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In this article the level of preventive dentistry performed by dentists in Greece is being discussed. Several items like the composition of the dental curricula, the intake of students and the structure of the health system in Greece are discussed. Furthermore some suggestions for future policy are given.
The diet of ordinary people in Greece and Rome was derived from cereals, pulses, vegetables, fruit, olive oil, milk, cheese and a little fish and meat. This pattern fits well with what we would not regard as a healthy diet. In both Greece and Rome the bulk of cereals had to be imported, with a good deal of government control. The available evidence suggests that the official rations, if fairly distributed, would have provided an adequate energy intake. The cost of luxury foods such as meat, in relation to that of flour, was much higher than in modern times. The expectation of life at birth was only 30-35 years, but it was long enough to allow for children to be born and for the populations to expand. No reliable information has been found about infant and child mortality. The reasons for life on average being so short were probably disease and war, rather than malnutrition. It is difficult to conceive how the Greeks and Romans could have achieved such remarkable feats, which involved far more than a small elite, if they had not in general had an adequate and nourishing diet.
Replantation of complete or incomplete nonviable amputations of digits, hands, and major limbs along with a number of reconstructive microsurgical procedures reflect the work that has been done in the field of orthopedic microsurgery in Greece during the last ten years. The history of trauma microsurgery in Greece starts in the mid-1970s, when the first attempts were directed toward patients with complete or incomplete nonviable amputations of digits and hands. Few cases of major limb replantations without the aid of an operating microscope or other means of magnification have been reported for the years 1965-1975. The first successful digital replantation was performed in 1979 on a female patient with multiple digit amputations; only the little finger was successfully replanted. More than 310 replantations and revascularization procedures have been performed during the past decade, mainly in two major replantation centers, with an overall success rate of 85% for complete and 90% for incomplete nonviable amputations. Reconstructive microsurgical procedures are mainly related to free skin flaps, vascularized bone grafts, toe-to-thumb transfer, and peripheral nerve microsurgery.
Sarcoidosis is being increasingly recognised in Greece. The clinical spectrum and the epidemiological data of 62 sarcoid patients of the West department of Greece are analysed for the first time. These patients have been studied over the last 10 years. Young females outnumbered males. The diagnosis was histologically confirmed in all the patients. Intrathoracic involvement was present in 98% of the patients (stage I 70%, stage II 20%, stage III 10% respectively). Skin lesions were present in 65%, lymphadenopathy 26%, uveitis 21%, joints 15%, and nervous system involvement 5%. Kveim test was positive in 60% of the patients, while 60% were tuberculin negative. Steroids were used in 50%. In the initial symptoms of the diagnostic period resolution occurred in 60% of them. For the period of follow-up the mortality was 3%.
The authors have accomplished an epidemiological clinical and genetic study on primary open-angle glaucoma among 411 persons in the North Western district of Greece (Epirus), belonging to 4 genealogical trees. 112 of the 411 persons were offsprings aged 30 years or more, alive or dead, and they had direct blood-relation to the propositus. 35 of these offsprings were suffering from primary open-angle glaucoma. The classification and the number of the affected subjects suggested that one major gene, expressed by the autosomal dominant character, is the main factor for the heredity of primary open-angle glaucoma in Epirus-Greece.
From contemporary clinical accounts we hypothesized that the 1928 dengue epidemic in Greece may have been an earlier occurrence of dengue hemorrhagic fiver/dengue shock syndrome (DHF/DSS). To study the possibility that two different dengue viruses may have been involved, serums from 62 Athenians alive during the epidemic were examined for dengue antibodies; 73 per cent showed evidence of prior dengue infection. Monotypic neutralizing antibodies were found to two different dengue viruses, types 1 and 2. A large proportion of the sampled population had evidence of two or more past dengue infections. Since there is no evidence that dengue viruses have been transmitted in Greece since 1928, during the epidemic a very large number of persons immune to one dengue type must have acquired infections with a secon type. The virological criteria for secondary infection DHF/DSS are thus satisfied. Although DHF/DSS is currently restricted to Asia and the Pacific, the Greek oubreak suggests a biological potential for fatal consequences of dengue infections in Caucasians, particularly the elderly.
Multidimensional epidemiological research on drug use in Greece comprising five studies--a study of known cases, a general population survey, a survey of high school students, a study of imprisoned drug addicts and a case identification study--has been undertaken by the Department of Psychiatry, University of Athens. This article summarizes preliminary results obtained in the study of known cases and the general population survey. A study of prevalence of known cases identified 9,689 cases of drug use in Greece (8,821 males and 868 females) who came to the attention of the authorities in 51 counties of the country from 1973 to 1983. Average-age adjusted rates of known drug users per 100,000 were 50 for males and 3 for females. Cannabis resin was the drug most often used by males and heroin and other opiates by females. The average age was 35.7 for male and 31.2 for female drug users. A nation-wide general population survey of drug use, carried out in 1984 on the basis of a probability sample covering the population aged 12 to 64 years, showed that at some time in their lives 5.5 per cent of the respondents (9.1 per cent of the males and 2.5 per cent of the females) used illicit drugs and 11.1 per cent (6.5 per cent of the males and 14.9 per cent of the females) licit drugs. Cannabis resin was the most frequently used illicit drug by both male and female respondents.(ABSTRACT TRUNCATED AT 250 WORDS)
The seasonal variation of birth rates in Greece was studied for the years 1956-1979. The relatively constant pattern of the period 1956-1974 (with peak in January and February) turned abruptly into a new one (peak in May-July) for the following years. Whereas the seasonal variation of the first period could be explained as an effect of sociocultural (religious) factors on the rate of conceptions, no explanation was found for its change or for the new pattern. Regional differences between NW and SE Greece were also studied. Seasonal factors and their changes were almost similar in both regions.
In relation with the recent outbreak of leishmaniasis in Greece, the authors undertook entomological investigations for delimiting the foci of transmission. A first survey, during june 1977, in continental Greece, gave 6 633 sandflies with 21% of P. major and 20% of P. perfiliewi. Captures are analysed for each species with systematic and epidemiological comments.
Over the last 13 years 2745 patients from all over Greece suspected to have a lysosomal storage disorder were referred to the Institute of Child Health. 1581 of those were suspected of having a mucopolysaccharidosis (MPS). 94 cases (3.42% of the total referrals) were positive: 36 patients with MPS, 6 with mucolipidosis (1 type I, 1 type II and 4 type III) and 3 with mannosidosis. Sanfilippo B was not only the most frequent type III MPS but also the most frequent MPS identified in our study. Sphingolipidoses and other lysosomal disorders were diagnosed in 47 cases and non-lysosomal disorders in 19 cases. In our experience Gaucher disease, Sanfilippo B and Hunter syndrome are the most frequent lysosomal disorders in Greece accounting for 23.4%, 17.0% and 7.6% respectively of all diagnosed cases. 13% of the patients originated from Thessaly including 5/16 Sanfilippo B, 2/3 Morquio B, 2/3 Maroteaux-Lamy, 2/6 Metachromatic leukodystrophy and 2/12 Gaucher type 1.
A study of the literature and mosquito collections in Greece has yielded 3 species that have not been recorded from Greece. They are Aedes annulipes, Aedes berlandi, and Culex pusillus. Notes on their recognition and geographic distribution are also given.
Heterozygotes for beta-thalassemia usually have raised levels of HbA2, but in Greece about 5% of beta-thalassemia carriers are observed to have normal or borderline levels. It is postulated that such cases have mild beta+ thalassemia mutations or coinheritance of delta-thalassemia. We selected 18 heterozygotes with the hematological phenotype of normal HbA2 (type 2) beta thalassemia who were negative for the delta beta Corfu mutation, and screened them for previously defined Mediterranean beta-thalassemia and delta-thalassemia mutations. The coinheritance of beta and delta-thalassemia was demonstrated in four cases with the following genotypes: in cis beta+ IVSII -n745/delta+ 27, beta 0NS39/delta 059(-A), beta+ IVSI-n110/delta 059(-A) and in trans beta+ IVSI-n6 and delta+ 27. A further nine heterozygotes had mild beta(+)-thalassemia mutations (eight with the beta+ IVSI-n6 mutation, one with the beta+ polyA (A-->G) mutation). In four heterozygotes with severe beta-thalassemia chromosomes (2 beta+ IVSI-n110, 1 beta 0 FSC-6, 1 beta 0 IVSI-n1) no known delta-thalassemia mutations were observed. One case had a delta beta deletion chromosome. These results indicate that the hematological phenotype of normal HbA2 (type 2) beta-thalassemia in Greece is genetically heterogeneous; it is mainly associated with the delta beta Corfu mutation or coinheritance of beta and delta thalassemia mutations or with very mild beta(+)-thalassemia mutations, mainly beta+ IVSI-n6. In the rare cases with severe beta-thalassemia mutations, the normal levels of HbA2 may be due to coinheritance of as yet undefined delta thalassemia mutations.
The aim of the study was to compare the systolic and diastolic blood pressures in 525 individuals who had migrated from rural Greece to Melbourne, Australia with those in 367 nonmigrant relatives (all aged 30 to 59 years and still living in the source area), and to relate any differences to previously identified correlates of BP. This migrant family design offers enhanced environmental heterogeneity while controlling in large part for genetic and other familial factors. Migrating siblings differed from nonmigrating siblings on some variables determined at the time of migration but these were not independently associated with BP. Migrants had been in Australia for an interquartile range of 19 to 25 years. DBP was higher in migrants by 4.57 (+/- 0.97) mmHg for males and 2.66 (+/- 0.86) mmHg for females. SBP was not different at age 30 years but increased more steeply with age in the migrants: 0.89 (+/- 0.17) mmHg/yr vs. 0.41 (+/- 0.13) mmHg/yr in males and 1.18 (+/- 0.14) mmHg/yr compared with 0.83 (+/- 0.15) mmHg/yr in females. Significant associations, independent of age, were found only with body mass index and ambient temperature at the time and place of measurement. There was no consistent association with alcohol despite a wide range of exposures, with dietary and psychosocial variables, or with length of residence independent of age. The higher body mass index of and lower ambient temperatures for migrants accounted for differences in mean DBP but not in SBP. Proportions defined as hypertensive were similarly associated only with migrant status, body mass index and temperature. Pressures in Greece were substantially below predictions derived from the Intersalt data set, suggesting unidentified protective factors.
The report presents the available prenatal diagnosis (PND) services in Greece. PND for chromosomal anomalies after amniocentesis was initiated in 1976 and became gradually widely accepted. Chorionic villus sampling was introduced in 1983. Approximately 6,500 women undergo PND for chromosomal anomalies annually, most of them for advanced maternal age. 700 cases are also tested prenatally each year for haemoglobinopathies. The study describes the PND services available in the country, the procedures currently used, the impact of prenatal testing on the prevention of genetic diseases and the legal issues concerning PND in Greece.
Greece, a country of 10.25 million people and about 100,000 births per year, has changed its health care system significantly in the last 10 years and has made substantial improvements in neonatal-perinatal care. Infant mortality decreased from 18/1000 in 1983 to 9/1000 in 1991; neonatal mortality decreased from 15/1000 in 1983 to 6.1% in 1991; perinatal mortality decreased from 23.8% in 1983 to 11.06/1000 in 1991. There are currently 15 neonatal intensive care units in the Greece, with approximately 180 intensive care beds, which are adequately equipped for respiratory support and relatively well staffed with doctors. However, there is a great shortage of nursing personnel, and most neonatal units have an unacceptable ratio of nurses to infants. The goal of health policies for the upcoming years is to promote the regionalization of perinatal care, to increase the number of and personnel for neonatal intensive care units, and to develop several intermediate care units, which will minimize unnecessary admissions to the tertiary neonatal centers.
Keys to the adult females and 4th instar larvae of the mosquitoes of Greece are presented. In all, 53 species in 7 genera are included. Also, Aedes albopictus is added because of the potential for its introduction into Greece.
BACKGROUND: Blood donors are routinely screened for antibodies to human T-cell lymphotropic viruses type I and II (HTLV-I and HTLV-II) in the United States, Canada, Japan, and some European countries. Previous reports from our group in relatively small numbers of donors have shown a zero prevalence of HTLV-I/II markers in our region. In this study, seven blood banks in the north and west of Greece participated in order to determine whether mandatory screening of blood donations for HTLV-I/II infection should be established. METHODS: Sera from 51,714 consecutive donors were investigated for anti-HTLV-I/II using two commercially available enzyme immunoassays (EIAs). Reactive samples in one or both EIAs were repeatedly evaluated further by Western blot, which is specific for both confirmation and differentiation of HTLV-I and HTLV-II seroreactivities. Investigation for HTLV DNA was also done in all EIA-reactive donors, irrespective of the WB result, using a combination assay based on the polymerase chain reaction (PCR) and a DNA EIA. RESULTS: A total of 115 donors (0.222%; 95% CI 0.018-0.26%) were initially considered reactive for anti-HTLV-I/II by EIAs. However, only 7 of the 115 were confirmed as positive by WB (five HTLV-I and two HTLV-I/II). Thus, the prevalence of anti-HTLV-I/II in donors from northern and western Greece was 0.013% (95% CI 0.003-0.023%). Interestingly, the majority of WB-confirmed anti-HTLV-positive individuals were detected in the blood bank of Corfu (5/7, all anti-HTLV-I). This prevalence (5/15383; 0.032%; 95% CI 0.004-0.061%) was six times the prevalence found at the other blood banks combined (2/36331; 0.0055%; 95% CI 0-0.013%), but it was not statistically significant. None of the EIA-reactive donors had detectable HTLV DNA. CONCLUSIONS: The very low prevalence of confirmed anti-HTLV-I/II infection markers in northern and western Greek blood donors, together with the negative PCR results in EIA-reactive subjects, indicates that anti-HTLV-I/I routine screening is not really justified in this area of our country. However, the increased prevalence of WB-confirmed anti-HTLV-I-positive donors in the Corfu blood bank calls for further prospective and careful investigation in order to address whether this finding represents a real cluster phenomenon of HTLV infection.
Oral and pharyngeal cancer (OC) mortality is very low in Greece, especially among men, compared to other European countries. We conducted a case-control study of OC in Athens, and obtained information on tobacco, alcohol use and other potential risk factors and confounding variables for 110 incident cases and 115 hospital-based controls. We used multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tobacco smoking (pack years, P(trend)=0.01) and alcohol use (drinks/week, P(trend)=0.07) were independent risk factors, with a multiplicative effect for combined exposures (OR, 8.3; 95% CI, 2.4-29.1, for >28 alcohol drinks/week and >50 pack years of cigarette smoking). The type of alcoholic beverage also seemed important: drinking ouzo and tsipouro (liquors of high ethanol concentration) was associated with greater increased OC risk than drinking comparable amounts of wine, beer or dark spirits. While alcohol drinking is more common for male cases versus controls, few men reported regularly consuming large quantities of ethanol associated with highest risk of OC in other studies. This may partially explain the low rates of male OC mortality in Greece. Among the 38% of our cases who were women, however, neither smoking nor alcohol drinking frequencies were significantly elevated compared to controls, and so the etiology of OC risk in females requires further investigation.