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PubMed2005

Intrafamilial spread of hepatitis B virus infection in Greece.

OBJECTIVE: No study has investigated the intrafamilial spread of hepatitis B virus (HBV) in Greece. We conducted a 9-year prospective study to determine the rate of HBV spread in family members when a member is identified as an HBV carrier, the possible routes and risk factors for transmission of HBV and the family members with the highest risk of infection according to kinship degrees. METHODS: A total of 387 family members of 166 hepatitis B surface antigen (HBsAg) carriers were investigated for the detection of HBV infection markers using standard enzyme immunoassays; 6.696 blood donors from the same area were used as controls. RESULTS: Serological markers of past or current HBV infection were detected significantly more frequently among family members of HBsAg carriers (23.2 and 15.8%, respectively) compared with blood donors (14.1 and 0.85%, respectively). The prevalence of the above markers was higher among siblings, husbands and parents of the carriers. Offspring of the female index cases had higher rates of current or past infection. HBV infection markers were significantly increased in family members who reported common use of syringes (P<0.001), birth in rural areas (P<0.001) and a low level of education (P<0.001). CONCLUSIONS: We demonstrated a high risk of HBV transmission among family members of HBsAg carriers, which was associated with special risk factors for contracting HBV. Our findings indicate the need for strict adherence to the universal guidelines of vaccination against HBV and also the need for an immediate investigation of other potentially infected relatives among family members of HBsAg carriers.

Adolescent↗
PubMed1999

Lung cancer and occupational risk factors in Greece.

This study estimated the proportion of lung cancer in Greece that was attributable to occupational exposure. Two hundred eighty-two patients with lung cancer and 494 controls were interviewed about their socioeconomic characteristics, sex, age, and occupational, smoking, and residential histories. Each subject was classified as exposed or unexposed to known occupational lung carcinogens. Because of the small number of females exposed, only males were included in the multivariate analyses. When the occupationally exposed subjects were compared with the unexposed subjects and an adjustment for smoking was made, the relative risk for lung cancer was 2.9 (95% confidence interval, 1.95-4.31). If 5% to 10% of the Greek population were occupationally exposed, the attributable risk would be 9.9% to 16.6%, respectively. Occupational exposures conferred an additional risk that was approximately threefold that of smoking alone. Risks increased in a dose-response fashion with increasing cigarette consumption.

Adult↗
PubMed2001

Comparison of the additive intraocular pressure-lowering effect of latanoprost and dorzolamide when added to timolol in patients with open-angle glaucoma or ocular hypertension: a randomized, open-label, multicenter study in Greece.

PURPOSE: To compare the intraocular pressure-lowering effect of latanoprost with that of dorzolamide when added to timolol. PATIENTS AND METHODS: This randomized, open-label study with two parallel groups was conducted in five centers in Greece. The study enrolled 148 patients with inadequately controlled open-angle or pseudoexfoliation glaucoma (intraocular pressure of at least 22 mm Hg) or ocular hypertension (intraocular pressure of at least 27 mm Hg) who were receiving monotherapy with a beta-blocker or dual therapy in which one of the agents was a beta-blocker. The patients were switched to timolol 0.5% twice daily for 2 to 4 weeks (run-in period) before the start of the study (baseline). At baseline, the patients were randomized to receive latanoprost 0.005% once daily or dorzolamide 2% twice daily as add-on therapy to timolol. The intraocular pressure was recorded at 9:30 AM, 12:30 PM, and 3:30 PM at baseline and at 3 months. Safety was followed throughout the study. RESULTS: The diurnal intraocular pressure reduction was significant in both groups (P < 0.001). The mean intraocular pressure reduction from baseline was 32% for the latanoprost plus timolol group and 20% for the dorzolamide plus timolol group. The least square estimate of the mean diurnal intraocular pressure reduction after 3 months was -7.06 mm Hg in the latanoprost plus timolol group and -4.44 mm Hg in the dorzolamide plus timolol group (P < 0.001). Drugs administered in both treatment groups were well tolerated. CONCLUSION: This study clearly showed that the additive diurnal intraocular pressure-lowering effect of latanoprost is superior to that of dorzolamide in patients treated with timolol.

Adrenergic beta-Antagonists↗
PubMed2006

Short-term effects of atmospheric temperature and humidity on morbidity from acute coronary syndromes in free of air pollution rural Greece.

STUDY OBJECTIVE: An evaluation of the effect of ambient temperature on morbidity from acute coronary syndromes (ACS) while avoiding confounding by air pollution. DESIGN: An ecological study in rural Greece. METHODS: Daily admissions to hospital because of ACS were recorded for 1 year and analysed versus daily temperature and humidity. RESULTS: For a 1 degrees C decrease in temperature there was a 1.6% (95% confidence interval 0.9-2.2%) increase in admissions. This effect was more prominent in the elderly. No difference was detected according to sex or type of ACS. CONCLUSION: It is important to implement measures against cold in coronary heart disease prevention, irrespective of air pollution.

Air Pollution↗
PubMed2007

Natural history of chronic hepatitis B virus infection in children of different ethnic origins: a cohort study with up to 12 years' follow-up in northern Greece.

AIM: To investigate the mode of transmission and the natural history of chronic hepatitis B virus (HBV) infection in children of different ethnicities in Greece. This study was part of the Interreg I-II EC project. PATIENTS AND METHODS: One hundred seventy-three hepatitis B surface antigen (HBsAg)(+) carriers, median age 6.9 (5-12) y, were prospectively followed-up for a mean period of 5.3 (1-12) y for serological markers of HBV infection, serum alanine aminotransferase (ALT), HBV-DNA, alpha-fetoprotein levels and ultrasonography. RESULTS: Vertical transmission predominates (61.8%) in Moslem children and horizontal (44%) in those born in Russia. At entry, 73 of 173 (42%) HBsAg(+) genotype D children were hepatitis B e antigen (HBeAg)(+), ranging from 27% to 67% among ethnic groups; 55 of 173 (32%) had ALT > 2 x upper normal limit (UNL), ranging from 21% to 39%. Of 100 anti-HBe(+) children, 85 (85%) were inactive carriers. During the follow-up period, seroconversion to anti-HBe was observed in 40 of 73 (55%) children with an annual rate of 11%; 35 of 40 (87.5%) had biochemical remission, and 28 of 35 (80%) lost HBV-DNA. In the anti-HBe(+) group, 27 of 100 (27%) lost HBV-DNA and 9 of 100 (9%) lost HBsAg. The annual seroconversion rate for HBeAg was significantly lower: in children with vertical transmission compared with horizontal (7.7% vs 14.8%, respectively, P < 0.001) and in Muslim children compared with both Christian children and those born in Russia (8.6% vs 12%, respectively, P < 0.001). No differences were found among the ethnic groups after adjusting for the mode of infection. Two of 173 children had progression of liver disease. CONCLUSIONS: The differences in HBeAg(+) status and seroconversion rate among the ethnic groups are related to the time/mode of HBV infection. The majority of children who developed anti-HBe immunity had biochemical remission, and a substantial number of the inactive carriers lost viremia during the observation period of up to 12 y.

Child↗
PubMed2003

Medical aspects of malpractice crisis in Greece: medical responsibility: a doctor's view.

Malpractice and medical liability have been introduced into Greek reality over the last decade. Forensic sciences hold a key role in the investigation of medical liability cases. Along these lines, the medical examiner stands between colleagues and lawyers, who have divergent intentions in the investigation of such cases. This article offers an overview of the rapidly changing reality in Greece and approaches medical liability from the doctor's viewpoint. The role of forensic science and the medical examiner is portrayed, along with the emerging difficulties in the investigation of medical liability cases. Also attempted is an interpretation of the crisis phenomena that are very often seen between doctors and lawyers. However, the intent of this article is to search for ways to turn competition and tension between medical and law professionals into cooperation and understanding for the best interest for both professions and, more importantly, for the community.

Forensic Medicine↗
PubMed2004

The mosaic of equestrian-related injuries in Greece.

BACKGROUND: This study aims to estimate the burden and describe the profile of equestrian injuries in Greece, where horses, donkeys, and mules are still used in agriculture and where horse riding is a popular leisure activity. METHODS: Prospectively collected information on 140,823 injuries reported in the national Emergency Department Injury Surveillance System was examined and 244 equestrian-related injuries that occurred during farming, equestrian sports, or horse racing were analyzed. RESULTS: The estimated countrywide injury incidence for farming and equestrian sports combined was 21 per 100,000 person-years, but it was 160 times higher for horse-racing personnel. Men had higher rates of racing injuries and women had higher rates of equestrian sport injuries. Fractures accounted for 39.0% of injuries in horse racing and 30.5% in farming; head injuries accounted for approximately 50% of injuries among farmers. Farming injuries were more serious, with 25% requiring hospitalization. Analysis through the Barell matrix pointed to the role of spurs in the causation of ankle fractures and dislocations and the likely contribution of helmets in preventing traumatic brain injuries. CONCLUSION: Equestrian-related injuries are a serious but underappreciated health problem and merit targeted prevention efforts for each category affected.

Accidents, Occupational↗
PubMed2000

Thermococcus aegaeicus sp. nov. and Staphylothermus hellenicus sp. nov., two novel hyperthermophilic archaea isolated from geothermally heated vents off Palaeochori Bay, Milos, Greece.

Two novel, hyperthermophilic, anaerobic, heterotrophic archaea were isolated from shallow hydrothermal vents off Palaeochori Bay, Milos, Greece. Strain P5T (BK17S6-3-b2T) is an irregular coccus, with a single polar flagellum, growing optimally at 90 degrees C, pH 6 and 2% NaCl. The DNA G+C content was 45 mol%. Due to its morphology, phylogenetic analyses based on 16S rRNA gene sequencing, DNA-DNA hybridization experiments, physiological properties and nutritional features, this strain represents a new species within the genus Thermococcus for which the name Thermococcus aegaeicus is proposed. The type strain is P5T (= DSM 12767T = JCM 10828T). Strain p8T (BK20S6-10-b1T) is a coccus that forms aggregates. It grew optimally at 85 degrees C, pH 6 and 3% NaCl. The DNA G+C content was 38 mol%. Physiological properties and sequence analysis of the 165 rRNA gene, as well as DNA-DNA hybridization experiments, indicate that this strain is a new species belonging to the genus Staphylothermus for which the name Staphylothermus hellenicus is proposed. The type strain is P8T (= DSM 12710T = JCM 10830T).

Base Composition↗
PubMed2000

A comparative study of immunocapture ELISA and RT-PCR for screening clinical samples from Southern Greece for human influenza virus types A and B.

An immunocapture (IC) ELISA and reverse transcriptase (RT)-PCR assays were evaluated as screening methods for the detection of influenza virus types A and B in clinical samples collected from individuals presenting with influenza-like symptoms in Southern Greece. Standard virus isolation in embryonated hens' eggs was taken as the reference method. According to the reference method, 25 (16.7%) of the 150 clinical samples examined were infected by influenza viruses - 19 type A (H3N2) and 6 type B. The sensitivity of immunocapture ELISA was 64% and that for RT-PCR was 100%. The specificity of IC ELISA was 98% and by RT-PCR 97%. The positive diagnostic value of IC ELISA was 94% and of RT-PCR 86%, whereas the negative diagnostic values for IC ELISA and PCR were 93% and 100%, respectively. These findings confirm that RT-PCR provides significantly increased sensitivity over IC ELISA and can be of value in the management of regional influenza screening surveys conducted by the national public health services.

Adolescent↗
PubMed1993

Serogroups, serotypes and subtypes of Neisseria meningitidis isolated from patients and carriers in Greece.

The increase in the number of cases of meningococcal disease reported to the Ministry of Health in Athens since 1989 prompted the present study to determine if isolates from patients or carriers expressed the same phenotypic characters as those in other parts of Europe. None of the isolates from patients (31) or carriers (547) expressed the antigenic combinations associated with outbreaks in northern Europe, i.e., B:15:P1.16 or B:4:P1.15. The majority of the Greek isolates did not react with any of the six monoclonal serotype reagents tested; however, most reacted with one or more of the 11 monoclonal subtype antibodies. The results suggest that additional serotype reagents are needed for epidemiological studies in southeastern Europe and that vaccines based on serotype antigens developed against outbreak strains in northern Europe would not be effective in Greece.

Adolescent↗
PubMed1979

The heterogeneity of normal Hb A2-beta thalassaemia in Greece.

Nine patients have been observed with homozygous beta thalassaemia in each of whom one parent has a normal level of Hb A2. On the basis of clinical, haematological and globin chain synthesis studies these families have been divided into two groups. Group 1 (six families). Heterozygotes for normal Hb A2-beta thalassaemia in this group showed minimal red cell abnormalities, normal osmotic fragility but imbalanced globin chain synthesis (alpha/beta=1.6), and appear to correspond to previous descriptions of 'silent' beta thalassaemia. Double heterozygotes with high Hb A2-beta thalassaemia have a clinical picture of mild beta thalassaemia intermedia characterized by relatively low levels of Hb F (less than 20%) and gamma chain synthesis. Group 2 (three families). beta Thalassaemia heterozygotes with normal HbA2 levels in this group showed more marked red cell abnormalities, decreased osmotic fragility and more imbalanced globin chain synthesis (alpha/beta=2.5) than those in group I. Double heterozygotes with high Hb A2-beta thalassaemia are more severely affected and are transfusion dependent. Haemoglobin F and gamma chain synthesis are high in these cases. The frequency of normal Hb A2-beta thalassaemia in Greece may be as high as 10% of all beta thalassaemia genes and this poses a significant problem for genetic counselling. Various molecular mechanisms are discussed which could account for the heterogeneity within these disorders.

Adolescent↗
PubMed2005

Standardization of the motor scales of the Griffiths Test II on children aged 3 to 6 years in Greece.

AIMS: The present study aimed at the standardization of the motor scales (A-locomotor and D-eye-hand co-ordination) of the Griffiths Test II on Greek preschool-aged children. PARTICIPANTS: Nine hundred and thirty children living in Northern Greece were assessed (455 boys and 475 girls), aged from 37 to 72 months (3-6 years old). RESULTS: Percentile ranks were determined depending on the developmental quotient and the chronological age of the child. Through the present application of the Griffiths Test to the children in our country, we showed that the average developmental quotients of the two scales were higher than the relevant published quotients of the Griffiths Test II. DISCUSSION: Some of the factors that may have contributed to faster motor development are passage of time and the environmental and cultural differences between countries. The findings reinforce the need for standardization of a test before it is applied to the population of a country, and its re-standardization on the population of the country where it was first applied.

Child↗
PubMed2006

Dental health of 5-year-old children and parents' perceptions for oral health in the prefectures of Athens and Piraeus in the Attica County of Greece.

OBJECTIVES: This study was undertaken in 2001 in order to investigate the dental health status of 5-year-olds in an urban community within Attica County in Greece and the views of the carers of this age group. METHODS: Three hundred and forty-five nursery children were examined, using the WHO methods and criteria. Parents' views were recorded in a questionnaire. RESULTS: Overall, 48.4% had some experience of dental decay. The mean dmft of the whole study population was 2.6, whereas the mean dmft of the subjects with active decay was 5.4; in these cases untreated decay was the highest component (mean dt = 5.0). A questionnaire using phone calls to the children's homes achieved a 100% response rate. Ninety-five per cent of parents thought that a child should visit the dentist at this early age and 79.5% of responders answered that they had already visited the dentist with their child for different reasons. Three-quarters (75.4%) of parents had received information about fluoride, whereas 72.5% answered that did not use any type of fluoride for their child at home. It was reported that 63.5% of children ate snacks, sweets, cakes, biscuits, and gums between the main meals of the day and 31% of the subjects more than once per day. CONCLUSIONS: Caries indicies were higher from the National 2003-4 survey and were attributed to the increasing number of immigrants in some areas. The population under investigation had the appropriate information for the prevention of dental decay but they appear to maintain unhealthy behaviours in their everyday living.

Attitude to Health↗
PubMed2005

Comparative typing of Pseudomonas species isolated from the aquatic environment in Greece by SDS-PAGE and RAPD analysis.

AIMS: Three broadly used typing methods were employed in order to assess and compare the identification and classification of environmental Pseudomonas strains. The reproducibility, typeability and discriminatory power of the methods were also compared to evaluate their application. Finally, the potential impact on public health of the isolates is to be discussed. METHODS AND RESULTS: Pseudomonas strains (160) isolated from the aquatic environment in Greece and identified by a rapid identification commercially available system (API20NE), were subjected to whole-cell protein electrophoresis (Sodium dodecyl sulfate-polyacrylamide gel electrophoresis) and Randomly Amplified Polymorphic DNAs (RAPD) using two 10-mer primers. In general, the obtained results were in agreement. Twenty isolates that could not be identified by the API20NE system were classified by the other methods. CONCLUSIONS: Rapid identification systems may serve only for a first rough identification of environmental Pseudomonads. In order to acquire further information, so that conclusions about their role in the ecosystem and human health could be drawn, other phenotypic or genotypic methods have to be applied. SIGNIFICANCE AND IMPACT OF STUDY: It is important, from a public health point of view, to monitor the identities of environmental Pseudomonas isolates using specific methods due to their ubiquity, heterogeneity and their pathogenicity, either established or potential.

Bacterial Typing Techniques↗
PubMed2006

Use of technological equipment in critical care units: nurses' perceptions in Greece.

AIMS AND OBJECTIVES: The aim of this study was to determine the perceptions of nurses who work in critical care units about positive and negative effects related to the use of technological equipment and identify relationships between these perceptions and demographic characteristics of participants. BACKGROUND: Previous researchers have investigated the perceptions of nursing personnel about the effects of technology on clinical practice. However, most of them focus on specific negative effects. Positive and negative effects have never been studied as a whole. DESIGN: Critical care nurses were surveyed to elicit their perceptions regarding the use of technological equipment. The instrument comprised a 14-item questionnaire and a series of demographic characteristics. A five-point Likert scale was used for each of these 14 questions. METHODS: The questionnaire was administered to 122 nurses working at the four critical care units of a major academic hospital in Patras, Greece, from 1/10/2003 to 31/12/2003. The completion of the questionnaires was achieved by means of a personal interview. RESULTS: A total of 118 questionnaires were completed. The majority of nurses recognized the positive effects of equipment regarding patient care and clinical practice. At the same time, they agreed that use of equipment possibly leads to increased risk due to human errors or mechanical faults, increased stress and restricted autonomy of nursing personnel. CONCLUSIONS: The use of machines does not add to nursing prestige and this may be related to decreased autonomy. Human errors, mechanical faults and increased stress do not seem to come as a result of time constriction but rather of inadequate education. Undergraduate and continuing education should respond efficiently to the needs of contemporary critical care. RELEVANCE TO CLINICAL PRACTICE: Recognition of positive and negative effects of machines through the investigation of perceptions of nurses is the first step before looking for ways of maximizing advantages and facing disadvantages of equipment use.

Adult↗
PubMed2006

Pharmacotherapeutic management of COPD patients in Greece--adherence to international guidelines.

BACKGROUND: International guidelines for Chronic Obstructive Pulmonary Disease (COPD) propose the most cost-effective management of the disease. However, the management of COPD differs between countries and between clinics within the same country. OBJECTIVE: To examine prescription trends for COPD by Lung Specialists (LS) and Primary Care Physicians (PCP) in Greece and to study prescription adherence to international guidelines. METHODS: A retrospective analysis of COPD prescriptions, obtained from pharmacies located all over the country, was performed between 1997 and the beginning of 2003. The data collected were compared with those of other European countries. A subgroup analysis was carried out for prescriptions issued by PCP and LS. RESULTS: Between 1997 and 2003, LS and PCP used different pharmacological interventions for the management of COPD. Only the LS prescriptions showed a tendency to guideline adherence. Differences in preferences for different pharmacological drug classes were noted. Thus, LSs were found to generally prefer inhaled corticosteroids (ICSs), followed by anticholinergic drug + a beta(2)-short-acting agonist combinations, long-acting beta(2)-agonists, xanthines, short-acting beta(2)-agonists and expectorants. In contrast, PCPs used mostly short-acting beta(2)-agonists followed by xanthines, ICSs, expectorants, anticholinergic drug + beta(2)-short-acting agonist combinations and long-acting beta(2)-agonists. CONCLUSIONS: It appears that compliance to international COPD management-guidelines in force at the time of the study increased between 1997 and 2003 only for LSs but not for PCPs.

Bronchodilator Agents↗
PubMed2006

Diet, blood lipid profile and physical activity patterns in primary school children from a semi-rural area of Greece.

BACKGROUND: Risk factors for heart disease are becoming increasingly prevalent among young populations. The aim of this study was to assess the cardiovascular risk profile of young adolescents living in a semi-rural area of mainland Greece, Volos. MATERIALS AND METHODS: A total of 198 children (106 females and 92 males) aged 11.6 +/- 0.4 years were randomly recruited. RESULTS: Mean body mass index was 20.4 +/- 3.5 kg m(-2), while 30.3% of children were overweight and 6.7% were obese; no differences were observed between boys and girls. Mean plasma cholesterol (4.93 +/- 0.75 mmol L(-1)), low-density lipoprotein-cholesterol (3.29 +/- 0.64 mmol L(-1)) and triglyceride (0.97 +/- 0.31 mmol L(-1)) concentrations were above age-specific recommended values. On the other hand, mean high-density lipoprotein-cholesterol was acceptable for 92.3% of the children. Self-reported daily energy intake (8.37 +/- 3.06 MJ) was adequate for age, but intake of fat was high (42.0 +/- 9.2% of energy) and that of carbohydrate was relatively low (44.5 +/- 10.0% of energy). Saturated fat consumption was elevated (15.6 +/- 4.3% of energy), while polyunsaturated fat intake fell short (4.8 +/- 1.6% of energy). The study participants spent 9.60 +/- 6.44 h week(-1) on moderate to vigorous physical activities, while they devoted 16.60 +/- 8.81 h week(-1) to sedentary activities. Boys spent significantly more time than girls on both physical (P < 0.001) and sedentary (P = 0.001) activities. No major gender differences were observed in anthropometric, dietary and plasma lipid parameters. CONCLUSION: The findings from the present study support the worrisome trends that have been documented in Greek youngsters elsewhere, and predict an unfavourable cardiovascular risk profile for the Greek population in the foreseeable future.

Adolescent↗
PubMed1994

Preterm delivery and low birthweight among refugees in Greece.

Recently Greece received a large number of refugees mainly from Eastern European countries, Middle East, Africa and the Pontus region. Refugee status, implying psychosocial adversities and financial problems, has traditionally been associated with unfavourable pregnancy outcome. This study aimed to compare the incidence of preterm delivery and low birthweight among 638 refugees and 1231 indigenous women giving birth at the same hospital in Athens. Conditional logistic regression was used in the analysis to account for parity and delivery date (matching variables) as well as controlling explicitly for maternal age and gender of the neonate. It was demonstrated that refugee status did not overall influence the occurrence of preterm delivery or low birthweight, thus implying that these two variables are not sensitive or early indicators of the adverse effects of psychosocial stress suffered by refugees.

Adolescent↗