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PubMed1998

The epidemic of Athens, 430-426 BC.

The Athenian epidemic of 430-426 BC, at the outbreak of the Peloponnesian War, caused the death of the great statesman, Pericles, decimated the population and contributed significantly to the decline and fall of classical Greece. In his remarkable documentation of the epidemic, Thucydides (who survived the disease) not only left us a clear clinical picture of the pestilence but also identified its infectious nature and the fact that it conferred at least partial immunity on survivors. As confirmed by a large number of scholars who studied the subject, Thucydides' description does not accurately fit any existing disease, but we suggest that analysis of the signs and symptoms, considered in conjunction with significant epidemiological evidence, narrows down the many possibilities to epidemic typhus, plague, arboviral disease (e.g. Rift Valley fever) and smallpox. Typhus and smallpox fit best, but we favour the latter for reasons given. Unless further primary sources of information become available (and this seems most unlikely), productive speculation as to the cause of Thucydides' epidemic has probably reached the end of the road.

Arbovirus Infections↗
PubMedDate not supplied

Personal exposures to PM(2.5) and polycyclic aromatic hydrocarbons and their relationship to environmental tobacco smoke at two locations in Greece.

In the context of a large-scale molecular epidemiology study of biomarkers of genotoxicity of air pollution, 24-h mean personal exposures to airborne PM(2.5) (particulate matter <2.5 microm) and associated polycyclic aromatic hydrocarbon (PAHs) were measured in 194 non-smoking technical institute students living in the city of Athens, Greece (an area with moderately high levels of air pollution) and the nearby small town of Halkida anticipated to have lower pollution levels. Extensive information relevant to the assessment of long-term and recent exposure to PAH was obtained from questionnaires as well as a time-location-activity diary (TLAD) which was kept by all subjects during a 4-day observation period. During the last 24 h of this period, subjects underwent personal exposure monitoring for PM(2.5) and PAH, while a sample of blood was donated at the end of this period. All subjects were monitored in this way twice; once during a winter season (October-February) and once during the following summer season (June-September). Nine subjects with plasma cotinine levels above 20 ng/ml were considered as unreported smokers and excluded from the study. Winter PM(2.5) exposures were lower in Athens (geometric mean 39.7 microg/m(3)) than Halkida (geometric mean 56.2 microg/m(3)) (P<0.001), while there was no significant location difference during the summer (Athens: geometric mean 32.3 microg/m(3), Halkida: geometric mean 32.9 microg/m(3); P=0.79). On the other hand, PAH exposures (sum of the eight carcinogenic PAHs) were significantly higher in Athens than in Halkida during the winter (Athens: geometric mean 8.26 ng/m(3), Halkida: geometric mean 5.80 ng/m(3); P<0.001) as well as during the summer (Athens: geometric mean 4.44 ng/m(3), Halkida: geometric mean 1.48 ng/m(3); P<0.001). There was a significant difference in the profile of the PAH exposures at the two locations, the proportion of lighter PAH (benzo[a]anthracene, chrysene [CHRYS], benzo[k]fluoranthene, and benzo[b]fluoranthene) being higher, and that of heavier PAH (benzo[ghi]perylene [BPer] and indeno[1,2,3,cd]pyrene) lower, in Halkida than in Athens, regardless of season. This difference appeared to be related to individual exposure to environmental tobacco smoke (ETS), as indicated by (a) the correlation at the individual level between the CHRYS/BPer ratio and declared time of recent exposure to ETS as well as plasma cotinine levels, especially during the winter; (b) the parallel variation of the mean levels of all three markers (declared ETS exposure, cotinine levels, CHRYS/BPer ratio) among three subgroups of subjects (Athens subjects who had lowest levels of all three markers; Halkida subjects other than those living in the institute campus area; and Halkida subjects living in the institute campus area who had the highest levels of all three markers). This demonstrates that ETS can have a distinctive effect on the PAH exposure profile of subjects exposed to relatively low levels of urban air pollution.

Adult↗
PubMed2002

Environmental surveillance of filamentous fungi in three tertiary care hospitals in Greece.

The environmental fungal load (FL) of three hospitals was studied in representative regions in Greece (Thessalonika, Northern Greece, Athens, Central Greece and Heraklion, Southern Greece). Air, surfaces and tap water from high-risk departments were sampled monthly during one year. Air FL was [median (range)] 10.6 (1.2-37), 5.5 (3-28.8) and 7.7 (3.1-12.1) cfu/m(3) at Thessalonika, Athens and Heraklion, respectively. Air FL was lower in winter and higher in summer and autumn but seldom above acceptable levels. Aspergillus spp. constituted 70.5% of the filamentous fungi isolated. Aspergillus niger was the most prevalent species in the air of all the hospitals followed by Aspergillus flavus and Aspergillus fumigatus. The least contaminated departments were the intensive care units, whilst most contaminated were the solid organ transplantation in Athens and haematology departments in Thessalonika. No correlation between fungal species, season, hospital or departments was observed. Sixty per cent of all surfaces examined yielded filamentous fungi and/or blastomycetes. While no fungi were recovered from water in Thessalonika and Athens, one-third of the samples in Heraklion (apart from those of ICU) yielded multiple fungal species. The higher air FL in Thessalonika and Athens was recorded in departments located close to renovation works. These findings suggest that the air and surface FL fluctuates over the year, is due to varying fungal species, but does not differ greatly among hospitals. The variation among hospitals, as well as the role of hospital water fungal contamination and appropriate measures to eliminate it, need further study.

Air Microbiology↗
PubMedDate not supplied

A case-control study of endometrial cancer in relation to reproductive, somatometric, and life-style variables.

A hospital-based case-control study of cancer of the endometrium was conducted in Athens, Greece, from 1992 to 1994. The cases were 145 women residents of Greater Athens with histologically confirmed incident cancer of the endometrium, operated in the two cancer hospitals of the Greater Athens area or the major University Department of Obstetrics and Gynecology. Controls were 298 women residents of Greater Athens hospitalized for bone fractures or other orthopedic conditions in the accident hospital of Greater Athens. The data were analyzed by modeling through multiple logistic regression. The risk of endometrial cancer decreased with the number of livebirths (p for trend < 0.01), with early age at menopause (p = 0.03), and with later age at menarche (p = 0.11), whereas miscarriages and induced abortions were clearly unrelated. There were nonsignificant relations of disease risk with smoking (inverse), alcohol (inverse), and menopausal estrogens (positive), whereas oral contraceptive use was too uncommon to allow meaningful study. The lower risk of the disease associated with current occupations requiring manual activity (p = 0.03) and the lower, although not significantly so (p = 0.36), energy intake of cases in comparison to controls suggest that physical inactivity could be an important risk factor for endometrial cancer. Women with endometrial cancer were significantly taller than control women (p = 0.02). The latter results indicate that excess energy intake in early life, leading to higher attained stature, and excessive energy intake in later life, on account of physical inactivity and leading to higher body weight, converge in increasing the risk for endometrial cancer.

Adult↗
PubMedDate not supplied

Benediktos Adamantiades and his forgotten contributions to medicine.

Benediktos Adamantiades was born in Prousa, Asia Minor in 1875, studied at the Medical School of the University of Athens and specialised in ophthalmology in Paris. After being director of the Ophthalmology Department of Hippocration Hospital in Athens he developed significant scientific activities. During the annual meeting of the Medical Society of Athens on November 15, 1930, Adamantiades presented "A case of relapsing iritis with hypopyon" identifying the three major signs of the so called Adamantiades-Behçet's disease and insisting on a single clinical entity. In the same year, his lecture was published in the Proceedings of the Medical Society of Athens, and in 1931 in the French journal Annales d'Oculistique. In the year 1946, Adamantiades defined thrombophlebitis as the 4th major sign of the disease. Later, he presented the first classification of the disease by describing the ocular, mucocutaneous and systemic forms in a review work. He pointed out that the disease can occur for years as a monosymptomatic or oligosymptomatic disorder and that eye involvement and severe prognosis are more common in men than in women. In this work he also proposed the first diagnostic criteria. In addition to Adamantiades-Behçet's disease, Adamantiades described the interstitial keratitis in trachomatic patients to be a bacterial infection and classified the epidemic idiopathic hemeralopia. Further pioneer works were those on the marginal corneal degeneration, the posterior vitreous detachment, the measurement of the optic fundi and of the ocular pressure as well as investigations on trachoma and the pathogenesis of glaucoma. Adamantiades compiled over 150 scientific papers many of which marked a new stage in his field. He died in 1962 in Athens.

Behcet Syndrome↗
PubMed1993

Reproductive variables, tobacco, ethanol, coffee and somatometry as risk factors for ovarian cancer.

A hospital-based case-control study of ovarian cancer was conducted in Athens from 1989 to 1991. The cases were 189 women, residents of Greater Athens and less than 75 years old, with histologically confirmed common malignant epithelial tumors of the ovary, operated in the 2 major cancer hospitals of the Greater Athens area. Controls were women residents of Greater Athens, less than 75 years old, who had never had cancer or had an ovary removed and who had visited patients hospitalized in the same wards as the ovarian cancer cases at the same time. The data were analyzed by modeling through multiple logistic regression. Statistically significant associations were found with induced menopause without oophorectomy [relative risk (RR) 0.17; 95% confidence interval (CI) 0.04 to 0.72], age at menopause (for an increment of 5 years RR 1.42; CI 1.00 to 2.01), hormone-replacement therapy (RR 5.73; CI 1.07 to 30.80), parity (RR 0.48; CI 0.24-0.96) and, marginally, age at first birth (for an increment of 5 years RR 1.30; CI 0.99 to 1.70). Non-significant but previously suggested or biologically plausible associations were noted with use of oral contraceptives (inverse), weight before onset of the disease (positive), and consumption of more than 2 glasses of alcoholic drinks per day (positive). There were no consistent associations with coffee, tobacco, moderate alcohol intake, broad occupational group, induced abortions, or age at menarche.

Adult↗
PubMed2000

The occurrence of trihalomethanes in the drinking water in Greece.

This paper summarizes and completes an investigation into the occurrence of trihalomethanes (THMs) in public water supplies in Greece. The investigation was conducted in three cities of Greece, Athens, Mytilene and Chalkida, from 1993 to 1998. Samples were collected from three treatment plants of Athens (Galatsi Treatment Plant--GTP, Menidi Treatment Plant--MTP, Kiourka Treatment Plant--KTP) and from the distribution systems of Athens, Mytilene and Chalkida. The sources for these systems are lakes, boreholes and wells. The concentrations of THMs ranged from 5 to 106 microg/l, from 4 to 27 microg/l and from 5 to 96 microg/l, in the distribution systems of Athens, Mytilene, Chalkida, respectively. The wide ranges of concentrations in three cities should be attributed to the organics concentration of raw water. In all the cases the THMs concentrations were higher during the summer and fall than in spring and winter. In GTP and in the distribution system receives water by GTP, from April 1993 to January 1995, Mytilene and Chalkida, brominated THMs dominated and existed at the highest concentration levels, whereas chloroform was the least prevalent compound, while in all the other cases the opposite was observed. In all samples the concentrations were lower than the maximum level of 100 microg/l for total trihalomethanes (TTHMs) set by European Community (EC).

Chlorine↗
PubMed2003

Background ozone monitoring and phytodetection in the greater rural area of Corinth--Greece.

Natural background ozone levels were monitored in three places within the greater rural area of Corinth, namely Bogdani Hill, Astronomical Observatory of Krionerion, and Kiato, and compared with ambient ozone monitored in the metropolitan area of Athens. Measurements were made sequentially, for a few weeks at each place, during the summer of 2000. In addition, ozone phytodetection, using tobacco (Nicotiana tabacum L.) plants of the Bel-W3 and Zichnomirodata varieties, was conducted in 12 places (the above included). Moreover, stomatal conductance was measured in the Bel-W3 plants, as well as in leaves of cultivated grape-vines (Vitis vinifera L.) and in needles of Aleppo pine (Pinus halepensis Mill.) trees and compared with the diurnal pattern of ozone concentrations. The 24 and 12 (08:00-20:00) hourly averages of ozone concentrations were high in Athens (37; 51 ppb), at Bogdani Hill (53; 56 ppb) and at the Astronomical Observatory (56; 55 ppb), but relatively low in Kiato (30; 34 ppb). Furthermore, the average daily AOT40 (accumulated exposure over 40 ppb for the daylight hours) (ppbh) was 193 in Athens, 212 at Bogdani Hill, 192 at the Astronomical Observatory and 47 in Kiato. Ozone concentrations exhibited the usual diurnal pattern in Athens (altitude 50 m), where they were maximum during midday and early afternoon hours, as well as at Bogdani Hill (300 m) and in Kiato (5 m) where, however, they were maximal 1-3 h later. At the Astronomical Observatory (altitude 920 m) ozone remained constant during both daylight and night hours. The differences in diurnal patterns are consistent with those in places of different elevation, reported elsewhere. The Bel-W3 plants were injured at all 12 places; Zichnomirodata plants exhibited lower injury and only in some of the places; probable ozone symptoms were also observed on vine plants and pine trees. The greatest injury was observed at the high altitude places of Astronomical Observatory and Mougostos. Stomatal conductance, in all three species, peaked during morning and early midday hours when ozone levels were higher in the high altitude, and lower in the low altitude, places.

Environmental Monitoring↗
PubMed2006

Modelling atmospheric pollution during the games of the XXVIII Olympiad: effects on elite competitors.

UNLABELLED: The present study investigated the specific atmospheric conditions expected in Athens during the summer of 2004 in relation to the performance of elite athletes. DESIGN: Atmospheric pollution and weather data for the period April 16th to September 30th covering the entire greater Athens area and collected from 1984 to 2003 were used for descriptive statistics and model fitting. The analysis was focused on carbon monoxide (CO), ozone (O3), sulfur dioxide (SO2), nitrogen oxide (NO), nitrogen dioxide (NO2), and particulate matter with a diameter of < 10 microm (PM10). Factor and cluster analysis were used to describe atmospheric pollution in the northern, central, and southern sector of Athens. Generalized estimated equations (GEE) analysis was used to predict mean August 2004 pollutant concentration. Increased concentrations of O3 and PM10 (mean 2003 values: 134.3 +/- 9.3, 44 +/- 1.9 microg/m3, respectively) may generate adverse health and performance effects. The highest O3 values were recorded in the northern Athenian sector during the period June 12th to July 23rd, peaking around mid-day (12:00-18:00) (p < 0.05). The highest PM10 concentrations were recorded in the central Athenian sector during the period August 20th to September 9th, peaking at late afternoon (14:00-22:00) (p < 0.05). Similar concentrations were observed during all days of the week (p > 0.05). GEE approximated mean August 2004 pollutant concentrations similar to: CO: 2.8 (mg/m3), O3: 136, SO2: 24, NO: 134, and NO2: 106 (microg/m3). Concentrations of O3 and PM10 during the XXVIII Olympiad may generate adverse health and performance effects on the cardiovascular function of the elite competitors. (The present manuscript was submitted shortly before the start of the Games and became published after their completion. In this light, the actual pollution rates in Athens during August 2004 are presented in the Note Added in Proof as credence to the statistics used).

Air Pollutants↗
PubMed1978

Iodide organification defect in iodine deficiency endemic goiter.

In 17 goitrous persons in an iodine-deficient area, in 23 nongoitrous inhabitants of the same village, in 10 goitrous persons in Athens, and 8 normal controls the perchlorate discharge test was performed, either in the simple standard form or after pretreatment with either 0.5 or 2.0 mg potassium iodide or 2.5 mg carbimazole. With the simple test or with 0.5 mg potassium iodide, there was no significant discharge in any group studied. With 2.5 mg carbimazole, there was a profound discharge of the trapped iodide in both groups in the iodine-deficient area. With 2.0 mg potassium iodide, however, there was a clear discharge in the two goitrous groups (i.e. the one in the endemic area and the second in Athens), a less pronounced discharge in the controls studied in Athens, and no discharge at all in the nongoitrous inhabitants of the iodine-deficient endemic area. These findings provide evidence for an abnormality present in the patients with endemic goiter, most probably faulty iodine utilization due to impaired organic binding. The nongoitrous persons in the endemic areas, on the other hand, seem to be even more efficient in handling the trapped iodide than the controls studied in Athens. These findings may provide an explanation for previous observations that in endemic areas only part of the population develop a goiter, whereas the others adapt successfully to iodine deficiency without significantly enlarging their glands.

Child↗
PubMed1995

Egg characteristics, carbohydrate metabolism, and thyroid hormones in late chick embryos from different genetic lines.

Functional eggshell qualities, thyroid hormones, and carbohydrate metabolism of chick embryos at the end of incubation were compared between a modern (Arbor Acres line) and a randombred control population (Athens-Canadian Randombred). Embryos from the Arbor Acres genetic line developed in larger eggs with more albumen and less yolk than Athens Canadian Randombred lines. Percentage shell and functional eggshell properties measured as eggshell conductance constants did not differ between genetic lines. On a relative basis, hearts were generally smaller and livers heavier in Arbor Acres than in Athens-Canadian Randombred birds. Heart and liver glycogen concentrations were greater in Athens-Canadian Randombred than in Arbor Acres embryos. However, blood glucose was greater in Randombred than in Arbor Acres embryos only at internal pipping, a time of hypoxia and hypercapnia. Blood plasma concentrations of thyroxine did not differ significantly between the modern and Randombred embryos at any stage examined. Modern broiler chick embryos possessed greater concentrations of triiodothyronine as well as greater triiodothyronine to thyroxine ratios than Randombred embryos at external pipping and hatching. It can be inferred from the data that chick embryos differ in their use of carbohydrate during late development between modern and Randombred genetic lines.

Animals↗
PubMed1996

Life-style factors and medical conditions in relation to esophageal cancer by histologic type in a low-risk population.

A case-control study of esophageal cancer was conducted in Athens, Greece, during the 3-year period 1989-1991. Cases were 43 patients with incident esophageal squamous-cell carcinoma and 56 patients with incident esophageal adenocarcinoma hospitalized in any one of the 9 major hospitals in Athens, whereas controls were 200 injury patients admitted to the only Athens accident hospital. The data were analyzed by modeling through multiple logistic regression. Tobacco smoking and alcohol drinking were associated with both histologic types, but the odds ratios were generally lower than those observed in several other investigations. It may be that the high consumption of vegetables and fruits by the Greek population cushions the deleterious effect of tobacco, while the intake of ethanol in the form of wine during meals reduces the impact of this substance on the esophageal mucosa. A preference for very hot temperature for beverages and food was associated with significant elevation of the odds ratio to about 1.8 for esophageal cancer in general. There was non-significant evidence in our data to support earlier reports that aspirin intake may reduce the risk of cancer of the esophagus. Overall, we found no striking difference in the risk profile of the 2 histologic types of esophageal cancer.

Aged↗