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PubMed2006

Fluoride content of bottled waters available in Northern Greece.

OBJECTIVE: The aim of this study was to evaluate the fluoride content of bottled drinking waters commercially available in northern Greece and to report on the accuracy of the labelling of fluoride concentration. MATERIALS AND METHODS: Twenty-two randomly selected commercial brands of bottled water were obtained from three supermarkets in Thessaloniki, Greece. Three bottles of each brand were purchased. Following calibration, six tests were conducted on each bottle using a combination fluoride-ion selective electrode (Orion, 96-09-00, MA, USA). The average reading for each brand was estimated and also compared with the fluoride content printed on the label. RESULTS: The mean (+/- SD) fluoride content of the bottled water samples was 0.35 (+/- 1.00) mg F/L with a range from 0.05 to 4.8 mg F/L. Only 18% (N = 4) of brands tested mention the fluoride concentration on the label, and 90% (N = 22) had a tested fluoride between 0.05 and 0.21 mg F/L. Of the remaining two brands, one was found to contain 0.3 mg F/L without having the fluoride concentration indicated on the label, and the other was labelled at 6 mg F/L, whereas the concentration was estimated as 4.8 mg F/L. CONCLUSIONS: The use of bottled water may be a significant source of systemic fluoride and therefore be considered as a risk factor for dental fluorosis in young children. This article shows that bottled drinking waters contain differing concentrations of fluoride. The manufacturers' labelling of fluoride concentrations may be inaccurate. When prescribing fluoride supplements, dentists should be aware of the fluoride content of bottled waters used by paediatric patients, especially brands with a concentration higher than 0.3 mg F/L. In view of the wide variation of fluoride concentration in the tested bottled waters, regulatory guidelines for controlling concentration in order to prevent dental fluorosis are recommended.

Fluorides↗
PubMed2004

Reconstructing and predicting the hepatitis C virus epidemic in Greece: increasing trends of cirrhosis and hepatocellular carcinoma despite the decline in incidence of HCV infection.

In this study, a comprehensive methodology for modelling the hepatitis C virus (HCV) epidemic is proposed to predict the future disease burden and assess whether the recent decline in the incidence of HCV may affect the future occurrence of cirrhosis and hepatocellular carcinoma (HCC) cases. Using the prevalence of HCV, the distribution of chronic hepatitis C (CHC) patients within the various transmission groups and their infection-onset times, it was possible to reconstruct the incident infections per year in the past that progressed to CHC in Greece. The natural history of the disease was simulated in subcohorts of newly infected subjects using transition probabilities derived either empirically between fibrosis stages 0-4 or from literature review. Annual estimates of the incidence and prevalence of CHC by fibrosis stage, HCC and mortality in Greece were obtained up to 2030. HCV incidence peaked in the late 1980s at five new infections/10,000 person-years. Under the assumption of 20-100% decline in HCV incidence after 1990, the cumulative number of incident cirrhosis and HCC cases from 2002-2030 was projected to be lower by 9.6-48.2% and 5.9-29.5%, respectively, than that estimated under the assumption of no decline. However, the prevalent cirrhotic/HCC cases and HCV-related deaths are predicted to decline in the next 30 years only under the assumption of complete elimination of new HCV infections after 1990. Despite the progress in the reduction of HCV transmission, primary prevention does not seem adequate to reverse the rise in the incidence of cirrhosis and HCC.

Carcinoma, Hepatocellular↗
PubMed1989

The Greek National Perinatal Survey. II: Socioeconomic factors and perinatal mortality in Greece.

Information concerning all 10,859 singleton deliveries in Greece in April 1983, were analysed to assess the contribution of socioeconomic factors to the perinatal mortality rate. Statistically significant associations were initially found with parental education, parental ages, duration of marriage, paternal occupation and parity. There was no association with maternal smoking habit, maternal occupation during pregnancy, type of health insurance or housing conditions. Once logistic regression analyses had taken account of the strong parity effect (P less than 0.0001), only a moderate association with maternal age (P less than 0.05) remained statistically significant, together with a marginally significant (P less than 0.05) association with maternal education level. Mothers who were moderately well educated had the lowest risk of loosing their baby. It is concluded that traditional measures of social deprivation appeared to have little effect on perinatal mortality in Greece in 1983.

Birth Rate↗
PubMed1995

Frequency and characteristics of post-transfusion hepatitis in Greece with emphasis on hepatitis C: comparing second- and third-generation assays.

In order to evaluate the role of hepatitis C virus (HCV) in post-transfusion hepatitis (PTH) in Greece we prospectively followed 143 transfusion recipients, receiving 790 units of blood and/or products from 789 donors, between October 1989 and December 1991. The mean number of units transfused per patient was 5.52. PTH was observed in 18 patients (12.59%). One patient (0.70%) developed hepatitis B, in four (2.80%) hepatitis could be attributed to CMV infection, 10 (6.99%) developed hepatitis C and three (2.10%) showed only raised alanine aminotransferase (ALT) levels. The risk of PTH per 1000 units transfused was 22.8. The patient who developed hepatitis B (PTH-B) was transfused with four units, one of which was positive for anti-HBc and anti-HBe. Seven of the 10 patients (70%) who developed hepatitis C (PTH-C) were transfused with at least one unit seropositive in the anti-HCV screening with 2nd-generation tests (ELISA-2 and RIBA-2), whereas 9/10 of PTH-C cases (90%) were transfused with at least one unit positive in 3rd-generation assays. Of the three patients who showed only ALT elevation, none was transfused with anti-HCV seropositive blood, although one of them was transfused with at least one unit with elevated ALT levels. We conclude that: (1) the incidence of PTH in Greece remains high, (2) screening of all donations for anti-HCV with an ELISA-2 does not exclude transmission of HCV and (3) ELISA-3 and RIBA-3 seem to be more sensitive in blood donor screening and in detecting seroconversions than ELISA-2 and RIBA-2.

Alanine Transaminase↗
PubMed1986

Sanfilippo disease in Greece.

In a series of cases collected in most parts of the world, Sanfilippo disease type A is more frequent than type B. Skin biopsies were obtained from Greek patients suspected for Sanfilippo disease and cultured fibroblasts were assayed for both N-acetyl-a-glucosaminidase and sulfamidase activity. Eleven patients with Sanfilippo disease were identified. Ten of them were type B and one type A. The 10 patients with type B came from East-Central Greece and the neighboring areas of Thessaly and Macedonia. Both parents of the type A patient were from the Greek ethnic community of Turkey. It remains unknown whether or not the higher frequency of type B than type A appears only in Greece or if it occurs in other Mediterranean countries as well.

Acetylglucosaminidase↗
PubMed1994

HLA class II DNA-RFLP typing in 102 individuals from Northern Greece.

The serological identification of HLA class II alleles is often doubtful. Since accurate HLA typing is essential for the matching of donor-recipient pairs in allogeneic transplantation, an effort was made to establish DNA restriction fragment length polymorphism (RFLP) typing and to assess the correlation between the serological and RFLP techniques in the population of Northern Greece. One hundred and two healthy individuals (204 HLA-DR alleles) from Northern Greece were HLA-DR, DQ typed with both the microcytotoxicity and the Taq I RFLP method, using three exon-specific probes. DNA-RFLP typing revealed (1) concordant results with serology in 69.9% (142/204) of the alleles and (2) at least one HLA-DR allele discrepant to serology in 30.4% (62/204) of the alleles. Incorrect serological DR types (weak reactions or inability to distinguish between two alleles with a common epitope) were identified in 54 alleles (26.5%), while 3.9% (8/204) of serological "blank" alleles turned out to be definable alleles by RFPL. Of the individuals tested, 10.8% (11/102) were DR-homozygous by RFLP. This comparison of results obtained by serology and RFLP demonstrated the necessity of the clinical application of DNA typing, especially for organ transplantation where accurate HLA typing has an important influence on graft survival.

Alleles↗
PubMedDate not supplied

Dermatophytosis in northern Greece during the decade 1981-1990.

Dermatophytic infections are very common in Greece. In the Mycological Laboratory of the Venereal and Skin Diseases Hospital in Thessaloniki, 6572 isolates of different dermatophytes were obtained from 17,120 patients examined. It is suggested that 5% of the people who present with skin problems in Greece suffer from dermatophyte infections. They are frequent causative agents of tinea pedis, tinea cruris, tinea corporis, tinea capitis and tinea unguium. In this paper, the species, the number and the prevalence of the dermatophytes were studied according to location and sex of the patients. The contribution of dermatophyte infections to the overall incidence of superficial fungal infection over 10 years was also studied.

Adult↗
PubMed1996

Illegal immigration and local labour markets: the case of northern Greece.

"The purpose of the present study is to enhance knowledge on the impact of illegal immigrants in Greece from both Eastern European and other developing countries. Our analysis is based on direct survey information from the four regions in Greece which employ considerable numbers of illegal aliens." (SUMMARY IN FRE AND SPA)

Demography↗
PubMed2004

Infective endocarditis in Greece: a changing profile. Epidemiological, microbiological and therapeutic data.

The epidemiology, and clinical and microbiological spectrum, of infective endocarditis (IE) in Greece was analysed in a prospective 4-year study in a tertiary hospital and a heart surgery centre in Athens. In total, 101 cases of IE (71 men, 30 women, aged 54.4 +/- 17.1 years) were studied, with a follow-up period of 3 months. Seventy-seven cases were definite and 24 possible; 59 involved native valves (native valve endocarditis; NVE), 31 prosthetic valves (prosthetic valve endocarditis; PVE), of which nine were early and 22 late, and 11 permanent pacemakers (pacemaker endocarditis; PME). There was a predominant involvement of aortic (48/101) and mitral (40/101) valves. Seven patients had rheumatic valvular disease, two had mitral valve prolapse, and eight had a previous history of IE. Thirteen and six patients had undergone dental and endoscopic procedures, respectively. In 13 patients, intravenous catheters were used within the 3 months before diagnosis of IE. There were three intravenous drug users among the patients. Staphylococcus aureus was the most important pathogen, isolated in 22% of cases, followed by viridans streptococci (19%) and coagulase-negative staphylococci (16%). Enterococcus spp. were responsible for 3%, HACEK group for 2%, and fungi for 6% of cases. Viridans streptococci were the leading cause of NVE (29%), Staphylococcus epidermidis of PVE (16%), and S. aureus of PME (54.5%). Six of 22 S. aureus and ten of 16 S. epidermidis isolates were methicillin-resistant. Surgical intervention, including total pacemaker removal, was performed in 51.5% of patients. Overall mortality was 16%, but was 29% with PVE, and was significantly higher with medical than with combined surgical and medical therapy (24.5% vs. 8%). Compared with previous studies, there were changing trends in the epidemiology, microbiology, treatment and prognosis of IE in Greece.

Adolescent↗
PubMed2005

A seroprevalence study of poliovirus antibody in the population of northern Greece.

This study assessed immunity to poliomyelitis in a representative sample of 1064 persons living in northern Greece. Antibody prevalences in the individuals tested were 91.1% (95% confidence interval (CI): 89.4-92.8), 92.1% (95% CI: 90.5-93.7) and 83.1% (95% CI: 80.8-85.4) for poliovirus types 1, 2 and 3, respectively. For poliovirus type 3, a gap in immunity was found in individuals aged 10-29 years. Re-vaccination of adolescents living in northern Greece is suggested to ensure herd immunity and to minimise the risk of importation of wild poliovirus from endemic countries.

Adolescent↗
PubMed2006

Spread of Staphylococcus aureus clinical isolates carrying Panton-Valentine leukocidin genes during a 3-year period in Greece.

Three collections of Staphylococcus aureus isolates (n = 1,058) were investigated to assess the spread of Panton-Valentine leukocidin (PVL)-producing strains in Greece and their association with skin and soft-tissue infections (SSTIs). The isolates were collected during 2001-2003 from inpatients and outpatients with invasive infections in two distinct geographical areas. Clonal types were identified according to their ClaI-mecA::ClaI-Tn554::pulsed-field gel electrophoresis patterns, and the presence of the lukS-PV and lukF-PV genes was assessed by PCR. In total, 287 (27%) S. aureus isolates carried the PVL genes: 45% of methicillin-resistant S. aureus (MRSA) and 12% of methicillin-sensitive S. aureus (MSSA). All the PVL-positive MRSA isolates belonged to a single clone that was disseminated in the community and hospitals. The PVL-positive MSSA isolates were polyclonal, with 14 of 65 isolates being associated with hospital-acquired infections. The community-acquired isolates were from SSTIs, while the hospital-acquired isolates were associated with surgical wound infections, especially those involving prosthetic devices. Thus, a unique clone of PVL-positive MRSA has spread in both the community and the hospital setting in Greece, and has replaced older clonal types.

Anti-Bacterial Agents↗
PubMed2006

Nosocomial spread of OXA-58-positive carbapenem-resistant Acinetobacter baumannii isolates in a paediatric hospital in Greece.

Twelve non-repetitive Acinetobacter baumannii isolates producing the carbapenem-hydrolysing oxacillinase OXA-58 were recovered from patients in the same paediatric hospital in Athens, Greece, between November 2003 and May 2005. All isolates were clonally related, but the bla(OXA-58) gene was not always plasmid-located and there were variations in the DNA sequences surrounding the OXA-58 gene in different isolates. This study emphasises the importance of the bla(OXA-58) carbapenemase gene in conferring carbapenem resistance among A. baumannii isolates in Greece.

Acinetobacter Infections↗
PubMed2006

A survey of public awareness, understanding, and attitudes toward epilepsy in Greece.

PURPOSE: To assess familiarity, understanding, and attitude toward epilepsy in Greece and identification of negative predictive factors. METHODS: A 19-item questionnaire was administered to 750 adults. The magnitude of social stigma toward epileptic people with epilepsy was measured with a quantitative scale of social rejection. Statistical analysis with chi-square and multiple regression analysis were used to identify factors associated with negative attitudes. RESULTS: Of our respondents 38.8% knew someone with epilepsy and 50.8% had witnessed a seizure. Nineteen percent believed that epilepsy is a type of mental retardation, 15% believed it is a type of insanity, 91.8% considered epilepsy as a brain disorder while 5.2% considered it as a supernatural phenomenon. Seventy-seven percent considered epilepsy as a curable disease while 57.5% believed that the risk of inheriting it is very high. Regarding marriage to a patient with epilepsy 45.4% rejected it while regarding his employment 37.7% were positive, 47.8% were skeptical while 12.8% were against it. The Greek public's rejection tendency toward epileptic people was generally low. Negative predictive factors were older age, low educational level, unfamiliarity with epilepsy, and erroneous beliefs about epilepsy. CONCLUSIONS: The Greek public is familiar with epilepsy but has a suboptimal level of appropriate understanding of essential aspects of the disease. The overall public's level of rejection toward people with epilepsy is low but certain groups of people are highly rejective. Information campaigns targeting specific population subgroups are necessary in Greece in order to improve the public's understanding of epilepsy and tolerance toward people with epilepsy.

Adolescent↗
PubMed1994

The screening programme for congenital hypothyroidism in Greece: evidence of iodine deficiency in some areas of the country.

Newborn screening for Congenital Hypothyroidism, using TSH measurement in dried blood spots, was started in Greece in 1979. A total of 1,274,000 neonates have been screened and 377 cases of Congenital Hypothyroidism were detected, for an incidence of 1:3370. Employing a cut-off point of 30 mU/L of TSH in whole blood, 0.3% of the infants were recalled for repeat examination. The sensitivity of the screening test was 0.99 and the predictive value of a positive test 0.1. The frequency of "false positive" cases in the different geographic regions of Greece showed wide variation between the south and the north areas of the country. We suggest that these differences reflect the degree of iodine deficiency in the population and may be used as an epidemiological indicator of this deficiency.

Congenital Hypothyroidism↗
PubMed2004

Nosocomial outbreak of extended-spectrum beta-lactamase SHV-5-producing isolates of Pseudomonas aeruginosa in Athens, Greece.

Seven nonrepetitive Pseudomonas aeruginosa isolates producing the clavulanic acid-inhibited extended-spectrum beta-lactamase SHV-5 were isolated in the same hospital in Athens, Greece, from 1998 to 2002. All isolates except one were clonally related, and the bla(SHV-5) gene was chromosomally located. This study underlined that this gene, which is widespread in Enterobacteriaceae in Greece, may disseminate also in P. aeruginosa.

Adolescent↗
PubMed1980

Etiological characterization of hepatitis B surface antigen-negative hepatitis among adult patients in Athens, Greece.

In a 4-month period, 216 cases of acute viral hepatitis were diagnosed in adults at the Infectious Diseases Hospital, Athens, Greece. Twenty-six percent of these were hepatitis B surface antigen negative. A full set of clinical specimens was obtained from 19 of these patients, who were studied in depth for the etiology of their hepatitis. A total of 7 of the 19 patients had serological evidence of hepatitis A virus infection, and 2 had evidence of recent hepatitis B virus infection. The remaining 10 patients lacked evidence of hepatitis A virus, hepatitis B virus, cytomegalovirus, or Epstein-Barr virus infection related to their illness and were classified as having type non-A, non-B hepatitis. Types A and non-A, non-B hepatitis were clinically similar in these adults patients. However, patients with type non-a, non-B hepatitis were, on the average, older and more likely to have received parenteral inoculations during the 6 months before contracting hepatitis. Approximately 76% of the 216 consecutive cases of acute viral hepatitis were probably type B, approximately 10% were probably type A, and approximately 14% were probably type non-A, non-B, although the latter two types may be underestimated because of the possibility of superinfection with these viruses in asymptomatic hepatitis B surface antigen carriers. Thus, all three types of viral hepatitis appear to be important in the etiology of liver disease in Athens, Greece.

Acute Disease↗
PubMed2003

Two international methicillin-resistant Staphylococcus aureus clones endemic in a university hospital in Patras, Greece.

Pulsed-field gel electrophoresis (PFGE) of SmaI macrofragments and hybridization of ClaI digests with the mecA- and Tn554-specific DNA probes were used to define the endemic clones of methicillin-resistant Staphylococcus aureus (MRSA) among strains collected in 1993 and 1998 to 2000 at the University Hospital of Patras, Patras, Greece. Representatives of each clonal type were analyzed by spaA typing, multilocus sequence typing (MLST), and staphylococcal chromosomal cassette mec (SCCmec) typing. The results indicated the existence of two successive international MRSA clones: (i) a clonal type with PFGE type A, sequence type (ST) 30 (ST30), and SCCmec type IV, which was very similar to a clone widely spread in the United Kingdom, Mexico, and Finland, and (ii) a clonal type with PFGE type B, ST239, and SCCmec III, which was related to the Brazilian clone. Both clones seem to be widespread in Greece as well. A novel MRSA clone is also described and is characterized by a new MLST type (ST80) associated with SCCmec type IV and with the presence of Panton-Valentine leukocidin genes.

Bacterial Typing Techniques↗
PubMed1998

Car restraints and seating position for prevention of motor vehicle injuries in Greece.

The protective effect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staff from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective effect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well as a high childhood accident mortality.

Accidents, Traffic↗