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PubMed2003

An objective definition of air mass types affecting Athens, Greece; the corresponding atmospheric pressure patterns and air pollution levels.

This work aims at defining characteristic air mass types that dominate in the region of Athens, Greece during the cold (November-March) and the warm (May-September) period of the year and also at evaluating the corresponding concentration levels of the main air pollutants. For each air mass type, the mean atmospheric pressure distribution (composite maps) over Europe and the Mediterranean is estimated in order to reveal the association of atmospheric circulation with air pollution levels in Athens. The data basis for this work consists of daily values of thirteen meteorological and six pollutant parameters covering the period 1993-97. The definition of the characteristic air mass types is attempted objectively by using the methods of Factor Analysis and Cluster Analysis. The results show that during the cold period of the year there are six prevailing air mass types (at least 3% of the total number of days) and six infrequent ones. The examination of the corresponding air pollution concentration levels shows that the primary air pollutants appear with increased concentrations when light or southerly winds prevail. This is usually the case when a high pressure system is located over the central Mediterranean or a low pressure system lays over south Italy, respectively. Low levels of the primary pollutants are recorded under northeasterly winds, mainly caused by a high pressure system over Ukraine. During the warm period of the year, the southwestern Asia thermal low and the subtropical anticyclone of the Atlantic Ocean affect Greece. Though these synoptic systems cause almost stagnant conditions, four main air mass types are dominant and ten others, associated with extreme weather, are infrequent. Despite the large amounts of total solar radiation characterizing this period, ozone concentrations remain at low levels in central Athens because of its destruction by nitric oxide.

Air Movements↗
PubMed2002

Transport of toxic organic aerosol pollutants from Yugoslavia to Greece during the operation "Allied Force".

Between March 24 and June 10, 1999 a large number of chemicals were ejected into the atmosphere because of air strikes on chemical industries and oil storage facilities in former Yugoslavia. Chemicals released into the atmosphere under suitable meteorological conditions can be transported across borders to large distances. The releases may have contained not only conventional air pollutants but also semi-volatile organic compounds (SOCs) which include dioxins, furans, PCBs and PAHs, all known to be hazardous to health. A measuring programme was initiated at Democritus University Thrace, Greece to monitor the chemical characteristics of atmospheric aerosol during February, March and April 1999. Particulate matter (aerosol) was collected on filters and was analysed using high-resolution gas chromatography coupled to high-resolution mass spectrometry for their content in SOCs. In the present work we show evidence of two events with three to twenty fold increased SOCs in the atmosphere of Northern Greece which were associated with air masses transported from the conflict area, following the destruction of chemical plants and oil storage facilities.

Aerosols↗
PubMed2005

Nutritional risk factors for iron-deficiency anaemia in children 12-24 months old in the area of Thessalia in Greece.

Iron-deficiency anaemia (IDA) is a common problem all over the world, which mainly attacks pregnant women, infants and children. The main objectives were to assess the prevalence of IDA in children 12-24 months old in the area of Thessalia located in the central part of Greece and to identify, by means of a simple questionnaire, its nutritional risk factors. The research was applied as a cross-sectional and case-control study. In the first part of the study, the haemoglobin (Hb) levels were estimated by a mobile photometer analyser in 938 children (approximately one-third of the total children population). In the second part, children with Hb?<?11 g/dl were compared with their random selected healthy controls in haematological, anthropometric and nutritional parameters. The estimated laboratory values were Hb, haematocrit, mean corpuscular volume, mean corpuscular Hb, mean corpuscular Hb concentration, zinc protoporphyrin, serum iron, serum ferritin, transferring saturation, total iron binding capacity and Hb electrophoresis. Finally, 75 children (34 boys, 41 girls; mean age 17.51+/-3.5 months), who were found to have IDA, constituted the case group while 75 healthy children constituted the control group. The studied nutritional variables through the application of a standardized food frequency questionnaire were: duration of breast feeding, milk that the child drinks during the research, age of solid food introduction, child's health status according to the mother's point of view, child's appetite and frequency of bread, cereals, meat, fish, egg, legumes, chocolate, marmalade, vegetables, fruit and tea intake. The prevalence of IDA in the region was 7.99%. The carriers of b-thalassaemia (2.13%) were excluded from the study. Significant statistical difference has been observed between the two groups (P?<?0.001) in all haematological and anthropometric parameters except head circumference (P?=?0.85). Concerning the nutritional indices the two groups were statistically different (P?<?0.001) in the following: the cases were breastfed less, were drinking fresh cow's milk and tea, were eating meat, vegetables and fruit less often, had a bad appetite and were more likely to get sick. In conclusion, the prevalence of IDA in this area of Greece is approximately similar to other areas in the developed world. The application of simple food frequency questionnaires for the detection of the nutritional IDA risk factors could prognose and prevent anaemia.

Anemia, Iron-Deficiency↗
PubMed2003

Particulate and sulfur dioxide concentration measurements in Patras, Greece.

The purpose of this study was to obtain a better assessment of the Patras, Greece, air quality, in terms of the primary pollutants total suspended particulates (TSPs) and sulfur dioxide (SO2), because limited and short-duration measurements have been conducted in the past. Installation and operation of a mobile air monitoring station at two different locations in the Patras downtown area and one location in the outskirts of the city was undertaken and covered the periods July 1, 1994-January 30, 1995; March 18-August 23, 1995; and April 19-July 27, 1996, respectively. For both pollutants measured at each location, the monthly average concentrations and typical weekly variation of daily averages, as well as the diurnal variations and frequency concentration distributions in each month of the monitoring periods, were calculated and are presented in bar diagrams. The annual and winter period medians and the annual 98th percentile were also calculated and are compared with the limit and guide values provided by the European Economic Community Council Directive 80/779/EEC. In addition, comparison of SO2 values is made with the limit values adopted by the more recent Directive 1999/30/EC. It was found that the TSP and SO2 levels at all locations were very low and were lower than the levels found in Thessaloniki and Athens, Greece. An attempt to explain what had been measured is also undertaken. The data presented are considered essential for future reference and comparison purposes.

Air Movements↗
PubMed2001

First report of Cryptococcus neoformans var. gattii serotype B from Greece.

A plethora of cases of Cryptococcus neoformans infections have been recorded worldwide in immunocompromised individuals. The number of such cases showed a steady rise before 1981 and increased dramatically thereafter due to the AIDS epidemic. A similar pattern has been seen in Greece but, so far, infections appear to have been caused by C. neoformans var. neoformans. This paper describes for the first time two culture-proven C. n. var. gattii serotype B infections in Greece, one in an AIDS patient and one in a patient with systemic lupus erythematosus.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Physicians and complementary and alternative medicine cancer therapies in Greece: a survey.

OBJECTIVES: To assess the prevalence of complementary and alternative medicine (CAM) cancer therapies and attitudes toward them in a nonrandom sample of physicians in Greece. SUBJECTS: Four hundred and ninety-four (494) physicians from private practices and hospitals in the Athens area were approached to complete a questionnaire on perceived cancer etiology, self-reported knowledge, and attitudes about CAM therapies used by cancer patients. Two hundred and thirty-six (236) (47.8%) questionnaires were returned. RESULTS: Greek physicians are most familiar with homoeopathy (58.5%), diets (58.1%), antioxidants (vitamin C) (55.9%), and acupuncture (47.9%). Perceived rates of patients using CAM are low. Predominantly, physicians shared concepts of carcinogenesis accepted by conventional biomedicine. Only physicians who considered disorders of cellular metabolism or in the flow of body energy to be relevant believed that homoeopathy could be an adequate CAM therapy. CONCLUSIONS: Greek physicians in our sample displayed little interest in CAM. However, media and Internet coverage may generate a greater demand for these methods in the future in Greece and physicians will thus need to be better informed.

Adult↗
PubMed2004

Evidence for association of endothelial cell nitric oxide synthase gene polymorphism with earlier progression to end-stage renal disease in a cohort of Hellens from Greece and Cyprus.

Nitric oxide (NO) is thought to be an important factor in the deterioration of renal function. A variable-number tandem 27-bp repeat in intron 4 of the endothelial cell nitric oxide synthase (NOS3) gene has been found to be associated with the plasma levels of NO metabolites. Two alleles are of varied frequencies in different populations (a and b). The shorter allele a has been associated in Japanese populations with the progression of renal disease. Here we investigated this hypothesis by studying the putative role of this polymorphism in a Hellenic population of patients with end-stage renal disease (ESRD). We analyzed the genotypes of 361 ESRD patients and 295 healthy Hellens from Greece and Cyprus. The frequencies of NOS3-4bb, NOS3-4ab, and NOS3-4aa were 0.69, 0.27, and 0.03, respectively, in the control group and 0.71, 0.24, and 0.04 in the group of patients. The data in the two populations were analyzed by the chi-square and Fisher's exact tests. The frequencies of these three genotypes of NOS3-4 polymorphism in the Hellenic population of Greece and Cyprus are similar to those observed in other Caucasian populations. Moreover, our results from three patient groups, autosomal dominant polycystic kidney disease (ADPKD), diabetes mellitus (DM), and non-DM, showed that the frequencies of aa and ab genotypes in the patient populations were not significantly different from those observed in the control group. This work indicates that NOS3-4 polymorphism does not show any association with the development of ESRD in this studied European population. However, examination of the data regarding progression to ESRD within 5 years or after more than 5 years following clinical diagnosis of ADPKD provided evidence of statistical difference (p = 0.048, before Bonferroni correction), with faster progression in the group of ADPKD patients who carried allele a.

Alleles↗
PubMedDate not supplied

Hemorrhagic fever with renal syndrome in Greece: clinical and laboratory characteristics.

The clinical and laboratory characteristics of a severe form of hemorrhagic fever with renal syndrome (HFRS) in Greece are presented. Twenty-seven patients with serologically confirmed HFRS were studied; 10 required renal dialysis, six had hemorrhagic manifestations, and four died. In patients with hemorrhagic manifestations, the platelet counts were generally less than 100,000 cells/microL. In three patients findings were compatible with disseminated intravascular coagulation. Laboratory investigation showed a consistent rise in levels of serum urea nitrogen and creatinine beginning on the fifth or sixth day of illness and reaching a maximum level between the ninth and 12th days of illness. The disease in Greece more closely resembles the Asian form of HFRS (Korean hemorrhagic fever) than the Scandinavian form of the disease (nephropathia epidemica) because of the high mortality rate, the occurrence of hemorrhagic manifestations, and the severity of the clinical disease.

Creatinine↗
PubMed2003

Cigarette smoking, alcohol consumption, and serum lipid profile among medical students in Greece.

BACKGROUND: The lack of data regarding health habits of medical students in Greece prompted a cross-sectional study to assess tobacco use, alcohol consumption and serum lipoprotein levels among students in the University of Crete School of Medicine. METHODS: A self-administered questionnaire on smoking and alcohol consumption was distributed to third-year medical students for twelve consecutive years (1989-2000). A total of 849 students (462 males, 387 females) participated in the survey. Biochemical measurements were taken and multi-variant analysis of the data was performed. RESULTS: The prevalence of smoking among males and females was 33.2% (N = 150) and 28.4% (N = 108), respectively (mean cigarette consumption 13/day). As many as 349 males (77.2%) and 220 females (58.0%) reported consuming alcohol on a regular basis. The prevalence of low HDL-cholesterol (< 0.9 mmol/l) was 14.5% in males and 5.1% in females, and of high LDL-cholesterol levels (> 4.1 mmol/l) in 11.1% of male and 5.5% of female participants. Smoking was related to higher triglyceride (p = 0.032), and lower HDL-cholesterol (p = 0.037) serum levels. Total cholesterol, LDL-cholesterol, and the TC/HDL-cholesterol ratio were strongly related with the level of smoking (p = 0.006, p = 0.008, and p = 0.006 respectively). CONCLUSIONS: The results document a high prevalence of smoking among physicians-to-be in Greece. Tobacco use was strongly associated with a lipid profile predisposing to increased risk for cardiovascular disease. Health promotion programmes should therefore be instituted not only during the first years of medical studies, but rather at a much earlier stage in life.

Adult↗
PubMed2004

Factors associated with self-rated health in Greece: a population-based postal survey.

BACKGROUND: Self-rated health (SRH), as an indicator of population health, is a concept useful both for research and planning. This study reports SRH, and factors related to it, in Greece. METHODS: Population-based postal survey, using World Health Organisation (WHO) questionnaires with a sample of randomly selected geographically stratified individuals. Response rate reached 41%. RESULTS: As expected, age, income and education were related to SRH, but accounted for only 20% of the variance. CONCLUSIONS: SRH in Greece is related to sociodemographic factors, but perhaps not as strongly as in other populations. Other explanatory variables will require further research.

Adolescent↗
PubMed2001

Dementia and depression: two frequent disorders of the aged in primary health care in Greece.

BACKGROUND: Dementia and depression are very common disorders among elderly people and their presence decreases the well-being of the aged. OBJECTIVES: The purpose of this study was to assess the magnitude of dementia and depression among elderly people living in different settings in the catchment area of the Chrisoupolis health centre (HCCh) in northern Greece. METHODS: A total of 536 patients aged 65 years and over, including 48 subjects living in an old people's home, 75 subjects who were taking part in the activities of the open centre for the elderly and 413 subjects randomly selected from those visiting the HCCh, were interviewed by the primary health care team of the HCCh. Medical and family history data were recorded, while cognitive and mood disorders were assessed by using the Mini Mental State Examination and Geriatric Depression Screening Scale. RESULTS: At the time of the examination, 37.6% of the men and 41.6% of the women showed various degrees of cognitive impairment, while 29.9% of the women and 19.6% of the men showed mild to moderate depression. Diabetes mellitus and hypertension frequently were found to co-exist with depression and dementia. CONCLUSION: The results reaffirm that there is a high prevalence of the studied mental disorders in older patients in the out-patient setting in Greece. A set of recommendations to Greek GPs has now been formulated, with specific emphasis on the use of different screening tools and the appropriate treatment of the most frequently co-existing chronic diseases.

Aged↗
PubMed1988

Regional differences in maternal mortality in Greece, 1973-1982.

Maternal mortality in the ten regions of Greece during the period 1973-82 is examined. In Greece as a whole, maternal mortality declined from 27.2 per 100,000 livebirths in 1973, to 12.0 in 1982. During these ten years, the age standardized maternal mortality ratios (SMRs) of two regions was significantly raised, Thrace (SMR = 295, 95% CL = 187-443) and the Aegean Islands (SMR = 197, 95% CL = 117-311). Greater Athens was the only region with significantly reduced maternal mortality (SMR = 77, 95% CL = 59-99). In two regions, Thrace and Epirus, maternal mortality increased during the ten years studied. To explore the possible reasons for the observed geographical differences in maternal mortality, data on three sociodemographic and three obstetric service indicators are presented. Regions with the highest proportion of hospital births had the lowest SMRs (p less than 0.05); and it is suggested that cultural factors in the case of Thrace, mainly emanating from the Muslim minority living in this region, and topographical factors, in the case of the Aegean Islands and Epirus, may have influenced maternal mortality by adversely affecting maternity service usage and availability.

Female↗
PubMed1984

Two cases of hemorrhagic fever with renal syndrome in northern Greece.

Two cases of hemorrhagic fever with renal syndrome were diagnosed in woodcutters presumably exposed to wild rodents and their urine in a forest in northern Greece. The disease was characterized by acute renal insufficiency without hemorrhagic manifestations. One patient required hemodialysis, but both recovered without sequelae and developed a fourfold increase in titer of antibody to Hantaan virus, as determined by an immunofluorescence test. These are the first reported cases of hemorrhagic fever with renal syndrome in Greece.

Adult↗
PubMed1996

Are operative delivery procedures in Greece socially conditioned?

Caesarean section rates have increased in Greece by almost 50% during the last 13 years. We conducted a study in Athens, Greece, to assess the importance of a series of medical and socioeconomic factors in the use of Caesarean section or operative vaginal procedures, rather than a non-operative process, for the delivery of singleton, liveborn babies of primiparous mothers. We used a case control approach to compare 444 babies delivered through a Caesarean section and 130 delivered through operative vaginal delivery with 1235 normally delivered babies in a public and a private hospital. Data were analysed through multiple logistic regression. Caesarean section was more commonly performed in older, shorter or overweight mothers and for high and low birth-weight babies, as well as in response to several obstetric complications and following in-vitro fertilization. A similar pattern was noted with respect to operative vaginal delivery, except that this procedure was not unusually frequent among overweight women and was not encountered in this study among children born after in-vitro fertilization. Caesarean section was performed twice as often in the public teaching hospital as in a private maternity hospital, and operative vaginal delivery was several times more common in the former than in the latter, after controlling for biomedical risk factors. The unequal distribution of operative delivery procedures between the public and the private hospital raises questions about the justification of their performance in a substantial fraction of deliveries, and indicates that social factors condition their use.

Adolescent↗
PubMed1993

Prevalence of the type I and type II DHFR genes in trimethoprim-resistant urinary isolates of Escherichia coli from Greece.

Trimethoprim resistance in 64 Escherichia coli urinary isolates from five hospitals in Greece was studied. Of the 40 isolates exhibiting transferable high-level resistance (MIC > 1024 mg/L), 21 hybridized with a specific probe for dihydrofolate reductase (DHFR) I, 13 with a probe for DHFR II, and one with a probe for DHFR V. Eleven isolates hybridized with a probe for transposon Tn7. Among the 17 isolates with non-transferable high-level resistance, seven hybridized with the probe for DHFR I, three with the probe for DHFR II, and eight were Tn7-positive. None of the seven isolates with low-level resistance (MIC 4-1024 mg/L) reacted with the probes used. Of the 28 isolates positive for DHFR I, 12 (43%) failed to hybridize with the Tn7 probe. Conversely, three isolates hybridized with the Tn7 probe, but not with the probe for DHFR I. Colony hybridization experiments showed that all but three transconjugants reacted similarly to their respective parent strains. The plasmids coding for trimethoprim-resistant DHFRs were found to differ on the basis of restriction enzyme analysis. These findings suggest that trimethoprim resistance among E. coli urinary isolates in Greece is mediated predominantly by heterogeneous transferable plasmids encoding either DHFR I or DHFR II. The dissociation between DHFR I and Tn7, together with the high incidence of trimethoprim-resistant isolates which did not hybridize with the probes for the common DHFR I or II types, indicates the continued evolution of trimethoprim resistance determinants.

Bacteriuria↗
PubMed2004

Dissemination of vancomycin-resistant enterococci among haemodialysis patients in Athens, Greece.

OBJECTIVES: Vancomycin-resistant enterococci (VRE) may colonize haemodialysis patients, but their epidemiology in this population is not well defined. Within the few last years, VRE strains have emerged and are increasingly isolated in the nosocomial environment in Greece, but colonization of dialysis patients has never been evaluated before. This study sought to determine the epidemiology of VRE colonization within this high-risk population and define the risk factors. MATERIALS AND METHODS: During a 4 month period, rectal swabs or faecal specimens were collected from 334 consecutive outpatients, who were treated at four independent dialysis units located in the same area of Athens and referring patients to the same local hospital. The relatedness of isolates was defined by molecular typing, and demographic and clinical patient data were recorded. RESULTS: Thirteen multiresistant Enterococcus faecium vanA strains were isolated corresponding to a colonization frequency of 3.9%. They were separated into seven clusters: type A (two strains), type B (six strains) and types C to G (one strain each). Type B strains originated from three units, while a single unit demonstrated four type B and two type A strains. Univariate statistical analysis revealed that prior hospitalization (P=0.001), prior administration of antimicrobials (P=0.026) and male gender (P=0.019) were associated with VRE colonization. CONCLUSIONS: In Greece, haemodialysis patients are colonized with VRE at a low frequency. The predominance of one clone and its isolation from several units strongly indicate interfacility transmission of strains, most probably within a health care environment shared by all patients.

Aged↗
PubMed2006

Antimicrobial susceptibility of Neisseria gonorrhoeae in Greece: data for the years 1994-2004.

OBJECTIVES: Surveillance data concerning antimicrobial susceptibilities of Neisseria gonorrhoeae isolated in Greece during the 11 year period 1994-2004 are presented. METHODS: Antimicrobial susceptibilities of all gonococcal isolates received by the Greek National Reference Center for N. gonorrhoeae during the study period were determined in terms of MICs using Etest. Trends in yearly isolation frequencies by susceptibility category were estimated for defining significant changes in overall susceptibility figures. RESULTS: Cefotaxime and spectinomycin retained undiminished activity against all isolates throughout the study period. High rates of resistance and intermediate susceptibilities were noticed for penicillin, tetracycline and erythromycin, and even for norfloxacin and ciprofloxacin. A substantial portion (16.5%) of the gonococcal samples consisted of multiresistant strains exhibiting resistance to two or more agents of different antibiotic classes. Although annual rates of low-level chromosomal resistance decreased, high-level resistance owing to the presence of penicillin- and tetracycline-resistance plasmids increased. Fluoroquinolone resistance also showed a significant increasing trend after 1996, reaching a peak rate of 11.3% in 2004. CONCLUSION: Third-generation cephalosporins and spectinomycin should be considered as first-choice drugs for the empirical treatment of gonorrhoea in Greece.

Anti-Bacterial Agents↗
PubMed1996

Water wells as a habitat of sand fly (Diptera: Psychodidae) vectors of visceral leishmaniasis in Greece.

Overall, 37 of 79 water wells in 3 diverse geographic areas of Greece were found to harbor sand flies. The predominant species were Phlebotomus tobbi Adler, Theodor & Lourie and P. neglectus Tonnoir, species implicated in the transmission of Leishmania infantum Nicolle. Three additional species of Phlebotomus and 2 Sergentomyia spp. also encountered. Wells appear to be resting and possibly breeding habitat for sand flies in Greece.

Animals↗