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E Petridou

Publications and source records attributed to E Petridou.

At least 37 records · Page 2Linked to original sources
PubMed2002

Why is endometrial cancer less common in Greece than in other European Union countries?

Among European countries, Greece has the lowest incidence of and mortality from endometrial cancer. We have undertaken a case-control study aiming to identify possible reasons for this. Cases were 84 women with histologically confirmed incident endometrial cancer, whereas controls were another 84 women with intact uterus admitted for small gynaecological operations, mainly pelvic prolapse. Women provided information concerning socio-economic, reproductive and medical variables. Most findings were in line with those previously reported from other investigations; no association was as striking as to suggest an effect modification that could underlay the favourable position of Greece with respect to endometrial cancer. Novel findings were the statistically significant inverse associations of endometrial cancer with coffee drinking and suggestive inverse associations with height-induced abortions. Low average height of Greek women, high frequency of induced abortions and low frequency of replacement oestrogens use may contribute to the lower endometrial cancer incidence in Greece.

Age Factors↗
PubMed2002

What distinguishes unintentional injuries from injuries due to intimate partner violence: a study in Greek ambulatory care settings.

OBJECTIVES: Intimate partner violence (IPV) is an important sociocultural and public health problem. This study aims to assess sociodemographic and injury characteristics of IPV victims among adults in a traditional southern European population. SETTING: Accident and emergency departments of three sentinel hospitals in Greece participating in the Emergency Department Injury Surveillance System (EDISS). METHODS: Data on sociodemographic variables, as well as event and injury characteristics were retrieved from the EDISS database during the three year period 1996-98. Out of a total of 27 319 injured women aged 19 years or more, 312 (1.1%) were reported as IPV related and were compared with 26 466 women with unintentional injuries. Among the 35 174 men with injuries 39 (0.1%) were reported as IPV related and were compared with 34 049 men with unintentional injuries. The data were analyzed through simple cross tabulations and multiple logistic regression. Positive predicted values for selected injury characteristics were also calculated. RESULTS: IPV is more common in rural than in urban areas of Greece. Women are 10 times more frequently IPV victims but men are also IPV victims; younger women and older men are disproportionately affected by IPV. The relative frequency of the phenomenon increases during the late evening and night hours. Certain types of injuries, notably multiple facial injuries, and presentation of the injured person on his/her own at the emergency department or combinations of predictive characteristics are strongly indicative of IPV. CONCLUSIONS: Injuries due to IPV are not uncommon in Greece, not withstanding the traditional structure of the society and the tendency of under-reporting. Certain injury characteristics have high positive predictive values and could be used in screening protocols aiming at the correct identification of the underlying external cause in injuries that may be caused by IPV.

Adult↗
PubMed2002

Bunk versus conventional beds: a comparative assessment of fall injury risk.

OBJECTIVE: To depict the magnitude and spectrum of childhood injuries attributable to falls from bunk beds in comparison with conventional beds and to outline sociodemographic risk factors and injury characteristics. STUDY DESIGN: Case-control investigation. SETTING: Accident and emergency departments of four hospitals in Greece, namely a teaching children's hospital and a trauma hospital in Greater Athens and the two district hospitals in the Magnesia county and the Corfu island. PATIENTS: During the three year period 1996-98, 1881 children (0-14 years) presenting with bed fall injuries were recorded by the Emergency Department Injury Surveillance System (EDISS). Out of these, 197 children with falls from bunk beds served as cases and 1684 children with falls from conventional beds served as controls. RESULTS: From the analysis and a nationwide extrapolation, it was calculated that each year about 5000 children in Greece (total population 10 million) seek medical attendance at an emergency department for a bed injury, corresponding to an estimated incidence of about 3 per 1000 children years. Out of bed fall injuries, 10.5% are from bunk beds, 10.4% from cribs, 3.1% from cots, and 76.0% from other conventional beds. Falls from the bed ladder accounted for 8% of all bunk bed injuries. Boys are at higher risk for falls from beds but there is no evidence that the proportion is different depending on the type of bed used. Relatively few falls from bunk beds are recorded outside the crowded apartments of Greater Athens or among migrant children. The increased relative risk of injuries from bunk bed falls during the sleeping hours indicates the higher risk of injury after a fall from a bunk rather than a conventional bed. Injuries from bunk bed falls are generally more serious than those from conventional bed falls (overrepresentation of brain injuries, fractures, multiple injuries, and injuries requiring hospitalisation). Overall, it can be estimated that almost half of the sleep related bunk bed injuries are easily preventable. CONCLUSIONS: Falls from bunk beds represent a non-negligible childhood injury risk. A sizeable fraction can be avoided with simple design modifications of the product, such as use of side rails in the upper bed or removal of the bed ladder when not in use.

Accidental Falls↗
PubMed2002

Countrywide estimation of the burden of injuries in Greece: a limited resources approach.

BACKGROUND: We have assessed the ability of the Emergency Department Injury Surveillance System (EDISS), a registration network operating with limited resources, to predict the burden and pattern of injuries in the whole Greece. METHODS: We have compared hospitalizations calculated on the basis of EDISS with those routinely recorded by the National Statistical Service countrywide. EDISS relies on data collected in the Emergency Departments of four hospitals, two located in the Greater Athens area, and two district hospitals in the remaining Greece. EDISS data concern hospitalized and non-hospitalized patients of all ages, with all types of injuries irrespectively of their etiology or intent. RESULTS: Over a three-year period 148 835 subjects with injuries were interviewed. Using sampling ratios of 2.2% for all injuries outside Greater Athens and for adults in Greater Athens but 28.9% for childhood injuries, the total annual number of injuries in Greece was estimated at 1.53 million (95% confidence interval: 1.48-1.57 million). Of those, about 18% concern children less than 15 years old. The difference between the EDISS estimated and the actually recorded hospitalized injuries was, in preliminary terms, acceptable. DISCUSSION: Of the ten major categories of injuries, seven among children and five among adults have shown deviations of less than 20%. For the remaining categories deviations were larger but in only one instance did the difference exceed 50%. It is concluded, that for a small and relatively homogeneous country, like Greece, injury data provided by four large hospitals can generate reasonably reliable estimates for large categories of injuries.

Adolescent↗
PubMed2001

The association between CagA status and the development of esophagitis after the eradication of Helicobacter pylori.

BACKGROUND: Strains of Helicobacter pylori with the cytotoxine-associated gene A (cagA) are linked to severe forms of gastroduodenal disease. Although eradication of H. pylori may predispose to the development of reflux esophagitis, the effects of CagA status on risk of esophagitis after successful H. pylori treatment are not known. METHODS: We studied 50 consecutive patients without esophagitis in whom H. pylori was eradicated successfully. CagA status was determined by immunoblotting sera from patients against H. pylori antigens. Patients underwent upper gastrointestinal endoscopy before eradication and 6, 12, 18, and 24 months after eradication or when reflux symptoms occurred. Biopsy specimens of the antrum and corpus were evaluated for gastritis before H. pylori eradication and at the end of the study. The sum of the scores for acute and chronic inflammation (both measured on a 0 [absent] to 3 [severe] scale) comprised the total gastritis severity score. RESULTS: In a multivariate proportional hazards regression analysis, positive CagA serology (hazard ratio [HR] = 10, 95% confidence interval [CI]: 1.3 to 81) and moderate-to-severe corpus gastritis (total severity score > or =4) before eradication (HR = 2.3, 95% CI: 1.2 to 6.1) were independent risk factors for the development of esophagitis after H. pylori eradication. CONCLUSION: Patients infected with strains of H. pylori that are cagA-positive are at increased risk of developing esophagitis after eradication of H. pylori.

Adult↗
PubMed2001

Transplacental chemical exposure and risk of infant leukemia with MLL gene fusion.

Infant acute leukemia (IAL) frequently involves breakage and recombination of the MLL gene with one of several potential partner genes. These gene fusions arise in utero and are similar to those found in leukemias secondary to chemotherapy with inhibitors of topoisomerase II (topo-II). This has led to the hypothesis that in utero exposures to chemicals may cause IAL via an effect on topo-II. We report a pilot case-control study of IAL across different countries and ethnic groups. Cases (n = 136) were population-based in most centers. Controls (n = 266) were selected from inpatients and outpatients at hospitals serving the same populations. MLL rearrangement status was derived by Southern blot analysis, and maternal exposure data were obtained by interviews using a structured questionnaire. Apart from the use of cigarettes and alcohol, very few mothers reported exposure to known topo-II inhibitors. Significant case-control differences were apparent for ingestion of several groups of drugs, including herbal medicines and drugs classified as "DNA-damaging," and for exposure to pesticides with the last two being largely attributable, respectively, to one nonsteroidal anti-inflammatory drug, dipyrone, and mosquitocidals (including Baygon). Elevated odds ratios were observed for MLL+ve (but not MLL-ve) leukemias (2.31 for DNA-damaging drugs, P = 0.03; 5.84 for dipyrone, P = 0.001; and 9.68 for mosquitocidals, P = 0.003). Although it is unclear at present whether these particular exposures operate via an effect on topo-II, the data suggest that specific chemical exposures of the fetus during pregnancy may cause MLL gene fusions. Given the widespread use of dipyrone, Baygon, and other carbamate-based insecticides in certain settings, confirmation of these apparent associations is urgently required.

Acute Disease↗
PubMed2001

Smoking and alcohol in the etiology of oral cancer: gender-specific risk profiles in the south of Greece.

Oral and pharyngeal cancer (OC) mortality is very low in Greece, especially among men, compared to other European countries. We conducted a case-control study of OC in Athens, and obtained information on tobacco, alcohol use and other potential risk factors and confounding variables for 110 incident cases and 115 hospital-based controls. We used multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tobacco smoking (pack years, P(trend)=0.01) and alcohol use (drinks/week, P(trend)=0.07) were independent risk factors, with a multiplicative effect for combined exposures (OR, 8.3; 95% CI, 2.4-29.1, for >28 alcohol drinks/week and >50 pack years of cigarette smoking). The type of alcoholic beverage also seemed important: drinking ouzo and tsipouro (liquors of high ethanol concentration) was associated with greater increased OC risk than drinking comparable amounts of wine, beer or dark spirits. While alcohol drinking is more common for male cases versus controls, few men reported regularly consuming large quantities of ethanol associated with highest risk of OC in other studies. This may partially explain the low rates of male OC mortality in Greece. Among the 38% of our cases who were women, however, neither smoking nor alcohol drinking frequencies were significantly elevated compared to controls, and so the etiology of OC risk in females requires further investigation.

Adult↗
PubMed2001

Evidence on the infectious etiology of childhood leukemia: the role of low herd immunity (Greece).

OBJECTIVE: Acute lymphoblastic leukemia (ALL) among children may be a rare outcome of a delayed non-specific infection in situations of overall low herd immunity. We evaluated the hypothesis as to whether newly diagnosed ALL cases, compared to their controls, are characterized by lower herd immunity, as reflected in a more seronegative spectrum to several agents, with the exception of a strongly positive response to a single infectious agent, assumed to trigger ALL. METHODS: The study included 94 incident cases of ALL, from all pediatric hematology-oncology units of Greece, and 94, matched for age and gender, controls hospitalized with minor non-infectious conditions. The past exposure to common infections was assessed using 10 serological markers. RESULTS: There was little evidence for an association of ALL with the serology of any of the studied infectious agents among the very young children. In contrast, among children aged 5 years or older, leukemia was inversely associated with seropositivity to Epstein-Barr virus, human herpes virus-6, Mycoplasma pneumoniae and parvovirus B19. CONCLUSIONS: Among children aged 5 years or older the risk of leukemia may be higher when the low herd immunity for several agents is challenged by late infection from an agent that, as a rule, would attack children at a younger age.

Case-Control Studies↗
PubMed2001

Sports injuries among children in six European union countries.

Since sports participation entails the risk of injuries that account for substantial morbidity and disability, the existence of adequate epidemiological information is essential for the development of sound preventive strategies. In this study, we present data on the occurrence of sports injuries among children in six European countries, namely Austria, Denmark, France, Greece, The Netherlands, and the United Kingdom. An operational definition for sports injuries was developed, and comparable data from the European Home and Leisure Accident Surveillance System, an established injury surveillance system operating in 12 European union countries, were collected from the participating member states, during a 1-year period (1998). Sports injuries were examined in schools, in organised and unorganised settings, and in specific types of sports by demographics and injury descriptive variables. Sports injuries represent a quantitatively important and sufficiently serious problem in European union countries, accounting for an estimated annual number of about a quarter of a million outpatient visits in two of the participating countries, which provide national estimates. It is evident, that sport injuries are not only common but also injuries of considerable severity, since a large fraction represents fractures, while approximately 4% of the total require hospitalisation. Football and basketball among male children are, in declining order, the two sports responsible for the most frequent injuries in the European union countries, whereas gymnastics and volleyball prevail among females. The study indicates the importance of injury surveillance in describing the epidemiology of sports injuries and provides an estimate of the magnitude and the profile of sport injuries that take place annually in European union countries.

Adolescent↗
PubMed2001

Lymphocyte alterations after prolonged sunlight exposure.

BACKGROUND: It has been suggested that prolonged exposure to sunlight may induce systemic or local immune alterations, which may facilitate the development of skin cancer and, perhaps, non-Hodgkin's lymphona. The effects of prolonged sunlight exposure on peripheral blood cells were studied. METHODS: Leukocytes and lymphocyte subpopulations of 12 volunteers aged 10-45 were investigated before and after a 3-week summer holiday in seaside resorts in Greece. Lymphocyte phenotypes were estimated using monoclonal antibodies and flow cytometry. RESULTS: There were no significant differences with respect to total numbers of T cells, T-helper/inducer, T-suppressor/cytotoxic, B cells or HLA-Dr+ cells. However, we have found evidence of lymphocyte stimulation, reflected in an increase in cells expressing the interleukin-2 receptor (IL-2R) and, more specifically, an increase in the T cells expressing IL-2R and HLA-Dr antigens. An increase in natural killer cells has also been noticed. CONCLUSIONS: These findings suggest that prolonged intense exposure to sunlight may be associated with immunostimulation, rather than immunosuppression.

Adolescent↗
PubMed2001

Are there common triggers of preterm deliveries?

OBJECTIVE: To assess the effect(s) of transient events which are perceived as stressful on the inseption of preterm delivery. DESIGN: A case-control study, with immature infants as cases and borderline term babies as controls. SETTING: A teaching maternity hospital in Athens. POPULATION: All infants born at less than 37 weeks of gestation, during a twelve-month period. METHODS: Information was collected about maternal socio-demographic and lifestyle characteristics, clinical variables and stressful events occurring within two weeks prior to delivery. MAIN OUTCOME MEASURES: Factors affecting the risk of preterm delivery. RESULTS: Extreme prematurity (<33 weeks) is more common among younger (<25 years of age) and older (>29 years of age) women and is positively associated with parity, body mass index and smoking, whereas it is inversely associated with educational level, regular physical exercise and serious nausea/vomiting. After controlling for these factors, however, only coitus during the last weeks of pregnancy had a significant triggering effect on prematurity (P = 0.004, odds ratio 3.21, 95% CI 1.45 to 7.09 for very immature babies, and P = 0.04, OR = 2.20, 95% CI 1.03 to 4.70 for immature babies). On the contrary, several events perceived as stressful, such as illness of relatives or friends, husband's departure, loss of employment, were unrelated to the onset of premature labour. CONCLUSIONS: Coitus during the last few weeks of pregnancy appears to increase the risk of preterm delivery, while a possible detrimental effect of physical exertion seems more limited. Stressful events should not receive undue attention as possible causes of preterm delivery.

Adult↗
PubMed2001

How common is abuse in Greece? Studying cases with femoral fractures.

AIMS: To examine the extent of undiagnosed child abuse in Greece by studying young children with femoral fractures, which may be associated with abuse. METHODS: Fifty seven consecutive cases of children under 6 years of age with femoral fracture were identified from the Emergency Department Injury Surveillance System database. Controls were 4162 children with other orthopaedic injuries from the same database. RESULTS: Whereas in the literature about one third of femoral injuries among young children are attributed to child abuse, no child in the studied series had been diagnosed or even investigated in this context. Nevertheless, the pattern of occurrence of femoral injuries was compatible with that of child abuse, in that patients were frequently very young boys of low socioeconomic status, and the accident had frequently occurred under poorly identified or implausible conditions at time periods when most family members were crowded at home. CONCLUSIONS: Epidemiological risk factors for child abuse characterise femoral fractures in young children in Greece. It appears that child abuse is present in this country as in most other cultures. There is a clear need for refocusing medical personnel and hospital social services so that the problem is revealed, quantified, and appropriately dealt with.

Accidental Falls↗
PubMed2001

Insulin-like growth factor binding protein-3 predicts survival from acute childhood leukemia.

OBJECTIVE: To investigate whether the three principal components of the insulin-like growth factor (IGF) system, IGF-1, IGF-2 and IGF binding protein-3 (IGFBP-3), are associated with survival from childhood leukemia. PATIENTS AND METHODS: 116 children, 0--14 years old, with newly diagnosed and bone-marrow-biopsy-confirmed acute childhood leukemia between 1993 and 1996 were followed up until death or March 31, 1998. IGF-1, IGF-2 and IGFBP-3 were measured at diagnosis and clinical data, including presence of hepatosplenomegaly and number of white blood cells, were available. RESULTS: After controlling for gender, age, indicators of clinical severity and the other measured components of the IGF system there was a statistically significant (p < 0.05) inverse association of IGFBP-3 with survival. An increment of one standard deviation in IGFBP-3 was associated with a 65% reduction of the death hazard among the children with leukemia. Neither IGF-1 nor IGF-2 was associated with survival in this data set. CONCLUSION: The presented empirical evidence in conjunction with the fact that IGFBP-3 modulates IGF-1 and IGF-2 bioavailability and is likely to have proapoptotic effects makes this compound a plausible independent predictor of survival from childhood leukemia.

Adolescent↗
PubMed2001

Person, time and place coordinates of pedestrian injuries: a study in Athens.

UNLABELLED: The aim of this study was to investigate whether socioeconomic status of town of residence is associated with risk for childhood pedestrian injuries. The study population consisted of all pedestrian victims, aged 0-14 y, who lived in towns of Greater Athens and who presented to the Emergency Department of a major Children's Hospital during the period 1996-98. The towns were divided into three categories by socioeconomic status according to the proportion of (a) adult household heads with a higher education degree and (b) households with less than one person per room. The rate of pedestrian injuries was estimated by socioeconomic status of the residential town and by place of accident (inside or outside the respective town). The pedestrian injury rate ranged from 5.5 to 12 injured children among a 10000 childhood population per year, with an almost twofold excess among children residing in the less wealthy towns compared with the wealthier ones. The social gradient was steeper for injuries occurring outside the residential town. The population fractions of pedestrian injury rates attributable to educational level and household crowding differentials, regardless of the place of accident, were 39% and 25%, respectively. CONCLUSIONS: There is a considerable social gradient for childhood injuries irrespective of place of accident, a finding that could be partly attributable to lower socioeconomic background rather than to adverse environmental factors prevailing in less wealthy towns. Our findings indicate that there is a need for preventive programmes targeting people as well as places of low socioeconomic status.

Accidents, Traffic↗
PubMed2001

Intentional childhood injuries in Greece 1996-97--data from a population-based Emergency Department Injury Surveillance System (EDISS).

AIM: It has been gradually recognized that intentional injuries among children represent a largely hidden problem in modern societies. With the exception of mortality, population-based data from Greece have not been previously reported. To assess the magnitude and the characteristics of intentional injuries among children aged 0-14 years old, data from the population-based Emergency Department Injury Surveillance System (EDISS) database during the period 1996-97 were used. METHODS: EDISS relies on personal interviews with children and their escorts who contact the emergency departments of three hospitals. Two of these hospitals are district hospitals of the county of Magnesia and the island of Corfu, whereas the other is a university children's hospital that covers the Greater Athens area on alternative days. RESULTS: Among 46.807 children recorded in EDISS, 108 injuries (0.23%) were attributed to acts of violence. Among the 108 intentional injuries, only 11 were caused by firearms or other weapons and only 4 concerned infants. In comparison to unintentional home and leisure injuries, intentional childhood injuries increase significantly with age and they are more common among migrant children. They occur more frequently during late night and early morning hours, they are more serious, and they are more often multiple and concentrated on the head. CONCLUSIONS: In Greece. a problem of violence directed against children does exist. The actual magnitude of this problem is difficult to estimate, but its size appears to be smaller in comparison with that reported in other populations.

Accidents↗
PubMed2000

Human factors in the causation of road traffic crashes.

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.

Accident Proneness↗