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Preliminary survey of outdoor gamma dose rates in Lesvos Island (Greece).

This study reports the first attempt to record the radioactive background due to gamma radiation in Lesvos Island (Greece). The study reports the results from 335 outdoor total gamma effective dose rate measurements conducted using GPS navigation and a Geiger-Muller detector (Bicron, Micro Sievert) on the whole surface of the island together with a digital map produced by appropriate mapping GIS programme. The study also reports the measurements of outdoor gamma dose rates due to the 238U, 232Th and 40K radionuclides as estimated via in situ gamma-ray spectrometry measurements performed at 26 sites using a 3 x 3 inch NaI (thallium activated) portable detector. The results from the outdoor total gamma effective dose rates range between 0.0023 and 0.28 microSv h(-1). The highest outdoor total gamma effective dose rates (0.013-0.28 microSv h(-1)) were detected in the northeastern part of the island and the intermediate rates (0.066-0.13 microSv h(-1)) in the central region. The outdoor gamma dose rates due to 238U, 232Th and 40K radionuclides range between 1.7 +/- 0.8 and 154 +/- 7 nGy h(-1) with an average of 86 +/- 6 nGy h(-1). The average contribution of each of the examined radionuclides (238U, 232Th and 40K) to the total gamma dose rate was found to be equal to 12 +/- 4% for 238U, 58 +/- 6% for 232Th and 29 +/- 7% for 40K, respectively.

Background Radiation↗

Coffee intake and other factors in relation to multiple deliveries: a study in Greece.

We conducted a case-control study of factors that may be related to the prevalence of multiple births with at least one liveborn. Over a period of 15 months during 1991-1992 in Athens, Greece, we identified 380 women who had a multiple birth that was delivered in one of the six larger maternity hospitals in the area. We selected as controls 380 livebirth singleton pregnancies delivered at the same hospitals immediately following a multiple pregnancy. All mothers were interviewed in the maternity wards or at home, and zygosity was ascertained through the similarity method. The odds ratio for ovulation-inducing drugs was not elevated for monozygotic twins, but it was 9-fold for dizygotic twins and 90-fold for triplets or quadruplets. We excluded drug-induced pregnancies, twins of indeterminable zygosity, and all triplets from further analyses. We found no remarkable association between any of the study variables and the occurrence of monozygotic twins, with the exception of an increasing trend with age. For dizygotic twins, we found weak associations in the expected directions with maternal age (positive) and height (positive) as well as with parity and number of induced abortions (positive). A history of oral contraceptive use was inversely, but weakly, associated with dizygotic twinning. Each cup of coffee per day was associated with an increment in the odds ratio of 1.23-fold. (95% confidence interval = 1.05-1.43). Restriction of the analysis to dizygotic twins of different gender increased the point estimate of the odds ratio to 1.31 for each cup of coffee consumed daily.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Caring for dying children: a comparative study of nurses' experiences in Greece and Hong Kong.

The purpose of this transcultural descriptive study was to explore the subjective experiences of 63 oncology and critical care nurses who provide care to dying children in Greece and Hong Kong. Semistructured interviews were conducted with 39 Greek and 24 Chinese nurses who described their experiences and responses to the dying process and death of children. The data were analyzed qualitatively and quantitatively, and nurses' responses were compared for their work setting (oncology versus critical care) and their ethnic background (Greek versus Chinese). Findings revealed that most nurses experience a sense of helplessness when caring for a dying patient and difficulties in their communication with the child and parents during the terminal phase of the disease. The large majority acknowledge that the impending or actual death of a patient elicits a grieving process, which is characterized by a fluctuation between experiencing and avoiding loss and grief. Greek and Chinese nurses differ in their expression of their grief and how they attribute meaning to childhood death. Despite the suffering caused by multiple deaths, nurses report significant rewards from caring for chronically and acutely ill children, and the majority are satisfied with their job, despite the difficulties they encounter, in both countries, mostly as a result of shortage in personnel and cooperation problems with physicians.

Adult↗

The environmental behavior of 131I in northwestern Greece following the nuclear reactor accident at Chernobyl.

A three compartment (air-grass-milk) milk contamination model for 131I has been applied to atmospheric, grass and milk data, following the April 1986 nuclear accident at Chernobyl. Samples of ovine and bovine milk collected daily by a large dairy company in Ioannina (northwestern Greece), throughout the month of May 1986 have been employed. The contamination impulse in the area, which provides the input to the model, has been approximated by a first order gamma-variate curve. Transfer rates and decay constants have been extracted by fitting predictions of the model independently to each set of data (air, grass and milk). All model parameters obtained from more than one set of data show remarkable consistency. These parameters are used to calculate the transfer coefficients fm for the transport of radioiodine at equilibrium for sheep and cows. The results are also employed for the extraction of radiation dose estimates sustained through ingestion and inhalation by the population in the area.

Accidents↗

Radioiodine retention in ovine thyroids in northwestern Greece following the reactor accident at Chernobyl.

Iodine-131 concentrations were measured throughout the summer of 1986 in thyroids of lambs slaughtered at Ioannina (Northwestern Greece) following the accident at the Chernobyl nuclear reactor. During the survey, 40 thyroids were collected. The highest level of 131I detected was 2471 +/- 339 Bq per thyroid. The thyroids of 20 lambs did not contain detectable 131I concentrations, while the contamination content of the others was greatly variable. The transport of 131I from pasture to thyroids of lambs has been described through a simple model for the retention of 131I in the glands. The transfer coefficient fT, expressing the steady-state equilibrium, was estimated to be 564 +/- 270 kg-1 d. This result reflects the sensitivity of animal thyroids as biological radioiodine monitors.

Accidents↗

Examination frequencies and patient doses from computed tomography examinations in the area of Athens, Greece.

A survey was conducted in the Athens region between the years 1996-1997, in which 33 CT scanner facilities from the 67 operating in this area participated. Examination frequencies from the 33 scanners were 187,875 per year for all types of examinations. Using published estimations for the mean effective dose for each type of examination, it was estimated that the collective dose from the above examinations was about 1,100 person-Sv, which, if projected to the total number of 152 CT scanners operating in Greece at the time of the survey, results in about 0.5 mSv per caput dose each year for the Greek population, which is probably the highest in Europe.

Greece↗

A survey of 222Rn concentrations in dwellings of the town of Metsovo in north-western Greece.

A radon survey has been carried out of indoor radon concentrations in dwellings located in the town of Metsovo, in north-western Greece. To measure indoor radon concentrations, CR-39 detectors were installed in randomly selected houses and were exposed for about 3 mo, during summer and winter. Gamma spectroscopy measurements of the soil's radium content also were performed. The indoor radon concentration levels varied from 17.6 to 750.4 Bq m(-3), while the radium concentration of soil varied from 4.9 to 97.1 Bq m(-3). Seasonal variation of the radon levels and the influence of house features and soil are discussed.

Air Pollution, Indoor↗

Radon in public water supplies in Migdonia basin, Central Macedonia, Northern Greece.

The main objective of this work is the accurate measurement of radon concentration in the public water supplies of the Migdonia basin in Northern Greece. The main aim is to localize the sub-areas that present high radon concentrations in water and to inform the local authorities so that more detailed studies might be set up in these areas. About 80 samples from special bore holes and taps that supply the local population with fresh water were collected in order to obtain detailed radon measurements. For the analyses, a liquid scintillation counting system, using the Packard protocol for measuring radon in water, was employed. The results of the investigation show that radon concentrations in these public water supplies are significant. The concentrations ranged from background concentrations to 170 Bq x L(-1). The level of 50 Bq x L(-1) is exceeded in 23% of water supplies. These preliminary results with initial data interpretation and inter-comparison assessment are presented. These results of the analyses showed that elevated radon concentrations were detected in water samples from an area at the western part of the Lake Volvi, due probably to the local intense tectonism, and from a village above the Lake Koronia.

Fresh Water↗

Ulcerative colitis in Greece: clinicoepidemiological data, course, and prognostic factors in 413 consecutive patients.

The clinical course and prognosis of ulcerative colitis was studied in a group of 413 Greek patients. The study lasted for 16 years and follow-up was achieved in 95% of the patients. Both sexes were almost equally affected, mainly between the ages of 40-49. Most of the patients lived in cities and had high educational levels. Familial clustering for inflammatory bowel disease was found in 2.7% of the patients. In most of them the disease was confined to the rectosigmoid area or left bowel and was of mild to moderate severity. The disease course included exacerbations--mainly of mild to moderate severity--and remissions. Mortality was absent during first attack, and it was generally low at the completion of the study. Excluding deaths caused by colorectal cancer, most of the deaths were unrelated to the ulcerative colitis itself. Unusual combinations of ulcerative colitis with other diseases, including diseases of autoimmune origin, were noted. There were no differences between men and women in the various clinicoepidemiologic parameters or in the course of the disease. Surgery was performed in 16.7% of patients, whereas surgery at first attack was required in 0.5%. In comparison with the nonoperated group, patients who were operated on were significantly younger at the time of onset of symptoms and had significantly more extensive disease. Factors prognostic of severe attacks and colectomy were extensive disease, young age at onset, and severe recurrences. Evolution to cancer was observed in 1.45%, whereas extraintestinal cancers also appeared in 1.5%. At the completion of the follow-up period, 5.8% of the patients were dead, 16% had only one attack, 2.7% experienced continuous symptoms, whereas in 58.8% of them, the disease course included exacerbations and remissions. On the basis of the outcome of severe attacks and the more favorable short-term prognosis, it could be argued that ulcerative colitis in Greece runs a milder course compared with that of other developed countries in Western Europe and North America.

Adolescent↗

The incidence of Helicobacter pylori infection is not increased among obese young individuals in Greece.

GOALS: To identify possible risk factors affecting the acquisition of Helicobacter pylori (Hp) infection and to investigate whether the incidence of infection is higher among obese and overweight verus normal-weight young adults in Greece. STUDY: Serum was obtained from 224 young male Navy recruits (mean age, 22.84 years) during their induction into the Hellenic Navy. An enzyme-linked immunosorbent assay to detect Hp-specific IgG serum antibodies, as well as gastroscopy with biopsy, were used to identify the infected individuals. A structured questionnaire was filled out for each subject regarding environmental conditions, socioeconomic conditions, dietary habits, and data related to their personal and family health history. RESULTS: H. pylori positivity rate was 27.23%. Univariate analysis recognized that the number of siblings in the same bedroom was significantly higher among Hp-positive than Hp-negative individuals. Logistic regression analysis showed that sharing the same bedroom with more than one sibling during childhood and consumption of fast food are independent predictors of Hp acquisition. The presence of obesity (body mass index > or =25 kg/m2) remained unrelated to the Hp status of the individuals. CONCLUSIONS: These data suggest that the risk of Hp infection does not increase in overweight young persons. Sharing the same bedroom with more than one sibling during childhood is an important determinant in acquiring Hp infection. Increased fast food consumption could be an important source of the infection outside of the home.

Adult↗

Status and management of hypertension in Greece: role of the adoption of a Mediterranean diet: the Attica study.

OBJECTIVE: To evaluate the prevalence, awareness, treatment, and control of hypertension, in a random sample of adults free of cardiovascular disease, in Greece. A secondary goal was to evaluate the association between hypertension status and adoption of the Mediterranean diet. DESIGN: Cross-sectional survey. PARTICIPANTS: On the basis of multistage sampling, 1,128 men and 1,154 women older than 18 years were enrolled. MAIN OUTCOME MEASURES: The survey included a detailed interview and, among other clinical measurements, status and management of blood pressure were recorded. Adoption of the Mediterranean diet was assessed through a special questionnaire. RESULTS: The prevalence of hypertension was 38.2% in men and 23.9% in women (P < 0.05). The majority of men (65%) and women (40%) were untreated, and of those who were treated, only 109 of 319 (34%) had their blood pressure adequately controlled. Thus only 15% of the hypertensive population had their blood pressure well controlled. Multivariate logistic regression analysis revealed that consumption of a Mediterranean diet was associated with a 26% (odds ratio = 0.74, P = 0.008) lower risk of being hypertensive, and with a 36% (odds ratio = 1.36, P = 0.021) greater probability of having the blood pressure controlled. CONCLUSIONS: A considerable proportion of the general population remain unaware of having hypertension or do not have their blood pressure well controlled. However, consumption of a Mediterranean type of diet seems to reduce rates of hypertension in the population, and may contribute to the control of hypertension at the population level.

Adult↗

Maintenance antipsychotic pharmacotherapy, relapse, and length of stay out of the hospital in chronic schizophrenics in Greece.

A retrospective study of 820 rehospitalization of chronic schizophrenics in Greece showed no significant difference in the discharge-rehospitalization, discharge-relapse, and relapse-rehospitalization time intervals, between the patients who continued to receive their medication after discharge regularly, and the patients who discontinued their medication upon discharge. Furthermore, there seemed to be an increased social adaptability or tolerance of the psychotic behavior of the patients who had discontinued their medication, suggested by their longer relapse-rehospitalization time interval.

Adult↗

Type-specific prevalence of genital human papillomaviruses in benign, premalignant, and malignant biopsies in patients from Greece.

BACKGROUND AND OBJECTIVES: More than 30 different human papillomavirus (HPV) types infect the anogenital mucosa and are responsible for a variety of benign, premalignant, and malignant lesions including cervical cancer. The goal of this study was to determine the distribution of individual HPV types in various grads of cervical precancerous lesions and cervical carcinoma in patients from Greece. STUDY DESIGN: Specimens were analyzed for HPV-DNA sequences by polymerase chain reaction and Southern blot hybridization. Polymerase chain reaction analysis was performed with consensus and type-specific primers. Restriction length fragment polymorphism analysis and/or hybridization of the general primer polymerase chain reaction product were used for HPV typing. RESULTS: In cervical carcinomas HPV-16 was found in 56%, HPV-18 in 23%, and HPV-31 in 6% of the HPV-positive patients. In precancerous lesions HPV-16 was found in 13% of low-grade squamous intraepithelial lesions (LG-SIL) as compared with 41% of high-grade squamous intraepithelial lesions (HG-SIL) patients. HPV-18 was found at similar frequency both in LG-SIL (13%) and HG-SIL (14%). HPV-31 and HPV-33 were detected at moderate levels both in LG-SIL (11%) and in HG-SIL (14%). In addition, HPV-53 and HPV-66 were detected at low frequency in LG-SIL (2%), whereas HPV-51 was found only in HG-SIL (4%). Finally, HPV-6 was associated with 13% of LG-SIL. CONCLUSIONS: Overall, the prevalence rate of the genital HPV types was in the range previously described for many western countries but the HPV-18 positivity was higher than that reported for most European countries.

Carcinoma↗

Epidemiologic aspects of male gonococcal infection in Greece.

OBJECTIVE: To report male gonorrhea incidence trends between the years 1974 and 1996 and compare the epidemiologic characteristics of the affected population during periods of high and low incidence of the disease. STUDY DESIGN: Retrospective study of all available data for male gonorrhea cases recorded annually in a major STD hospital in Greece since 1974. RESULTS: An abrupt drop in gonorrhea relative incidence occurred in 1986, followed by low rates thereafter. In the context of the overall decline in the incidence of the disease, a shift to older ages, longer time elapsed before seeking medical assistance, and higher proportion of disease repeaters was noticed among the patients. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence presented erratic time fluctuations, indicating that they have not been established as endemic in the Greek population. CONCLUSION: The core group hypothesis in terms of nighttime sociosexual activity can be used to interpret most of the findings.

Adult↗

Visceral leishmaniasis acquired in Greece: diagnosis and treatment in an American child.

Reported is a case of visceral leishmaniasis acquired in Greece by a 3-year-old American child. Untreated, this protozoan infection causes a high mortality. Specific treatment is available, making early recognition of the illness important. This child's infection responded dramatically to a course of sodium antimony gluconate. Repeat bone marrow cultures demonstrated persistent organisms and a second course of treatment was required. Monitoring of his response to therapy suggested that serial bone marrow cultures and the neutrophil response may be sensitive means for following the course of this infection.

Antimony Sodium Gluconate↗

Cervical human papillomavirus infection in women attending gynaecological outpatient clinics in northern Greece.

Human papillomavirus (HPV) is the necessary cause for the development of invasive cervical cancer. Identification of HPV determinants may contribute to the targeting of high-risk groups for cervical cancer. The study was aimed at estimating HPV prevalence and its determinants among 1296 women attending six gynaecological outpatient clinics in northern Greece. Information was available through personal interview and the study of cervical exfoliated cells. HPV DNA was detected by reverse line-blot polymerase chain reaction using the L1 primers PGMY09/11. The overall HPV prevalence was 2.5%. After controlling for potential confounders, the two independent risk factors associated with an increased prevalence were young age and parity. The prevalence odds ratio (POR) for those younger than 27 years against those older than 42 years was 5.31 (95% confidence interval (CI)=1.53-18.44) and the POR for nulliparous women compared with women with two or more children was 4.15 (95% CI=1.35-12.76). HPV was present in 10 of 12 women with low-grade cervical intraepithelial lesions (CIN) (83.3%) and in 3 of 4 with high-grade CIN (75%). The prevalence of genital HPV infections in the study population was among the lowest ever reported internationally.

Adolescent↗

An integrated evaluation of socioeconomic and clinical factors in the survival from childhood acute lymphoblastic leukaemia: a study in Greece.

An evaluation of the role of socioeconomic factors in the survival of children with leukaemia, controlling for major clinical prognostic indicators, has been attempted in very few studies and the role of these factors may be different in various cultural settings. Our investigation aims to study the independent role of socioeconomic factors on the prognosis of childhood acute lymphoblastic leukaemia (ALL) in Greece. During a 7-year period (1996-2002) 293 cases of incident ALL were diagnosed and followed up in four Childhood Haematology-Oncology Units, which covered over half of all childhood ALL cases nationwide. At the time of diagnosis, information concerning age, gender, maternal schooling, maternal marital status, sibship size, distance of residence from the treating centre, attendance of day care centre and clinical information was recorded. The influence of these factors on survival was studied by modelling the data through Cox's proportional-hazards regression. After adjustment for clinical prognostic factors, children of mothers who were not currently married, were of low educational level or were living far from the treating centre tended to have lower survival (P-values 0.02, 0.14 and 0.08, respectively). There was also evidence that two factors that are predictive of disease occurrence, that is sibship size and attendance of day care centre, may also predict survival (P-values 0.04 and 0.26, respectively). In conclusion, socioeconomic factors are likely to influence survival from ALL at least in some sociocultural contexts. Moreover, there is evidence that factors that could affect incidence of ALL through modulation of herd immunity may also have prognostic implications for this disease.

Age Factors↗

An epidemiological study of acute upper gastrointestinal bleeding in Crete, Greece.

OBJECTIVES: Information about the epidemiology of acute upper gastrointestinal bleeding (UGIB) in southern Europe is very limited and especially in Greece non-existent. Our study sought to determine the current epidemiology of acute UGIB (incidence, mortality and case fatality) in the prefecture of Heraklion-Crete. DESIGN/METHODS: From February 1998 to February 1999, we prospectively obtained data on all patients with acute UGIB in the prefecture of Heraklion-Crete. All patients who were permanent residents of the prefecture of Heraklion, aged 16 years and over with acute UGIB were included in the study. RESULTS: During this period, 353 cases of acute UGIB were included in the study. The overall incidence of acute UGIB is 160/100,000 adults per year with a male-to-female ratio of 1.7 and a mean age 66.2 +/- 17.1 years. The incidence rises from 30 in those aged under 30 years to 609 in those aged over 75 years. The overall population mortality was 9/100,000 adults per year. Overall case fatality during hospitalization was 5.6%. All deaths occurred in patients older than 60 years. One or more comorbid illnesses were noted in 61% of cases. Recent intake of non-steroidal anti-inflammatory drugs (NSAIDs) was reported in 49% of the cases. The most common recorded diagnoses were erosive disease in 108 (30.5%) patients, duodenal ulcer in 97 (27.4%) and gastric ulcer in 75 (21.2%). Rebleeding occurred in 41 patients (12%). Twelve patients (3.3%) had surgery during hospitalization. CONCLUSIONS: The overall annual incidence of acute UGIB in the prefecture of Heraklion-Crete is one of the highest reported in Europe and increases appreciably with age. Both population mortality and case fatality are slightly lower compared to those reported in most previous studies.

Adolescent↗