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PubMed2001

How common is abuse in Greece? Studying cases with femoral fractures.

AIMS: To examine the extent of undiagnosed child abuse in Greece by studying young children with femoral fractures, which may be associated with abuse. METHODS: Fifty seven consecutive cases of children under 6 years of age with femoral fracture were identified from the Emergency Department Injury Surveillance System database. Controls were 4162 children with other orthopaedic injuries from the same database. RESULTS: Whereas in the literature about one third of femoral injuries among young children are attributed to child abuse, no child in the studied series had been diagnosed or even investigated in this context. Nevertheless, the pattern of occurrence of femoral injuries was compatible with that of child abuse, in that patients were frequently very young boys of low socioeconomic status, and the accident had frequently occurred under poorly identified or implausible conditions at time periods when most family members were crowded at home. CONCLUSIONS: Epidemiological risk factors for child abuse characterise femoral fractures in young children in Greece. It appears that child abuse is present in this country as in most other cultures. There is a clear need for refocusing medical personnel and hospital social services so that the problem is revealed, quantified, and appropriately dealt with.

Accidental Falls↗
PubMed2003

Familial Mediterranean fever associated pyrin mutations in Greece.

OBJECTIVE: To search for pyrin mutations associated with familial Mediterranean fever (FMF) in Greece. PATIENTS AND METHODS: 62 patients fulfilling the Tel Hashomer diagnostic criteria for definite (33) or probable (29) FMF diagnosis were studied. Eight point mutations of pyrin gene were tested by standard methods. Of the 62 patients tested, 48 were Greek, four were Jewish, seven were Armenian, and three were Arab. RESULTS: 42 patients were found to be homozygotes for pyrin mutations; 11 patients were found to carry only one of the tested mutations; in nine patients no mutations were detected. CONCLUSION: Molecular detection of pyrin gene mutations seems useful in confirming suspected cases, and in detecting asymptomatic cases, of Mediterranean fever in Greece. It may also be used as a screening tool within affected families.

Arabs↗
PubMed1996

Risk factors for childhood poisoning: a case-control study in Greece.

OBJECTIVES: To identify child or family related risk factors for unintentional childhood poisoning in Greece and to explore whether product specific poisonings might have special features that make them amenable to preventive interventions. SETTING: A case-control study was undertaken in Athens, Greece in 1995. Cases were 100 consecutive children brought with poisoning to the emergency clinics of the two university affiliated children's hospitals. For every case two age, gender, and hospital matched controls were chosen from among children brought to the outpatient clinics of these hospitals on the same date. METHODS: All children and their guardians were interviewed by the same person using a standard questionnaire that covered demographic, socioeconomic, behavioral, and past injury characteristics. Information was also obtained concerning type and conditions of poisoning for cases. Statistical analysis was undertaken by modeling the data using conditional logistic regression. RESULTS: Socioeconomic factors were not important risk indicators in these data but children living with other than both parents were at increased risk (odds ratio (OR) = 4.7, p = 0.08), as were children with a history of previous poisoning that required medical care (OR = 5.1, p = 0.05). Unintentional poisonings caused by chewing or swallowing cigarettes were concentrated in families where both parents were smokers. CONCLUSIONS: Absence of a parent appears to be associated with increased likelihood of childhood poisoning. The importance of product accessibility is underlined by the concentration of tobacco poisoning among children of parents who were both smokers. In the cultural context of this study, sociodemographic factors do not appear to represent demonstrable risk factors. Instead, control of childhood poisoning should be concentrated on safe packaging, storage, and disposal of potentially hazardous products.

Case-Control Studies↗
PubMed1999

Factors affecting motorcycle helmet use in the population of Greater Athens, Greece.

OBJECTIVES: Helmet use is the best preventive measure available against two wheel motorized vehicle (TWMV) related head injuries. In some countries, however, helmets are used only by a minority of TWMV riders. In collaboration with the Road Traffic Police Department, an inspection survey was undertaken to assess the prevalence and to determine predictors of helmet use. SETTING: The Greater Athens area, Greece, during July and August 1998. METHODS: A total of 982 TWMVs were stopped, 349 of which had two riders (36%). All riders were interviewed by staff members of the Centre for Research and Prevention of Injuries among the Young. RESULTS: The average prevalence of helmet use was 20.2%. It ranged from 9.7% on small suburban roads to 50.8% on highways. Prevalence of use was significantly lower during the weekend days and at night. Women were significantly more likely to wear a helmet and, controlling for gender, drivers were significantly more likely to be helmet users. Riders of more powerful TWMVs and passengers, who themselves had a TWMV driving license, were helmet users more frequently. Among non-users, the majority (46%) indicated that "the helmet made them feel uncomfortable", particularly in warm weather, whereas 18% claimed that there was little need for a helmet in low speed riding. CONCLUSIONS: A multipronged campaign is urgently needed in Greece to increase the prevalence of helmet use by TWMV riders. The campaign should include not only police enforcement but also initiatives to make helmets more convenient to wear and less expensive.

Adult↗
PubMed1981

The falling twin rate in Greece.

A significant fall of 33% has occurred in the incidence of twins in Greece over the past 45 years. In 1933-5 the twinning rate in the whole country was 14.3 per 1000; in 1974-6 it was 9.6 per 1000. The decline was smaller in Greater Athens than in rural and urban areas outside the city. Changes in the fertility behaviour of the women of Greece, a reduction in parity, and the shorter reproductive life of mothers, were the main reasons for the decline in the incidence of twins. The pattern of change has been different in the rural and urban populations outside Athens, which explains the steeper decline in the twinning rate in those areas.

Birth Rate↗
PubMed2001

Epidemiology of seropositive myasthenia gravis in Greece.

OBJECTIVES: To study the epidemiological characteristics of myasthenia gravis in Greece. METHODS: A population based study was carried out of seropositive myasthenia gravis in Greece for the period from 1 January 1983 to 30 June 1997; 843 patients were studied. RESULTS: The average annual incidence for the period 1992-7, for which the database is complete, was 7.40/million population/year (women 7.14; men 7.66). On 1 July 1997, there were 740 prevalent cases. The point prevalence rate was 70.63/million (women 81.58; men 59.39). The average overall annual mortality rate in the patients was 0.67/million population (women 0.53; men 0.82), and the mortality rate attributed to myasthenia gravis was 0.43/million population (women 0.41; men 0.45). The average age at onset was 46.50 years (women 40.16; men 54.46), and the mean age of the prevalent patients was 52.58 (women 47.65; men 59.48). The women:men incidence ratio was 1:1.04, and the prevalence ratio was 1.41:1. It is predicted that the prevalence and women: men prevalence ratio would increase if the patient list included all patients with a date of onset before 1983. CONCLUSIONS: The largest epidemiological study ever performed on myasthenia gravis is presented. The most important epidemiological indexes are provided.

Adolescent↗
PubMed2005

Assessing the secular trends in the transmission of HIV in Greece.

OBJECTIVE: To evaluate the current trends in HIV transmission in Greece. METHODS: A retrospective study of HIV infected individuals reported to the Hellenic Center for Infectious Diseases Control (HCIDC) was conducted. RESULTS: Since the beginning of the epidemic in Greece and until early 1990s most cases concerned men who have sex with men (MSM). After the mid-1990s the proportion of homosexual males among HIV positive individuals decreased slightly, then was stabilised but they still remain the dominant population among HIV positive people. On the other hand, heterosexual transmission increased steadily and has become a frequent route for the spread of HIV/AIDS in recent years. Individuals originating from or travelling to countries where this mode of transmission prevails were the most frequent cases in this category. A significant proportion of cases classified as "undetermined" were also recorded and were partially attributed to the increased heterosexual transmission among people (especially women) without obvious high risk behaviours. CONCLUSIONS: The HIV/AIDS surveillance system must evolve in order to find the new unreported risk information and identify the population groups at higher risk. This will help to implement preventive policies and information campaigns addressed to target populations with special attention paid to immigrants, women, and marginalized communities.

Emigration and Immigration↗
PubMedDate not supplied

Changing patterns of attempted suicide in Greece: clinicoepidemiological and psychodynamic data.

Greece is known to have one of the lowest rates of both completed and attempted suicides. Yet during the last three decades the pattern of suicide attempts has shown some differentiations, which point to possible changes in family structure and social behavior, bringing the pattern closer to that of western countries. While in 1971-72 the ratio of male to female attempters was 1:4.6, in 1994-96 it was 1:2.3 - the mean age rose from early to middle adulthood - more married people attempted suicide than before - more attempters took alcohol before the act etc. There are, nevertheless, many steady features, e.g. the low rates of attempters in old age (above 65 years: 7.9% of the total), the methods used, the type of preceding stressful life events (more financial than emotional in males), no drug abuse etc. Since the low rates of suicide attempts in Greece have been attributed to cultural parameters and the close bonds in the family, psychodynamic studies were also carried out, which showed that adolescent attempters preserve the ability for outward aggression and their self-destructive act is due to other than intrapsychic factors (usually social and relational problems).

Adolescent↗
PubMedDate not supplied

Prelingual nonsyndromic hearing loss in Greece. Molecular and clinical findings.

Mutations in the gene encoding the gap-junction protein connexin 26 (GJB2) on chromosome 13q11 have been shown as a major contributor to prelingual, sensorineural, nonsyndromic deafness. One specific mutation, 35delG, has accounted for the majority of the mutations detected in the GJB2 gene in Caucasian populations and is one of the most frequent disease mutations identified so far with highest carrier frequency of 3,5% in the Greek population. In a collaboration with the major referral centers for childhood deafness in Greece, patients were examined by an extensive questionnaire to exclude syndromic forms and environmental causes of deafness and by allele-specific PCR for the detection of the 35delG mutation. The 35delG mutation was found in 32.1% of the alleles in 173 unrelated cases of prelingual deafness: 50 homozygotes and 11 heterozygotes. Individuals heterozygous for the 35delG mutation were further analyzed by direct genomic sequencing of the coding region of the GJB2 gene, which revealed R184P and 486insT mutations in single alleles. We conclude that the 35delG GJB2 mutation is responsible for one third of prelingual, sensorineural deafness in Greece, which is higher than the usually quoted 20% for Caucasian populations.

Audiometry, Pure-Tone↗
PubMed2007

The effect of dietary habits and socioeconomic status on the prevalence of iron deficiency in children of northern Greece.

BACKGROUND: Despite encouraging reports concerning the declining prevalence of iron deficiency, this easily preventable disorder is still an existing problem in presumably developed regions. OBJECTIVE: To evaluate the prevalence of iron deficiency and relevant anemia in children residing in Northern Greece and to study possible associations. DESIGN: 3,100 children aged 8 months to 15 years were evaluated. Socioeconomic status was determined based on the parents' profession and place of residence. Nutrition habits were also evaluated. RESULTS: The incidence of iron deficiency was found to be 14% and that of iron deficiency anemia was 2.9%, with a higher prevalence in children younger than 2 years of age. The place of residence was the most significant factor in relation to the development of iron depletion in the children studied. Additional independent factors were revealed to be breast-feeding, meat-containing meal consumption and the consumption of non-home-cooked meals. CONCLUSION: Iron deficiency remains prevalent in Northern Greece, mainly affecting the vulnerable toddler group. Nutritional iron deficiency is still a severe public health problem even in what are considered to be developed regions. An improvement of dietary habits and an upgrading of semiurban areas should contribute substantially to decreasing the prevalence of iron depletion in Greek children.

Anemia, Iron-Deficiency↗
PubMed1989

Prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece. A direct epidemiological study.

In a direct (door-to-door) epidemiological study, the prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece, was found to be 995 strokes per 100,000 inhabitants over 20 years of age. This number is considerably lower than the prevalence rate (1,417 strokes per 100,000 inhabitants over 20 years of age) found in the urban population of the same county (Patras, Greece).

Adult↗
PubMed1984

Enzyme polymorphism in placentae from northern Greece.

Variations at the PGM1, GOTm, GOTs, and EsD loci were studied in placental samples from Northern Greece. The gene frequencies of GOTm and GOTs were found to be comparable with frequencies reported in other Caucasian populations. The frequencies of the EsD and PGMa11 alleles, however, were lower in Northern Greece than in other European populations.

Alleles↗
PubMed1975

Incubation as a form of psychotherapy in the care of patients in ancient and modern Greece.

Incubation or temple sleep in sanctuaries of Aesculapius, Amphiaraos, Trophonios, etc., for the care of patients was practised even in the older times of ancient Greece and may be viewed as a form of psychotherapy and especially as 'dream-psychotherapy'. In Greek antiquity, as it is known, dreams were considered as a way of communication between gods and men. Survival of the custom of incubation exists even in our times in modern Greece, but are disappearing slowly. An attempt is made to find an explanation, if any, of those miraculous cures in accordance with the scientific thought of today.

Dreams↗
PubMed1981

Prevention of chronic mental disorders in Greece.

A critical review of the post-war development of the prevention of chronic mental disorders in Greece offers useful information for the future. Present-day experience and knowledge--both in Greece and internationally--allow plans to be made on a national scale. A careful study of priorities will enable the appropriate measures to be financed and applied in stages, thus ultimately benefiting the chronic mental patient.

Chronic Disease↗
PubMed1999

Stroke incidence and case fatality in southern Greece: the Arcadia stroke registry.

BACKGROUND AND PURPOSE: For Greece, information on incidence of stroke and distribution of type of stroke has not been reported. We determined the incidence of first-ever stroke in men and women, the incidence of stroke by type, and the associated case fatality. METHODS: A population-based registry was established in the Arcadia province, located in eastern central Peloponessos, in the southern part of Greece. Between November 1, 1993, and October 31, 1995, all subjects with a first-ever stroke were identified. For case ascertainment, information from death certificates, hospital records, public health centers, and general practitioners was used. RESULTS: During a 24-month period, 555 subjects with a first-ever stroke were registered. The incidence rates (per 100 000) by age group (18 to 34, 35 to 44, 45 to 54, 55 to 64, 65 to 74, 75 to 84, >/=85 years) for men were 5, 31, 113, 240, 662, 1275, and 3218, respectively. For women, the rates were 11, 18, 48, 196, 478, 1166, and 2137, respectively. Age- and sex-standardized to the European population, the annual incidence rate for subjects aged 45 to 84 years was 319.4/100 000 (95% CI, 283 to 356). In men, cerebral infarction was diagnosed in 81% of cases, intracerebral hemorrhage in 16%, and subarachnoid hemorrhage in 2%. For women, these figures were 85%, 12%, and 3%, respectively. The 28-day case fatality rate was 26.6% (95% CI, 22.9% to 30.2%), with no differences between men and women. Case-fatality increased with age and was higher for intracerebral hemorrhage than for cerebral infarction. CONCLUSIONS: The incidence of stroke in our population-based study ranks low part compared with other European studies. The distribution of stroke types and case fatality rate appear to be similar to those of other industrialized countries.

Adolescent↗
PubMed1986

Recent developments in the care, treatment, and rehabilitation of the chronic mentally ill in Greece.

The chronic mentally ill in Greece are primarily cared for in large public mental hospitals or by their families because of the absence of community-based alternatives and the centralization of existing services in Athens and Thessaloniki. However, in the last decade new legislation to improve the lives of the chronically ill has been passed, additional day care facilities have been opened, and the development of decentralized mental health services has been scheduled by the National Health System. A case report illustrates the care provided at Greece's first community mental health center, established in 1979 in Athens.

Chronic Disease↗
PubMedDate not supplied

The control of dyslipidemia in outpatient clinics in Greece (OLYMPIC) Study.

The objective of this study was to determine the proportion of Greek patients referred to outpatient clinics for dyslipidemia who achieved the low-density lipoprotein cholesterol (LDL-C) goal defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guidelines, using lifestyle changes, lipid-lowering drug treatment (LLDT), or both. Adult patients with dyslipidemia, who had been receiving a hypolipidemic diet and/or LLDT for at least 3 months were assessed in a multicenter study performed at 66 sites across Greece. Patients were followed up for an additional 3-month treatment period. Lipid levels were recorded at baseline and at the end of the study. The primary endpoint was the proportion of patients achieving their individual LDL-C target at the end of the study, according to their coronary heart disease (CHD) risk status or its equivalents, as defined by the NCEP-ATP III guidelines. Multivariate logistic models were used to identify determinants of undertreatment. The study included 2,660 adults (20-75 years) from 7 regions of Greece. Of the evaluable sample (n = 2,211; men 51%; mean age 62 +/-9 years) 81% were receiving LLDT (96% with statins and 3% with fibrates), 44% had a history of CHD, 61% arterial hypertension, 36% diabetes, and 26% a family history of premature CHD. Overall, 6% were at low CHD risk, 30% at medium CHD risk, and 63% at high CHD risk. At the end of the study, 26% of all patients and 30% of those receiving LLDT achieved the NCEP-specified LDL-C target levels. The percentage of patients at LDL-C goal according to CHD risk status was: low risk 67% (95% CI = 59-75), medium risk 29% (95% CI = 26-33), and high risk 20% (95% CI = 18-22). Statins proved to be more effective than fibrates (p <0.0001). Atorvastatin-treated subjects (n = 1,222, mean dose 19 mg/day) attained the LDL-C target (31% of the cases) at a higher rate than those receiving other LLDT (n = 574, 26% at target, p <0.01) or not receiving drug treatment (n = 415, 8%, p <0.001). This outcome was more evident in the high-CHD risk group (n = 1,402, 26% with atorvastatin vs 16% with other LLDT and 3% not receiving LLDT attained the LDL-C goal, ANOVA, p <0.001). The majority of dyslipidemic patients receiving LLDT, mainly those with high-CHD risk, are not achieving the NCEP LDL-C target. This is mainly explained by inadequate dose titration to ensure target goals are met. Promoting healthy lifestyle and appropriate LLDT (potent statins with sufficient dose titration) must be implemented to ensure that patients attain LDL-C treatment goals and thus benefit from the reduction in individual CHD risk.

Adult↗