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Distribution of serogroups and genotypes among disease-associated and carried isolates of Neisseria meningitidis from the Czech Republic, Greece, and Norway.

The distribution of serogroups and multilocus sequence types (STs) in collections of disease-associated and carried meningococci from the period 1991 to 2000 in three European countries (the Czech Republic, Greece, and Norway) was investigated. A total of 314 patient isolates and 353 isolates from asymptomatic carriers were characterized. The frequency distributions of serogroups and clone complexes differed among countries and between disease and carrier isolate collections. Highly significant differentiation was seen at each housekeeping locus. A marked positive association of serogroup C with disease was evidenced. The ST-11 complex was strongly positively associated with disease; associations for other clone complexes were weaker. The genetic diversity of the clone complexes differed. A single ST dominated the ST-11 clone complex, while the ST-41/44 complex exhibited greater levels of diversity. These data robustly demonstrated differences in the distribution of meningococcal genotypes in disease and carrier isolates and among countries. Further, they indicated that differences in genotype diversity and pathogenicity exist between meningococcal clone complexes.

Carrier State↗

Simultaneous detection of "Rickettsia mongolotimonae" in a patient and in a tick in Greece.

Rickettsia conorii, a spotted fever group rickettsia which is transmitted by Rhipicephalus sp. complex ticks, was considered until now the only pathogenic rickettsia prevalent in Greece. Here, we report the presence of "Rickettsia mongolotimonae" (proposed name) detected simultaneously in a patient and in a Hyalomma anatolicum excavatum tick, sampled on the patient.

Aged↗

Molecular characterization of wild-type polioviruses isolated in Greece during the 1996 outbreak in Albania.

During the present study three type 1 poliovirus strains isolated in Greece during the 1996 poliomyelitis outbreak in Albania were retrospectively investigated and determination of their relationship with other epidemic strains isolated in Albania or elsewhere during previous epidemics was attempted. SimPlot analysis revealed that the three Greek strains are the result of a recombination event in the VP2 coding region.

Albania↗

Haemoglobin Bart's hydrops syndrome in Greece.

A case of haemoglobin Bart's hydrops syndrome was characterised in a Greek family with a history of three other fetuses with hydrops. Family studies showed that both the mother and father carried alpha-thalassaemia genes, and globin-chain synthesis analysis of the present fetus showed a total absence of alpha-chain production. The haemoglobin composition of the fetus was similar to that seen in cases in south-east Asia, and analysis of DNA from the Greek case confirmed the total deletion of the alpha-chain genes. The extent of the deletion, however, differed from that seen in south-east Asian cases and included the loss of one of the embryonic zeta-chain genes. Thus the severe form of alpha-thalassaemia occurs in Greece but has arisen independently from the similar condition in south-east Asia. The condition must be considered in any woman of this racial background who gives a history of unexplained stillbirths.

Adult↗

Diet and other factors in the aetiology of diverticulosis: an epidemiological study in Greece.

A case control study exploring the role of diet and other biosocial factors in the aetiology of diverticulosis was undertaken in Athens, Greece, in 1981-1982. One hundred consecutive cases with radiologically confirmed diverticulosis and 110 control patients with fractures or other orthopaedic disorders were submitted to a structured interview, including frequency of consumption of about 80 food items. The main positive findings were, (i) the cases reported significantly less frequent consumption of vegetables, brown bread and, to a lesser extent, potatoes and fruits, and (ii) the cases reported significantly more frequent consumption of meat and, to a lesser extent, milk, and milk products. The difference in risk between those people who frequently consume vegetables but rarely consume meat, and those who rarely consume vegetables and frequently consume meat, was almost 50-fold.

Diet↗

Incidence of inflammatory bowel disease in north west Greece: rarity of Crohn's disease in an area where ulcerative colitis is common.

Ulcerative colitis (UC) and Crohn's disease (CD) are generally regarded as diseases of affluent societies of the Western World, although their frequency in less affluent areas is not well established. This retrospective study therefore, assesses the incidence of UC and CD in a semirural area of north west Greece during the 10 year period 1982-1991. By the 31 December 1991, 61 patients had met standard diagnostic criteria for UC (annual incidence 4.0/10(5), 95% confidence intervals 3.0 to 5.0/10(5)) and only five patients met the diagnostic criteria for CD (annual incidence 0.3/10(5), 95% confidence intervals 0.1 to 0.8/10(5)) in this area of 157,214 inhabitants. UC incidence was lowest in the first three years at 1.8/10(5) per annum and subsequently increased to 4.8 and 5.1/10(5) per annum for the successive four and three year periods respectively. UC incidence was slightly higher in men. A third of all cases of UC had pancolitis while a quarter had only proctitis. More than one half were categorised as having moderate or severe colitis. Three quarters of the patients resided in urban areas. The incidence of CD was a twelfth of the UC incidence, which is in considerable contrast with most Western countries where the incidence of CD is usually no less than a third that for UC. The rarity of CD points to the absence of aetiological environmental factors specific for CD.

Adult↗

Biosocial variables and auditory acuity as risk factors for non-fatal childhood injuries in Greece.

OBJECTIVES: To examine whether biosocial variables and auditory acuity are risk factors for injuries among children. SETTING: Children with injuries who presented at the emergency clinics of one of the two university hospitals for children in Athens, Greece between December 1993 and April 1994. METHODS: 144 children aged 5-14 years, residents of Athens, were brought to the emergency clinics for a moderate to severe injury. For each of these children one hospital control, matched for age and sex, and one classmate control similarly matched were identified. A standard interview form was completed for all 432 children and acouometric and tympanometric examinations were performed in each of them. Analysis was done through conditional logistic regression. RESULTS: The likelihood of an accident was higher in children of younger fathers (odds ratio (OR) = 0.7, p = 0.04), children of mothers with non-professional jobs (OR = 1.9, p = 0.03) as well as in children of higher birth order (OR = 1.7, p = 0.01), in those with predominantly other than parental daily supervision (OR = 2.6, p = 0.001), and those with a history of previous accident (OR = 1.3, p = 0.002). Somatometric factors, school performance, use of corrective eyeglasses and subnormal auditory acuity were not found to be risk factors, but auditory imbalance and abnormal tympanograms were positively related to the risk of childhood injury (OR = 2.6, p = 0.02; and OR = 2.3, p = 0.08 respectively). CONCLUSIONS: the findings of this study underline the importance of attentive supervision and safety training of children living in modern cities; they also suggest that children with auditory imbalance and history of an accident are at higher injury risk and they should be targeted with specific intervention programs.

Accidents, Home↗

Risk of upper limb injury in left handed children: a study in Greece.

OBJECTIVES: To investigate whether left handed children are at increased risk for injuries, particularly upper limb injuries. SETTING: Athens, Greece, during a six month period in 1995-96. METHODS: Cases were 129 children 4-14 years old with unintentional upper limb injuries from a population based injury database. Two control children matched for gender and age were selected from among those seen at the same medical institution for minor, non-injury ailments. On the basis of information provided by the children and their guardians, sociodemographic variables were recorded, hand preference was assessed, and each child's activity score was calculated through an abbreviated version of Achenbach's scale. RESULTS: Left handed children have a moderately increased upper limb injury risk with a tendency of recurrence of this injury. The risk of upper limb injury is also raised among children of young fathers, whereas it appears to be inversely related to crowding index and activity score--three variables that were controlled for as potential confounders. CONCLUSIONS: This study provides limited support for the hypothesis that left handed children are at increased risk for injury. The excess risk, if genuine, is likely to be limited to cultural settings in which right handedness is perceived as the norm.

Accident Proneness↗

Coxsackievirus B3 sequences in the myocardium of fatal cases in a cluster of acute myocarditis in Greece.

AIM: The investigation of three fatal cases during a nationwide cluster of cases of an upper respiratory tract infection (URTI) associated with myocarditis and/or pericarditis in Greece in 2002. METHODS: In the three women who died, necropsies were performed and tissue sections were taken for histological examination, antigen detection by immunohistochemistry and indirect immunofluorescence assay (IFA), amplification of viral genomes by nested reverse transcription polymerase chain reaction (RT-PCR), and sequence analysis. RESULTS: All samples showed histological signs of active myocarditis. Immunohistochemistry revealed the presence of the enterovirus VP1 family of proteins and IFA revealed the presence of coxsackievirus B3 antigen. Nested RT-PCR amplified enteroviral alleles of the 5'-untranslated region which were identical to each other and to the coxsackievirus B3 sequences. CONCLUSIONS: This study provides pathological evidence of enteroviral infection among fatal myocarditis cases in a nationwide URTI cluster of cases associated with myocarditis and/or pericarditis.

Acute Disease↗

Serum immunoglobulins in a rural and an urban population of Greece with special reference to immunoglobulin A.

The serum concentration of immunoglobulins G, A, and M was studied in 390 inhabitants of a rural community and in 204 residents of an urban area of Greece. It was found that serum IgA levels were significantly higher in the rural area where intestinal infections were more prevalent. No significant difference in serum IgG was found between the two groups. IgM was found to be lower among residents of the rural area. The present findings suggest a possible ecological association between increased IgA and chronic exposure to intestinal infection.

Adolescent↗

Residence in mountainous compared with lowland areas in relation to total and coronary mortality. A study in rural Greece.

STUDY OBJECTIVE: To investigate the association of residence in mountainous or lowland areas with total and coronary mortality, in a cohort with 15 years of follow up. DESIGN AND SETTING: Prospective study, based on the adult population of two lowland and one mountainous village in rural Greece. Baseline measurements on sociodemographic, lifestyle, somatometric, clinical, and biochemical variables were recorded in 1981 during a health survey and total and coronary deaths were ascertained on the basis of death certificates up to 1996. PARTICIPANTS: 1198 men and women, who had participated in the 1981 survey. Analyses are based on 504 men and 646 women with complete data. MAIN RESULTS: There were 150 deaths among men and 140 among women (coronary deaths: 34 and 33 respectively). In multivariate analysis with Cox regression, after adjustment for age, education, body weight, smoking, alcohol consumption, systolic blood pressure, serum total cholesterol, blood glucose, serum triglycerides, and serum uric acid, total and coronary mortality were lower for residents of the mountainous village in comparison with residents of the lowland villages (hazard ratios (95% confidence intervals) for men and women, respectively: total mortality, 0.57 (0.38 to 0.84) and 0.69 (0.47 to 1.02); coronary mortality, 0.39 (0.16 to 0.98) and 0.46 (0.20 to 1.05)). CONCLUSIONS: Residence in mountainous areas seems to have a "protective effect" from total and coronary mortality. Increased physical activity from walking on rugged terrains under conditions of moderate hypoxia among the mountain residents could explain these findings.

Adult↗

Clinical phenotype in patients with alpha-synuclein Parkinson's disease living in Greece in comparison with patients with sporadic Parkinson's disease.

OBJECTIVE: An Ala53Thr mutation of the alpha-synuclein gene has been recently identified as a rare cause of autosomal Parkinson's disease (PD). The clinical characteristics of 15 patients with PD living in Greece with the Ala53Thr alpha-synuclein mutation (alpha-synPD) were compared with patients with sporadic Parkinson's disease (sPD). METHODS: An investigator, blind to the results of the genetic analysis, examined 15 patients with alpha-synPD and 52 consecutive patients with sPD. Demographic data, age at onset of the illness, modality of presentation, and duration of PD were collected. The unified Parkinson's disease rating scale, the Hoehn and Yahr scale, and the Schwab-England scale were completed. The patients with alpha-synPD were matched for duration of disease with 32 of the 52 patients with sporadic PD (MsPD group). RESULTS: Patients with the alpha-synuclein mutation were significantly younger (mean 7.6 years), showed the first sign of the disease significantly earlier in life (mean 10.8 years), and had significantly longer duration of the disease compared with patients with sPD. Tremor at onset of the disease was present in only one (6.7%) of the patients with alpha-synPD, whereas it was present in 32 (61.5%) of the patients with sPD (p=0.0006). During the course of the disease one patient in the alpha-synPD group went on to develop tremor compared with six patients in the sPD group. Rigidity, bradykinesia, postural instability, orthostatic hypotension, intellectual impairment, depression, complications of therapy, and clinical severity of the disease at the time of examination did not differ significantly between patients with alpha-synPD and those with sPD, or between patients with alpha-synPD and the MsPD group. CONCLUSION: The younger age at onset of the illness, the much lower prevalence of tremor, and the longer duration of the disease characterise the clinical phenotype in this sample of patients with alpha-synPD. The other symptoms and signs of the illness did not seem to differentiate the patients with alpha-synPD from those with sPD.

Adult↗

Time trends and seasonal variation in hospital admissions for childhood asthma in the Athens region of Greece: 1978-88.

BACKGROUND: The aim of the study was to determine the trend and seasonal variation in hospital admissions for childhood asthma in the Athens region of Greece. METHODS: Data were obtained from hospital registries of the three main children's hospitals in Athens between 1978 and 1988. Children admitted with the diagnosis of asthma, asthmatic bronchitis, or wheezy bronchitis were included. The data were expressed as admission rates per 100,000 of the same aged population. RESULTS: There were 9795 admissions for asthma over the 11 years and the admission rate rose by 294%. Admissions among those aged 0-4 and 5-14 rose by 272% and 379% respectively. Monthly admissions showed a pronounced seasonal variation, rising during the cold damp period in the 0-4 age group, but peaking around May in the 5-14 age group. CONCLUSIONS: These findings suggest that hospital admissions due to asthma in the Athens region have increased considerably since 1978, and that clear cut seasonal variations exist which are specific to age.

Adolescent↗

Seasonal activity of ixodid ticks on goats in northern Greece.

Ixodid ticks were collected at monthly intervals for 20 consecutive months from 25 goats of the local breed selected at random from a flock grazing permanently around a village in northern Greece. Three species of ixodid ticks were recovered, Ixodes gibbosus, Rhipicephalus bursa and Dermacentor marginatus. I gibbosus was the most abundant and prevalent species. It was found on the animals from October to April, and its activity increased with lower mean temperatures and higher relative humidities. R bursa was present from May to August, and its activity increased with higher mean temperatures and lower relative humidities. D marginatus was present in very small numbers from January to March, with no significant correlation with climatic factors.

Animals↗

Prevalence of leptospira species among farmed and domestic animals in Greece.

A total of 1527 serum samples from pigs, goats, sheep, cattle and dogs in Greece were examined by the microscopic agglutination test and 11-8 per cent of them had antibodies against one or more Leptospira serovars at titres of 1/100 or more. The predominant serovar affecting farm animal species was Bratislava, and Copenhageni was common among dogs and the second most important serovar when all animals were considered together. Another prevalent serovar was Australis, but antibodies to Pomona were detected only in goats and cattle.

Animals↗

Plasma C-reactive protein and risk of cancer: a prospective study from Greece.

BACKGROUND: Inflammation is an important component of carcinogenesis but little research has been conducted on whether inflammation markers can be predictive of cancer risk in humans. METHODS: We analyzed C-reactive protein (CRP), a marker of inflammation, in plasma samples of 496 cases of cancer and 996 controls selected among participants in a prospective study from Greece. RESULTS: Plasma CRP level was higher in cancer cases than controls (odds ratio for increase in CRP level of 3.2 mg/L, 1.20; 95% confidence interval, 1.10-1.32): The corresponding odds ratio after exclusion of the first year of follow-up and of individuals with CRP level above 20 mg/L was 1.32 (95% confidence interval, 1.15-1.52). Although based on small number of cases, the association between elevated plasma CRP level and risk was stronger for cancers of the liver, lung, skin, kidney, and bladder, as well as for lymphoma and leukemia than for other neoplasms. CONCLUSIONS: Our results confirm the important role of inflammation in human cancer and suggest that plasma CRP level is a potential marker of increased cancer risk.

Adult↗

Sharp increase in illicit drug use in Greece: trends from a general population survey on licit and illicit drug use.

The study aims to follow trends in the prevalence of licit and illicit substance use between 1984 and 1998 in the Greek general population. Data are drawn from two nationwide cross-sectional household surveys. Probability samples consisted of 4,297 (1984) and 3,759 (1998) 12- to 64-year-old respondents. Regular tobacco smoking in the total sample increased in women and decreased in men while alcohol consumption remained at similar levels. The use of illicit drugs showed a 3-fold increase since 1984 reaching a lifetime prevalence of 19% in males and 6% in females. In contrast, a significant decrease was noted in the unprescribed use of psychoactive medicines, especially among women. Trends in licit and illicit substance use can be explained by sociocultural and policy changes in Greece in the last 15 years.

Adolescent↗

Increasing prevalence of high-level gentamicin resistance among Enterococci isolated in Greece.

High-level gentamicin-resistant enterococci (HLGRE) (MIC >512 microg/ml) were frequently recovered in the AHEPA University Hospital, Thessaloniki, Greece, during a 15-month period (67/158, 42.4%). PCR testing showed that high-level gentamicin resistance was attributable to the presence of the aac(6')-aph(2") gene, while the recently described genes aph (2")-Ic and aph(2")-Id were not detected. High-level gentamicin resistance could be transferred with varying frequency from 41 of 57 Enterococcus faecalis and 5 of 10 Enterococcus faecium isolates. All transconjugants acquired high-level resistance to streptomycin. HLGRE cause therapeutic problems in our region, since none of the clinically available aminoglycosides can be used in severe infections.

Anti-Bacterial Agents↗