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Prevalence of hemochromatosis gene (HFE) mutations in Greece.

The frequencies of the hereditary hemochromatosis gene (HFE) mutations C282Y and H63D vary between different populations. There are a limited number of reports regarding the frequency of these mutations in populations of southeastern Europe. Two hundred and sixty-four adult individuals of Greek origin were examined for the C282Y and H63D mutations to determine the allele and genotype frequencies. The HFE gene region of DNA samples extracted from peripheral leukocytes was amplified by the polymerase chain reaction. Restriction enzyme analysis was performed using RSAI for C282Y and MBOI for H63D. None of the 264 individuals carried the mutation C282Y. Forty-three individuals (16.2%) were heterozygous carriers of the H63D allele and 2 were homozygous for this mutation (0.75%). The overall H63D allele prevalence is thus estimated at 8.9%. HFE mutation frequencies were low in the population studied and this may explain, in part, the relative rarity of clinical cases of hereditary hemochromatosis in Greece.

Adult↗

The emergence of glycopeptide-resistant Enterococcus faecium in a university hospital in southwestern Greece.

BACKGROUND: Enterococci and especially glycopeptide-resistant strains (GRE) are widely distributed in the hospital environment, by acquiring resistance determinants and virulence factors. METHODS: The study included 48 GRE isolated during a 1-year period from different inpatients in a tertiary hospital in southwestern Greece. Antibiotic susceptibility was determined by the Etest, and the presence of resistance and virulence genes was shown by PCR. Clonal types were identified by pulsed-field gel electrophoresis of SmaI DNA digests. RESULTS: All GRE were multi-resistant of the VanA phenotype, verified by the detection of the gene by PCR. Two major clones were distributed in all hospital wards. The majority of the strains (46 of 48) harbored the esp gene, while 27 GRE expressed also the gelE and/or as genes. CONCLUSIONS: The spread of two clones expressing the vanA gene and virulence factors were responsible for the emergence of GRE in the University Hospital of Patras.

Anti-Bacterial Agents↗

Consumption of ready-to-eat cereals in relation to health and diet indicators among school adolescents in Crete, Greece.

BACKGROUND/AIMS: We aimed at examining the intake of ready-to-eat cereals (RTEC) among adolescents in Crete, Greece, and investigate relationships with health and diet indicators. METHODS: A sample of 392 adolescents (183 boys, 209 girls) aged 15 +/- 0.4 years, attending high schools of two major counties in Crete, was studied to determine consumption of RTEC using a frequency questionnaire. Anthropometric measurements were performed and blood was drawn for analysis of serum lipoproteins and blood glucose (BG). The physical fitness was assessed with the 20-meter shuttle run test (SRT) and the amount of time watching television was estimated. Nutrient intakes were calculated through 24-hour dietary recalls. RESULTS: 42% (n = 77) of boys and 43% (n = 90) of girls reported consumption of RTEC at least once per week. Approximately 40% of the male and 47% of the female consumers reported eating RTEC only at meals other than breakfast. RTEC consumption was inversely related to the obesity indices and BG levels, and positively related to the SRT (p < 0.05 in all analyses). RTEC consumers had significantly higher intakes of fibre, magnesium, calcium, iron, folate, and vitamins A, B2 and B6 (p < 0.05 in all analyses). CONCLUSION: Our results demonstrated favourable associations between RTEC intake and health and diet indicators in Greek adolescents, with potential implications for improved health status and chronic disease risk reduction.

Adolescent↗

C3 polymorphism in Greece.

The polymorphism of the third component of the human complement (C3) was investigated in a sample of 1,055 unrelated healthy individuals from nine different areas of Greece. The estimated gene frequencies were: C3S = 0.786 and C3F = 0.211. Three individuals were found to have rare variant C3 types. The allele frequencies resemble those reported for other Caucasian populations.

Alleles↗

Hemorrhagic fever with renal syndrome in an endemic area of Greece.

From 1983 to 1990, 32 patients with hemorrhagic fever with renal syndrome (HFRS) were admitted to our hospital. The diagnosis was confirmed by high IgM type titers of antibodies to Hantaan virus. All patients presented with serum and urine abnormalities suggesting renal involvement. Serum creatinine was elevated and ranged between 1.8 and 14.3 mg/dl. Proteinuria ranged between 0.5 and 6.4 g/24 h. Seven patients died due to shock or hemorrhage, while 6 patients were supported by hemodialysis or peritoneal dialysis. Five of them had a complete recovery. Two patients were discharged with some degree of renal impairment which remained stable 12-15 months later. Kidney biopsy in the first patient performed 1 year after his discharge revealed some degree of interstitial fibrosis and tubular atrophy as well as an area with ischemic and sclerosed glomeruli. We conclude that HFRS in Greece is a severe disease with a high mortality rate. The disease may cause chronic renal failure in a limited number of patients.

Adult↗

High incidence of malignant pleural mesothelioma in neighbouring villages of Northwestern Greece.

Between 1981 and 1985 seven patients from three villages of the Metsovo area in Northwestern Greece (population 5000) developed malignant pleural mesothelioma (MPM). The diagnosis was made with pleural biopsy and pleural fluid cytology. Six of these patients have died 18-24 months after the first symptoms (usually dyspnea on exertion) and 1 is still alive after 24 months. Seven MPMs in 5,000 in five years is about 280 times the expected incidence of 1/1,000,000/year. In the same area, endemic pleural calcifications linked to nonoccupational asbestos exposure have recently been reported, but none of our patients with MPM had pleural calcifications. The combination of MPM and pleural plaques in such a high frequency in the same area strongly suggests asbestos fiber as a common etiologic agent. On the other hand, the fact that the combination of MPM and pleural plaques did not occur in the same individuals, suggests a different response to this common offending agent.

Adult↗

Ulcerative colitis in Greece: course and prognostic factors.

The clinical course and prognosis of ulcerative colitis were studied in a group of 205 Greek patients. The study lasted for 6 years and follow-up was achieved in 98% of the patients. In most patients the disease was confined to the left bowel and it was of mild or moderate severity. Mortality was absent during the first attack and low at completion of the study while the cumulative colectomy rate was 14%. Bad prognostic factors leading to severe attacks and colectomy were: extensive disease, young age at onset and continuous symptoms. Compared to highly developed countries, the disease in Greece seems to run a milder course as can be judged by the better outcome of severe attacks and the more favorable short-term prognosis.

Adult↗

Molecular basis and haplotype analysis of delta, beta-thalassemic chromosomes in Greece.

The molecular defect was defined in 38 delta beta-thalassemic chromosomes from 30 unrelated heterozygous and 4 homozygous patients of Greek origin. Restriction fragment beta-gene cluster haplotypes were studies in 23 delta beta-thalassemic chromosomes. The molecular lesion was identical in all studied cases and corresponds to the 'Sicilian' type of delta beta-thalassemia. Restriction haplotypes analysis has shown that, with one exception only, all Greek delta beta-thalassemic chromosomes bear the polymorphic sites which characterize haplotypes I or VII, the former being probable by indirect evidence. The striking similarities of the molecular lesion and the underlying haplotypes are consistent with two theories: (1) The deletion occurred once on a chromosome and spread all over Greece and the Mediterranean area thereafter; (2) the 5' subhaplotype +----favors the deletional event in the delta-beta gene area.

Base Sequence↗

Prevention of thalassaemia and haemoglobin S syndromes in Greece.

Clinically severe thalassaemia and Hb S syndromes are a major public health problem in Greece. A wide programme aiming at reducing the births of new cases is under way; it comprises (a) carrier identification either at a premarital stage or prior to the birth of first child and (b) prenatal diagnosis. Participation is voluntary and free of charge. Reduction of births of affected children has been obtained to a very large extent.

Anemia, Sickle Cell↗

Mental health care delivery system in Greece: a critical overview.

The organizational profile of the mental health care delivery system in Greece is mainly characterized by centralization which is reflected in various functional parts of the system (uneven distribution of psychiatric beds and manpower, absence of psychiatric units in general hospitals serving a certain catchment area, lack of community-based psychiatric services, etc.) As a result of this centralized structure there is a centrifugal flow of the mentally ill patients toward Athens and Thessaloniki and consequently the existing possibilities for community-based care as an alternative to inpatient treatment are rather limited. Future immediate objectives of the national social policy planning should be based on decentralization and reorganization of the psychiatric services in order for the mental health delivery system to respond more effectively to the mental health needs of the Greek population.

Delivery of Health Care↗

Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece.

OBJECTIVE: This study evaluated the severity of posttraumatic stress and depressive reactions among children and adolescents 3 months after the 1999 earthquake in Ano Liosia, Greece, and additionally assessed the relationship of these reactions to objective and subjective features of earthquake exposure, sex, school level, postearthquake difficulties, death of a family member, and thoughts of revenge. METHOD: This school-based study of 1,937 students was conducted in two differentially exposed cities (Ano Liosia, at the epicenter, and Dafni, 10 kilometers from the epicenter) with an earthquake exposure questionnaire, the UCLA Posttraumatic Stress Disorder (PTSD) Reaction Index, and the Depression Self-Rating Scale. RESULTS: Endorsement of earthquake-related exposure items between the two cities was congruent with the extent of earthquake impact in each city. Median PTSD Reaction Index scores were significantly higher in Ano Liosia. The estimated rates of PTSD and clinical depression for both cities combined were 4.5% and 13.9%, respectively. Depression, subjective and objective earthquake-related experiences, and difficulties at home accounted for 41% of the variance in severity of PTSD reactions. PTSD score was the single most powerful variable predicting depression (36% of the variance), with only sex making a small but significant additional contribution. CONCLUSIONS: This study demonstrated the feasibility of conducting large-scale school-based postdisaster mental health screening for planning intervention strategies. The present findings regarding PTSD and depression indicate the need to provide targeted specialized postdisaster mental health services to subgroups with significant levels of posttraumatic stress and depressive reactions after an earthquake of moderate intensity.

Adolescent↗

Psychotherapeutic possibilities in a rural community mental health center in Greece.

The psychotherapeutic possibilities were explored in an experimental community mental health center covering a rural, secluded district in Greece. Cultural difficulties and visualization of the therapist as a protective figure produced some initial resistances, while somatization was common. Various psychotherapeutic approaches, including a mobile unit's intervention in the villages, were organized to cover the countryside's needs.

Community Mental Health Centers↗

Antiphospholipid syndrome in Greece: clinical and immunological study and review of the literature.

The aim of this paper is to analyze the epidemiologic, clinical, and immunologic characteristics of the antiphospholipid syndrome (APS), primary or secondary, in autoimmune patients from Northern Greece. Sixty-seven patients with APS were included (9 men, 13.4%, and 58 women, 86.6%). Fifty-two (77.6%) patients had secondary APS and 15 had primary APS (22.4%). The mean age was 46.0 +/- 15.4 years and the mean follow-up period was 62.7 +/- 15.0 months. Medical records were retrospectively analyzed from January 1994 until December 2001, according to a preestablished protocol. Eight patients (11.9%) had arterial thrombosis, 12 (17.9%) had vein thrombosis, 12 (17.9%) had thrombocytopenia, 20 (29.8%) had neurologic disorders, and 51.6% of the women in reproductive age had, at least 2 fetal losses (higher frequency in primary APS). Thirty-six patients (53.7%) had increased levels of both immunoglobulin G (IgG) and IgM anticardiolipin antibodies (ACA), 19 (28.4%) had IgG ACA only, and 12 (17.7%) had IgM ACA only. Antinuclear antibodies (ANA) were detected in 46 (68.6%) patients, and antineutrophil cytoplasmic antibodies (ANCA) in 29 (43.3%). All patients were prophylactically treated with aspirin (50-100 mg/day) and low-molecular-weight heparin and/or intravenous immunoglobulins-IVIGs occasionally (pregnant women). The findings of this study are, generally, similar to those described by others. Miscarriages seem to be more frequent in women with primary APS (p < 0.05), compared to other studies. Differences between these findings and those described by others concerning epidemiologic, clinical, or immunologic data are discussed.

Adolescent↗

Utilization of psychiatric inpatient care in Greece: a nationwide study (1984-1996).

This report examines the trends in the utilization of psychiatric inpatient care for the period 1984-1996, when the implementation of the psychiatric reform programme was initiated in Greece. Admissions in public mental hospitals declined by 7.2%. However discharges have been increased by 30.6% with a parallel decrease of the length of stay by 53.7% followed by an increase in discharges of patients diagnosed as suffering from schizophrenia and affective psychoses by 61.1% and 123.8% respectively. In the private sector a remarkable reduction in both admissions and discharges was noticed. Admissions in psychiatric departments of general hospitals for the same years have been increased by 1054.1%. It seems that the recent deinstitutionalization process resulted in increasing trends in the discharges of patients suffering from psychoses. Additionally, a substantial increase in the number of extramural psychiatric services and rehabilitation places between 1994-1996 was observed. The demand for the mental health care services expressed as the urbanization index was found to be related with mental health professionals and the extramural units ratios. The higher degree of urbanism is, the greater the number of extramural services exist. The models explained variance reached 50.6%.

Affective Disorders, Psychotic↗

Greece: the transition to community care.

The system of psychiatric care in Greece is described. It was based until recently on overcrowded, large asylums inhabited by chronic mental patients. The mental health system was highly centralized, with an uneven distribution of both facilities and manpower. Out-patient and rehabilitation facilities were particularly scarce. Recent reforms funded by both the Greek State and the Social Fund of the EC are outlined. These changes started in the late Seventies and are aimed at creating a comprehensive system of community-oriented mental health care. The new system is gradually being deployed, and it is expected that in the following years it will effectively cover the needs of the whole country.

Community Mental Health Services↗

Recent advances in community psychiatry and psychosocial rehabilitation in Greece and the other southern European countries.

During the late 1960s and early 1970s community psychiatry and the transformation of psychiatric services was introduced in several Northern European countries. In Southern Europe, with the exception of Italy, changes in the mental health care delivery system regarding mental health legislation and decentralisation of services have only taken place since the mid-1980s. In this report several issues related to developments in institutional and community psychiatric care in Greece, Italy, Portugal and Spain are presented. A comparison is provided between some socioeconomic and psychiatric morbidity indicators and the availability of alternative community based care and rehabilitation in these countries.

Community Mental Health Services↗