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PubMed2004

Review of clinical and toxicological features of acute pesticide poisonings in Crete (Greece) during the period 1991-2001.

BACKGROUND: In Crete, the largest island of Greece, many pesticide formulations are increasingly used in agriculture in order to raise crop production. This study reviews a number of pesticide poisoning cases registered at the Center of Toxicology and Forensic Sciences Research at the University of Crete between 1991 and 2001. MATERIAL/METHODS: The medical records and toxicological data of the pesticide poisonings are presented. The analyzed samples were mainly blood and/or urine, but also gastric fluids and other tissues. Analysis involved a variety of techniques. RESULTS: Eleven poisonings caused by paraquat (7 men, 4 women, aged 15-58 years) are reported, five of which had fatal outcome. Initial paraquat plasma levels ranged between 0.4-165 pg/ml. Thirteen intoxications due to various organophosphorous agents are presented (11 men, 2 women, aged 13-69 years). Pesticide blood levels upon admission ranged from 1.0-108 pg/ml and there were six fatalities. Carbamate poisonings (4 men, 2 women, aged 32-60 years) were caused by methomyl (initial blood levels 1.6-57 mg/l) and resulted in death. A case of methyl bromide intoxication is also presented. CONCLUSIONS: The results of the study highlight the toxic and potentially lethal effects of pesticide formulations used in agriculture. Special seminars should be run to educate farmers on the proper use of these agents and the supply of pesticides should be restricted to those who follow all safety measures. Physicians should be trained to promptly identify and treat pesticide intoxications.

Adolescent↗
PubMed2004

The Korydallos, Greece, prisons telemedicine system experience: why technology alone is not a sufficient condition.

In 1999 the Greek Ministry of Justice decided to utilise telemedicine to improve health services in the largest prison in Greece (Korydallos Prison). The Nikea Hospital in Piraeus undertook to support the effort. For 12 months following installation, intensive "hands-on" training on the use of the system was offered to the staff of both the Korydallos Prison and the Nikea Hospital. However serious operational problems related either to prison bureaucracy or to the inflexibility the Greek National Health Service has annulled the effectiveness of the Korydallos Prison telemedicine system. Still, analysis of the system development history reveals that: (1) if freed from bureaucratic and labour related obstacles, prison telemedicine is a viable option. (2) Telemedicine can avert transfers to out-of-prison medical facilities. (3) If properly implemented, telemedicine can generate substantial savings and (4) telemedicine can greatly improve the quality of care available to prisoners.

Delivery of Health Care↗
PubMedDate not supplied

Occupational injuries in Greece (1938-1955): history of medicine and descriptive epidemiology.

AIM: To describe the longitudinal trends in the rates of total and fatal occupational accidents in Greece during 1938-1955. MATERIAL AND METHODS: Information on occupational injuries have been provided from the yearly reports of the Organization of Social Insurances (1938-1955) and on population data from the tables of National Statistic Agency. Bio-statistical analysis was performed by the use of SPSS software and Stat-Calc of Epi Info. RESULTS: The evolution of the longitudinal trend of occupational accidents has revealed a biphasic character, with a decreasing trend during 1938-1945 and an increasing trend during 1946-1955. The phenomenon was obvious in both sexes and in all age groups. On the contrary fatal occupational injuries increased across the period 1938-1945 and subsequently decreased. These temporal trends can be interpreted on the light of the important reduction in the level of economic activity during the second world war and the subsequent gradual recovery in the post war period. CONCLUSION: The biphasic characteristics of the occupational accidents longitudinal trend seems to be influenced by historical factors. Important lessons were learnt from the period of war. The decrease of the rate of total occupational accidents does not necessary reflect a satisfactory level of safety at work. The level of the economic activity, the efficiency of the registration and prevention agencies play a role. In addition, the rate of fatal injuries has a critical role in benchmarking national occupational health performance.

Accidents, Occupational↗
PubMedDate not supplied

Economic evaluation of treatment strategies for patients suffering acute myocardial infarction in Greece.

INTRODUCTION: Acute myocardial infarction (AMI) is one of the leading causes of death in Greece and elsewhere. The objective of this paper was to conduct an economic evaluation of three alternative treatment options, alteplase, reteplase, and tenecteplase, in different groups of patients. METHODS: A systematic review of the literature was undertaken to identify studies evaluating the three treatments considered. Data from selected trials were extracted and applied to a decision analytic model, which has a time horizon extending to the end of a patient's life. The health outcomes included in the analysis contain all major health events that may occur after an AMI. Total treatment cost comprises the cost of initial treatment, the cost associated with hospitalisations due to AMI and events such as stroke, reinfarction, etc., and the lifetime costs of patients surviving. The model allows for different patient sub-groups. Simulation was used to test the robustness of the findings. RESULTS: For the baseline group, there was no major difference between the three treatments, in terms of treatment cost and survival. Specifically, lifetime cost per patient was around Euro 18,950 (range Euro 18,947 - Euro 18,990) and overall survival was around 8.4 years (range 8.359 - 8.472). Nonetheless, for patients above the age of 75 and for patients starting treatment 4 hours after symptom onset, tenecteplase was more cost-effective compared to the other two treatments. Its incremental cost effectiveness ratio was Euro 2,205 in the former group and Euro 868 in the latter and these results reached high levels of significance. CONCLUSION: Despite its higher price, in the setting of the Greek National Health Service tenecteplase is a cost-effective treatment for AMI patients, comparable to alteplase and reteplase, and it should also be included in the positive drug list along with the other two drugs. Simple price comparison of alternative treatments is not the best option for supporting decisions on pricing and reimbursement of new therapies.

Aged↗
PubMed2005

The attitude of nurses for the enhancement of palliative care in Greece.

PURPOSE: The aim of this study was to estimate the attitude and knowledge of nurses for the development of palliative care in Greece. MATERIAL AND METHODS: A certain questionnaire with closed questions was developed and was use as research method to collect all the necessary data to support or question the hypotheses. Eighty one nurses participated in this study. The data collected was analysed using the SPSS software. RESULTS: Of the 81 nurses questioned 22 (27.16%) were men and 59 (72.84%) were women. The average was 37.19 +/- 9.16 years of the working Experience was 14.83 +/- 9.02 years in different units, 34.3%. Answered that the palliative care must be specialty, 43.2% specialization and 23.5% course. CONCLUSIONS: The majority of nurses believe that if they had working experience in different units this won't give them the capacity to deal with patients who suffer from advanced disease.

Adult↗
PubMed2005

Health information on the internet: evaluating greek health portals and depicting users' attitudes in West Macedonia, Greece.

The increasing use of communication networks help individuals, organizations and governments to access this information as an every day practice to support their decision-making procedures. Information seekers use the web to get hold of information that exists on the Internet. A lot of times this information has to do health. The existence of health portals has made life easier for the people that need this information. However, the quality of portal interfaces as well as the portal content has many times been in doubt. Many surveys have obtained results that are negative as far as health portal quality is concerned. The purpose of this paper is to evaluate a representative selection of Greek health portals from the actual users' point of view. The evaluation takes place at a small town of North-West Greece called Ptolemais. Questionnaires and interviews as well as interface evaluation techniques are used. The outcome seems positive for the Greek health portals. The study is extended to get some estimate of simple and professional users' attitudes upon seeking health related information on the internet in Greek. The conclusions of this study regarding information preferences of health information seekers are compared to international surveys.

Attitude↗
PubMed2005

Knowledge and behaviour of tourists towards the sun, as studied in a region of northern Greece.

INTRODUCTION: Melanoma is considered one of the most malignant cancers. Its appearance is related to various factors such as ultraviolet radiation, recurrent sunburn, and phototype. During the summer holidays approximately 14 million tourists from northern European countries visit Greece; this does not include the local tourists. AIMS: To discover the extent of European visitors' awareness of the risk of sunburn. To explore the level of knowledge gained by local and foreign tourists from preventive campaigns related to the harmful effects of sun exposure. PARTICIPANTS: The sample consisted of 802 travelers from northern European countries, and 726 Greeks who departed from the airport 'Megas Alexandros' during August and September 2002. METHODS: A structured questionnaire was used to gain data about demographics, family history of skin cancer, and identification of phototype. Also requested was information about the hours of sun exposure, and the use of sunscreen (the pattern of application and its sun protective factor [SPF]). Comparisons of mean values between groups were made by Student's t-test, and the association between categorical variables was tested by Pearson's chi(2). Regression analysis was performed to examine the influence of different factors on the likelihood of being sunburned. RESULTS: The majority of foreigners belonged to phototype II or III, while the Greek tourists belonged to phototype III. Foreigners had a higher tendency to burn and a lower tendency to tan. Of the total sample, women presented a higher prevalence of sunburn (p <0.05), and they used sunscreen more frequently (p <0.001) than men did (p <0.001), in both groups. The mean SPF used was 17.3 (SD = 8.98) for the foreigners and 16.0 (SD = 2.0) for the Greeks. The media was the main source of information for both groups. Multiple regression analysis showed that skin type was significantly associated with a high probability of sunburn (p <0.001). Moreover, freckles (p <0.05) were a predictive factor for future sunburn. CONCLUSIONS: Our study showed that skin type is the most important predictor of future sunburn. The role of the primary care physician is to promote and encourage healthy habits, including attitude towards sun exposure. Increased susceptibility to sun-induced damage of persons with phototypes I and II mandates their identification as a target group in all media campaigns.

Adolescent↗
PubMed2005

Increasing incidence of melanoma in central Greece: a retrospective epidemiological study.

The increasing incidence of melanoma in the general population during the last few decades has provoked a great deal of research, aiming to identify the possible relationship between old and new etiological factors involved in the pathogenesis of this tumor. The aim of the study was to evaluate the incidence of melanoma in central Greece, especially in the prefecture of Larissa from January 1988 to December 1998. Data were collected from the General Hospital of Larissa. Seventy-one cases of melanoma were studied (41 females, 30 males). The incidence increased from 1.36/100,000 patients during the first year of the study (1988) to 5.2/100,000 patients in the last year of the study (1998). The patients'skin types were: type 12.8%, type II 52.1%, type III 45.1%. The median age of patients was 61.9 years, 61.4 years in female and 62.5 years in male patients. Concerning their occupation, farmers accounted for 56.3%. Melanomas were most frequently located on head and neck (36.6%), extremities (30.98%) and trunk (11.3%). Superficial spreading melanomas were observed in 44% of the patients and nodular melanomas in 20%. In conclusion. there was a rapid increase in the incidence of melanoma in our region especially during the last 3 years.

Female↗
PubMed2005

Long survival in a 69,XXX triploid infant in Greece.

The live birth of a triploidy infant is a very rare event and death usually occurs within the first hours of life. Triploid cases with a survival of more than two months are infrequent. We report on an infant with a 69,XXX chromosome constitution who survived 164 days. Chromosomal analysis demonstrated a 69,XXX karyotype with no evidence of mosaicism. This is the longest survival reported for this condition to date in Greece and the fourth longest worldwide. The infant was admitted to our clinic several times due to respiratory problems, and supplementary oxygen was required. The improved survival of our case was possibly due to better management of respiratory illness and prematurity, and these are essential factors that physicians should consider carefully with such rare cases.

Abnormalities, Multiple↗
PubMed2006

Presentation of childhood brucellosis in Western Greece.

The purpose of this study was to evaluate clinical and laboratory findings, treatment modalities and final outcomes of brucellosis in children and to compare our data with those of other studies performed in Greece. Fifty-two children treated for brucellosis in the Department of Pediatrics during the decade 1995-2004 were analyzed. Of the 52 children, 47 were reexamined during July 2005. Fever, arthritis or arthralgia, hepatomegaly and splenomegaly were the main findings. Young children had positive blood cultures and lower or negative antibody titers statistically significantly more often than did older children. Brucella abortus was isolated in 9 of 18 patients with positive blood cultures. Antibiotic treatment lasted for 28 days on average. There were no complications or relapses, except one, and the final outcomes were excellent.

Adolescent↗
PubMedDate not supplied

Kidney disease in medieval Serbian manuscripts from the Chilandar monastery (Mount Athos, Greece).

In the Chilandar monastery (Mount Athos, Greece) library, a collection of medical texts written in the Old Serbian Slavonic language was discovered in 1952. Because of its size and comprehensiveness, this manuscript was named the Chilandar Medical Codex. The Collection contains several manuscripts, which according to modern medical terminology, the manuscripts can be classified as texts on Internal Medicine, Infectious diseases, Toxicology, Pediatrics, Pharmacology and Surgery, belonging to different time periods. The oldest part, Text on uroscopy, is considered to have been written in 13th or 14th century and consists of 35 text pages divided into 62 paragraphs. Following the popular uroscopy methodology of macroscopic examination of urine, this text contains detailed descriptions of urine characteristics (color, consistency, sediment, odor), as well as a convincing Hippocratic description of urine formation from the filtration of metabolic and waste materials (involving the four humors) rather than blood and fumes (toxic metabolites) according to the theory of Theophilus Protospatharius and Isaac Israeli. Precise descriptions of normal and pathological urine characteristics are provided. Although kidney anatomy and function is unclear, the urinary bladder is very undoubtedly described as an organ for urine collection. In the Chilandar Medical Codex, there are about one hundred descriptions of kidney and urinary tract diseases and disorders. Many symptoms and syndromes such as hematuria, dysuria, pyuria, renal colic, anuria, polyuria, edema and dropsy, urine retention and fever, are incorporated in the broader clinical pictures of lithiasis of the kidney and/or bladder, pyelonephritis, cystitis, necrotic renal disease indicative of renal tuberculosis and tumors, acute and chronic nephritis, renal failure, and gout. Specific pharmacological prescriptions, mostly simple or compound herbal medicines, are given for each of those renal ailments.

Greece↗
PubMed2006

Caries prevalence of 11.5 year-olds between 1989 and 2001 in a province of North-Eastern Greece.

OBJECTIVE & DESIGN: To compare cross-sectional caries prevalence data of 11.5 year old children over a 13 year period (1989-2001) and to evaluate the maximum effect of the applied preventive programme (sealants to 1st molars and 6-year health education) on DMFT values during the last five years. PARTICIPANTS: Using the records of a Public Health Centre (PHC) in NE Greece, a number (153-250) of children aged 11.5-years were selected from each calendar year, constituting 11 study groups (totalling 2,217 children), stratified by area of residency. METHOD: Annual oral health education sessions provided in 1990, a year after the PHC was established. Light-cured fissure sealants were systematically mass introduced in 1996. The same dentist completed all DMFT records in the dental clinic during the children's routine visits. DMFT was analysed using two Poisson and two Binomial models for both data from all years, and for the last five years. The models had as factors: "Time" (year of examination of the study group), "Residency" (semi urban, rural lowland, rural highland), number of "Sealed 1st molars" and "Sealed posterior teeth". RESULTS: All the factors were highly statistically significant (p<0.001). Dental health was found to be good (DMFT=0), improving progressively year by year (range 12-50%). The mean DMFT decreased steadily from 4.5 (in 1989) to 1.81 (in 2001). The Significant Caries index was almost halved (from 8.08 to 4.23). CONCLUSION: An important improvement in the caries status of 11.5 year-olds since 1989 has been demonstrated, irrespective of the residency. The systematic application of fissure sealants to all 1st molars, parallel to the cumulative effect of the 6-year health education programme per child, played a significant role in reducing disparities in disease prevalence, despite the difficulty of improving rates of decline when the caries levels are relatively low.

Binomial Distribution↗
PubMedDate not supplied

Quality of life and smoking among industrial workers in Greece.

BACKGROUND: Smoking is a predictor of quality of life, while socio-economic factors influence the prevalence of smoking habits. Occupational medical research has been fairly late in coming to study quality of life aspects in working populations. OBJECTIVES: The aim of the study is the assessment of smoking prevalence among blue- and white-collar workers industrial workers in Greece and its impact on health-related quality of life. METHODS: In a cross-sectional study the Euro-Qol 5D questionnaire was been used in a random sample of 472 blue and white-collar heavy industry workers. RESULTS: 57% of the study population were current smokers. The difference in prevalence of smoking across all the examined socio-demographic variables (sex, age, education and occupation) was not statistically significant. Smoking had a significant impact on the health-related quality of life. Smokers recorded significant lower scores (74.9) in the overall Visual Analogue Scale in comparison with non-smokers (79.1), (p = 0.007). Further analysis revealed that age, smoking and education were significant predictors of VAS score. A non-significant contribution was found for occupation and sex. Smokers reported significantly higher rates of problems regarding mobility, self-care and anxiety/depression than non-smokers. Logistic regression analysis showed an independent impact of smoking on mobility, self-care and anxiety/depression level. CONCLUSIONS: Smoking is a significant hazard and a strong predictor of poor quality of life among the blue- and white-collar workers under study. Anti-smoking policies integrated into a broader context of occupational health and safety at work could reduce smoking rates and thus improve worker's quality of life.

Adult↗
PubMed2006

Prevalence of urolithiasis in rural Thebes, Greece.

INTRODUCTION: Worldwide, urolithiasis is the third most common urological disease affecting both males and females. Both genetic and environmental factors contribute to stone formation. The recurrence rate is approximately 50%, rising to 70% within 10 years and this condition represents a significant healthcare cost burden. An unusually frequent history of urolithiasis has been observed among patients from the rural area of Thebes, Viotia, Greece. OBJECTIVE: To determine the prevalence of urolithiasis in Thebes. METHODS: A representative sample of persons from the rural area of Thebes was questioned about the occurrence of urinary stones during their lifetime, and acute urolithiasis in 2005. A logistic regression model was used to contrast individuals with lithiasis to those without lithiasis. RESULTS: A total of 422 subjects participated in the study. We found a 15% prevalence of urolithiasis in the rural population of Thebes. The rate was slightly higher in men than in women in almost all age groups questioned, although this was not statistically significant. No case of urolithiasis was found in subjects under the age of 17 years. The prevalence of urolithiasis appeared to increase with age in both men and women. Those drinking bottled water were less likely to have lithiasis. CONCLUSION: The life time prevalence rate of urolithiasis observed in the rural area of Thebes was higher to that reported in other studies performed among males and females in the general population of Europe.

Adult↗
PubMedDate not supplied

Neisseria gonorrhoeae in Athens, Greece. Epidemiologic classification and antimicrobial susceptibility patterns of strains isolated between 1986 and 1989.

The incidence of gonorrhoea cases diagnosed in a major venereal hospital of Athens, Greece, was markedly reduced between 1986 and 1989. All 182 gonococcal isolates found during this period were epidemiologically classified into Sero-/Auxo-/Plasmid content (S/A/Pc) types. Susceptibility to six antimicrobials was also determined. Penicillinase-producing Neisseria gonorrhoeae (PPNG) strains were isolated in an increased frequency of 7.7% and a striking shift in their distribution into S/A/Pc types was noted from previous years. The isolates exhibited wide heterogeneity of type: none of the 14 PPNG strains was identical, while the 168 non-PPNG strains were distributed into 64 S/A/Pc types. Fifty-seven percent (57%) of the PPNG and 86% of the non-PPNG isolates were of the WII/III serogroup. Chromosomally mediated resistance to penicillin, ampicillin, or both was exhibited by 14% of the non-PPNG isolates. Greater frequency of reduced susceptibility to cefotaxime, tetracycline, and chloramphenicol was also found among PPNG and non-PPNG strains, mostly of the WII/III serogroup. Twelve percent (12%) of the non-PPNG and 57% of the PPNG strains had multiple patterns of resistance, involving 2 to 4 antimicrobials of different class lines.

Anti-Bacterial Agents↗
PubMedDate not supplied

Teaching of clinical nutrition at the University of Crete, School of Medicine, Greece.

The prevalence of malnutrition in hospitalized patients is reported to be unacceptably high, and lack of nutrition awareness among physicians/surgeons and medical students is considered an important contributory factor. We report our experience with the recently instituted clinical nutrition course at the medical school of the University of Crete, Greece. The course was designed with a bias in favor of the clinical application of nutrition at the patient and community level rather than in the format of formalized lectures. The students' answers to a questionnaire regarding the course indicated that 90% enjoyed it in terms of learning, 97% benefited from it, and 79% would like to see it adopted as the mode of teaching in the future. It is suggested that, in keeping with emerging evidence, such courses may have an important role in the teaching, application, and increased awareness of nutrition among medical students and practicing physicians.

Curriculum↗
PubMed1990

[Dental concerns and oral health in population of Greece--future perspectives].

With a profusion of statistical data the authors describe the dental service in Greece, pointing out in particular the difference between the facilities available in the cities and in the country. This is followed by details of the dental insurance system, epidemiological data on the oral health of the population, and examples of prophylactic dentistry. The article concludes with some thoughts on the outlook for the future.

Adolescent↗
PubMed1990

Diet and cancer: methodological complexities and case-control studies in Greece.

Some methodological difficulties of epidemiological studies exploring the role of diet in the etiology of human cancer are considered and suggested corrective approaches are discussed. The advantages and disadvantages of case-control studies in this field are critically examined. The results and implications of several such studies undertaken in Greece are reviewed.

Bias↗