of foci of brucellosis in the area.

Adolescent↗
PubMed2006

Comparing Shigella waterborne outbreaks in four different areas in Greece: common features and differences.

In Greece the public health surveillance for most infectious diseases, including shigellosis, is not well developed. However, four waterborne outbreaks of shigellosis have been recorded in Greece in the last three decades, in different areas of the country, under different environmental and socioeconomic conditions. This study presents the epidemiological characteristics of these four outbreaks in order to examine common points and differences and to investigate their possible association with environmental and socioeconomic conditions. All four outbreaks were caused by Shigella sonnei and related to drinking water. Epidemic curves, distribution of cases by age and gender, hospitalization rates, environmental conditions and laboratory results were compared. The outbreaks seemed to correspond to two different 'models' presenting two characteristic types of epidemic waves related to specific environmental conditions. The attack rates for the general population varied from about 9 to 13% and were similar for both sexes. Children were affected mostly. In these outbreaks there was a strong suspicion of contamination of the water distribution system from the sewage network, highlighting the importance of environmental health control measures.

Adolescent↗
PubMed2001

Occurrence and spatial and temporal distribution of pesticide residues in groundwater of major corn-growing areas of Greece (1996-1997).

During 1996-1997, residues of selected pesticides were monitored, at 3-month intervals, in 80 wells, including both irrigation and drinking water wells, distributed among the main corn-growing areas (Pieria, Thessaloniki, Serres, Kavala, and Evros) of Greece. Pesticide residues were found in 48% of the wells; however, in most cases residues were very low ranging from LOQs (quantification limits of the analytical methods) to <0.1 microg/L, while in 11% (nine wells) pesticide residues higher than 0.1 microg/L were present. Most of the latter wells were found in Evros and specificallythe Ardas Valley. The frequency of occurrence, in descending order, was atrazine > DEA > alachlor = metolachlor; however, the order of descending concentrations was atrazine > metolachlor > DEA > alachlor. The occurrence and the spatial and temporal distribution patterns of pesticide residues indicate that at the present the situation of groundwater quality is favorable throughout the corn-growing areas of Greece with the exception of the Ardas Valley.

Acetamides↗
PubMed1997

Prevalence of hepatitis A, B, and C markers in school children of a rural area of Crete, Greece.

OBJECTIVE: To determine the prevalence of hepatitis A, B, and C markers in children who were attending junior and senior high schools in a high risk area in rural Crete, Greece. METHODS: Three-hundred and thirty-four children who attended the three junior schools and one senior high school in the Agios Vassilios province of Southern Crete were invited to participate in the study. Three hundred and four of them were tested for hepatitis A, B, and C markers. Hepatitis B (HBV) markers (HBsAg and anti-HBc) as well as hepatitis A (anti-HAV) and hepatitis (anti-HCV) antibodies were tested with commercial enzyme-linked immunosorbent assay kits. RESULTS: Six of the 304 children (1.97%) were found to be positive for anti-HAV, 1 (0.33%) to HBsAg, 7 (2.30%) to anti-HBc and none were found positive for anti-HCV. No significant differences were seen between the prevalence of anti-HAV antibodies in males (2%) and females (1.95%), and of anti-HBc antibodies in males (3.33%) and females (1.30%). CONCLUSIONS: The very low prevalence of anti-HAV is obviously due to the improved conditions of hygiene and it raises the question of the possible emergence of this disease at an older age and therefore appropriate preventative strategies should be considered. The low endemicity of hepatitis B in Crete in contrast to other areas of Greece also calls for a vaccination policy probably during adolescence. The absence of hepatitis C markers in the children in contrast to the observed higher prevalence of HCV-infected people in the adult population in the same rural area raises questions regarding possible sources of transmission of hepatitis C during the preceding years.

Adolescent↗
PubMed2001

Hantavirus infections in Greece--an update.

Hantaviruses are emerging viruses spread worldwide and cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Two pathogenic hantaviruses are present in Greece: Dobrava/Belgrade virus (DOBV) and Puumala virus (PUUV). The predominant one is DOBV, carried in Greece by the rodent Apodemus flavicollis. Most human infections are sporadic, but epidemic outbreaks were also described. The severity of the disease ranges from a mild or moderate form to severe and fatal cases. Several endemic foci for HFRS have been identified. Phylogenetic analysis of hantavirus sequences revealed a stable geographical distribution.

Animals↗
PubMed2002

Overwintering sites and winter mortality of Euseius finlandicus (Acari: Phytoseiidae) in a peach orchard in northern Greece.

In peach orchards of northern Greece Euseius finlandicus Oudemans overwinters in various sites on the trees, usually in groups of 5-15 females. Overwintering females were mostly found in bark crevices near the hibernation cocoons of the peach moth Adoxophyes orana (Fischer von Rosslerstamm), and also in small crevices of the bark and in pedicels left after fruit harvesting. Empty scales of dead diaspidids and dead coccids, cocoons of lacewings and mummies of parasitized aphids sporadically found on trees, were less common overwintering sites for females of the mite. In two successive years, mortality of overwintering females was very low, approximately 4 and 4.5% which could be due to the mild climate of northern Greece and the high cold tolerance of the mite.

Animals↗
PubMed2003

Three new species of larval Charletonia Oudemans, 1910 (Acari: Prostigmata: Erythraeidae) and the first record of Charletonia krendowskyi (Feider, 1954) from Rhodes, Greece.

Three new species of larval Charletonia Oudemans, 1910 from Rhodes, Greece are described: C. dalegori from an undetermined orthopteran, C. glifadaensis from Oedipoda sp. (Orthoptera: Acrididae: Oedipodinae) and C. kaliksti from Aiolopus sp. (Orthoptera: Acrididae: Oedipodinae). C. krendowskyi is recorded for the first time from Greece. A key to the European species of larval Charletonia is provided.

Acari↗
PubMed2004

Creating an integrated health care system in Greece: a primary care perspective.

Over the past few years Greece has undergone several endeavors, aimed at modernizing and improving the national health care services. A Health Care Reform Act seeking quality improvement and coordination of outpatient and hospital services at the Regional level, through the enhancement of primary care, has been recently approved. This paper reports a proposal for integrated health system in the primary care system in Greece with a major focus on equity, quality, and outcomes. The equity and quality framework of this proposal will possess the main components focusing on the provision of essential services, clinical, and organizational standards.

Continuity of Patient Care↗
PubMed2003

Distribution and frequency of beta-thalassemia mutations in northwestern and central Greece.

OBJECTIVES: Beta-Thalassemia is a common autosomal recessive disorder resulting from over 200 different mutations of the beta-globin genes. The spectrum of beta-thalassemia mutations in Greece has been previously described in the population of the capital city of Athens, or in beta-thalassemia patients having transfusion therapy. The aim of the present study was to identify the distribution of the most common beta-thalassemia mutations in the population of northwestern and central Greece. METHODS: The data for this study were derived from a total of 1,130 unrelated subjects including 46 beta-thalassemia major, three beta -thalassemia intermedia and 1,081 carriers identified in our antenatal screening program. beta-Thalassemia mutations were identified by ARMS, DGGE and Reverse Dot Blot. RESULTS: The most common mutation, IVS-I-110, is followed, in order of frequency, by the mutations Cd-39, IVS-I-1, IVS-II-1, Cd-6, IVS-I-6, IVS-I-5, IVS-II-745, Cd-5 and 44 bp del. IVS-I-110 and Cd-39 frequencies are similar with those found in other Balkan countries. Significant differences in regional distribution were observed. The results showed a clear drift of the distribution of the most frequent IVS-I-110 mutation in the south-north (29.4, 40.0, 44.6 and 61.7%) and the east-west axis (31.8 and 44.6%). CONCLUSIONS: Population screening and prenatal diagnosis are significantly facilitated by these data. Furthermore, the detailed distribution tables of beta-thalassemia mutations are essential for counseling and extraction of genetic diversity estimates for population genetic studies in other inherited disorders.

DNA Mutational Analysis↗
PubMed1996

Space-time clustering of childhood leukaemia in Greece: evidence supporting a viral aetiology.

The method introduced by Knox for evaluation of space-time clustering has been applied to 872 cases of childhood (0-14 year old) leukaemia diagnosed in Greece over the 10 year period 1980-89. Greek towns are characterised by substantial population mixing due to internal migration, whereas there is relative isolation in mountainous rural areas. Predetermined space (5 km) and time (1 year) limits were used on the basis of previous reports in order to define the clustering cell. There is highly significant evidence for clustering of childhood leukaemia in Greece as a whole, the observed number of pairs that are close in both spaces and time exceeding the expected number by 5.2% (P = 0.004). The excess is particularly evident for leukaemia cases in 0 to 4-year-old children, among whom the observed number of pairs that are close in both space and time exceeded the expected number by 9.4% (P = 0.004). There is no evidence of space-time clustering for leukaemia cases older than 5 years. The overall pattern is descriptively similar in urban and semiurban areas and is especially marked for acute lymphoblastic leukaemia at the childhood peak ages (2-4 years) with an excess of 19% (P = 0.0006). In the rural population there is evidence for clustering of cases belonging to older and broader age groups, a phenomenon compatible with a delay in the development of herd immunity against putative infectious aetiological agents. The findings of the present study provide support for the hypothesis that a substantial proportion of cases of childhood leukaemia may arise as a rare sequel to exposure to an agent or agents, most probably viral in nature.

Adolescent↗
PubMed1989

Pseudoexfoliation glaucoma in Greece.

Pseudoexfoliation glaucoma is commonly seen in Greece, however there is little data concerning the prevalence and characteristics of this disorder. Patients undergoing trabeculectomy for open angle glaucoma were investigated both by the appraisal of the case notes and by re-examination. The prevalence of pseudoexfoliation glaucoma in this population was found to be 87.8%. The characteristics of this disease process in the population studied are discussed. These findings indicate that pseudoexfoliation is a major contributor to severe glaucoma in the population of Northern Greece.

Aged↗
PubMed2006

Flavonoid classes and risk of peripheral arterial occlusive disease: a case-control study in Greece.

OBJECTIVE: To assess the relation between specific flavonoid classes and peripheral arterial occlusive disease (PAOD), an important manifestation of atherosclerosis. DESIGN: Using data from a case-control study conducted in Greece in 1980 on the nutritional epidemiology of PAOD, we have exploited recently published databases on the content of foods in specific flavonoid classes to assess the relation between intake of these compounds and PAOD. SETTING: A major teaching hospital in Athens, Greece. SUBJECTS: Cases were 100 patients with PAOD and controls 100 patients with minor surgical conditions admitted to the same hospital. INTERVENTIONS: No interventions. All cases and controls were interviewed in the hospital wards, and a 110-food item semiquantitative food frequency questionnaire was administered by the same interviewer. RESULTS: Flavonols, flavones and perhaps flavan-3-ols were inversely associated with PAOD risk, the odds ratios (and 95% confidence intervals) for increments equal to the corresponding standard deviations being 0.41 (0.20-0.86), 0.56 (0.32-0.96) and 0.53 (0.26-1.05), respectively. Total flavonoids were also significantly inversely associated with PAOD. CONCLUSIONS: On the basis of these results, the biological properties of flavonoids and evidence concerning their relation to other manifestations of atherosclerosis, we conclude that dietary intake of specific classes of flavonoids, as well as total flavonoids, may have a protective effect against PAOD. SPONSORSHIP: This study was partially supported by a grant to Harvard University by the Samourkas Foundation.

Aged↗