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Biomedical subjects

S Charalambous

Publications and source records attributed to S Charalambous.

At least 19 recordsLinked to original sources
PubMed2007

Establishing a workplace antiretroviral therapy programme in South Africa.

Ways to expand access to antiretroviral treatment (ART) in low income settings are being sought. We describe an HIV care programme including ART in an industrial setting in South Africa. The programme uses guidelines derived from local and international best practice. The training component aims to build capacity among health care staff. Nurses and doctors are supported by experienced HIV clinicians through telephone consultation and site visits. Patients undergo a three-stage counselling procedure prior to starting ART. Drug regimens and monitoring are standardised and prophylaxis against opportunistic infections (isoniazid and cotrimoxazole) is offered routinely. Laboratory and pharmacy services, using named-patient dispensing, are centralized. The programme is designed to ensure that data on clinical and economic outcomes will be available for programme evaluation. Between November 2002-December 2004, ART delivery has been established at 70 ART workplace ART sites. The sites range from 200 to 12000 employees, and from small occupational health clinics and general practitioner rooms to larger hospital clinics. During this period, 2456 patients began ART. Of those on treatment for at least three months, 1728 (78%) have been retained on the programme and only 38 (1.7%) patients have failed the first-line ART regimen. This model for delivery of ART is feasible and successful in an industrial setting. The model may be generalizable to other employment health services in settings of high HIV prevalence, and as a model for implementing ART in other types of health-care settings.

Anti-HIV Agents↗
PubMed2006

Tension-free vaginal tape for the treatment of stress urinary incontinence in geriatric patients.

OBJECTIVE: To evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in geriatric patients. PATIENTS AND METHODS: Fifty-one women, aged 65-80 (mean 72.3) years, underwent a TVT procedure for genuine SUI from 2001 to 2004. A urodynamic test together with uroflowmetry were performed. The patients' SUI bother score was assessed using a visual analog scale (VAS). RESULTS: The mean operative time was 25 (range 14-29) min and mean hospitalization time was 1.2 (range 1-2) days. Bladder perforation occurred in 3 cases (5.8%) and was managed conservatively. Pre- and postoperative maximum flow rate were not significantly different (p > 0.05). The patients' SUI bother score estimated by the VAS was statistically significantly improved (p < 0.0001). After a mean follow-up of 35.6 (range 14-60) months, 49 patients (96%) had no SUI, while 2 patients (3.9%) had persistent SUI. Also, during the follow-up 5 patients (9.8%) were diagnosed with de novo urgency due to detrusor overactivity and 1 patient (1.9%) had persistent dysuria that was resolved with urethrolysis. CONCLUSIONS: SUI in elderly women can be safely treated with the TVT procedure in the vast majority of the patients. However, bladder perforation during surgery and de novo urgency postoperatively should be taken into account.

Aged↗
PubMed2006

Screening for tuberculosis prior to isoniazid preventive therapy among HIV-infected gold miners in South Africa.

SETTING: Human immunodeficiency virus (HIV) clinic for employees of a gold mine, Free State, South Africa. OBJECTIVE: To evaluate the process of screening for active tuberculosis (TB) prior to commencing TB preventive therapy in HIV-infected individuals. DESIGN: Cross-sectional study comparing performance of various combinations of screening tests for TB against a gold standard diagnosis of TB based on symptoms, chest radiograph (CXR), sputum microscopy and culture. RESULTS: Of 899 individuals, 44 (4.9%) had TB. The most sensitive symptom combination (59.1%) was any of night sweats, new or worsening cough or reported weight loss; measured weight loss > 5% or abnormal CXR increased sensitivity to 90.9%. Sputum microscopy did not increase sensitivity further, but including World Health Organization HIV clinical staging or CD4 count did. As the specificity of all these combinations was low, many individuals required further investigation to rule out TB. TB prevalence was high (11.7%) among individuals with a CD4 count < 200/mm3. CONCLUSION: CXR greatly increased the sensitivity of screening for TB in this population. Sputum microscopy conferred no additional benefit among asymptomatic patients with a normal CXR. The high prevalence of TB amongst those with a low CD4 count underlines the importance of screening for active TB prior to commencing TB preventive therapy, and before antiretroviral therapy.

Adult↗
PubMed2005

Management of nocturnal enuresis in Greek children.

Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7-18 years old (mean: 9.0+/-0.5) were included in this prospective study. Initially, behavioral conditioning therapy, using a body-worn urinary alarm, was instructed in all cases. If no improvement was recorded, 40 microg of intranasal desmopressin was administered, initially for three months. If urodynamic studies demonstrated pure detrusor instability, anticholinergics (5 mg oxybutinine or 2 mg tolterodine) were given instead. Combination medication (desmopressin and anticholinergics) was administered for coexisting diurnal enuresis, which was present in 8 children. Among the 142 children the overall response rate was 51.41%. Successful response was recorded in 16 children practicing conditioning behavioral therapy, in 47 receiving desmopressin (with or without anticholinergics), and in 10 children receiving only anticholinergics. During the follow-up period (mean: 6.2 months), no serious side effect was recorded. The use of desmopressin, and anticholinergics in specific subgroups, was found to be effective and safe for the management of nocturnal enuresis in children.

Administration, Intranasal↗
PubMed2005

Evaluation of antiretroviral therapy (ART)-related counselling in a workplace-based ART implementation programme, South Africa.

Counselling about antiretroviral therapy (ART) is thought important to prepare patients for treatment and enhance adherence. A workplace-based HIV care programme in South Africa instituted a three-step ART counselling protocol with guidelines prompting issues to be covered at each step. We carried out an early evaluation of ART counselling to determine whether patients understood key information about ART, and the perceptions that patients and health care professionals (HCP) had of the process. Among 40 patients (median time on ART 83 days), over 90% answered 6/7 HIV/ART knowledge-related questions correctly. 95% thought counselling sessions were good. 93% thought ongoing counselling was important. Recommendations included the need for continuing education about HIV/ART, being respectful, promoting HIV testing and addressing the issues of infected partners and stigma. 24 participating HCP identified additional training needs including counselling of family and friends, family planning, sexually transmitted infections and running support groups. 90% of HCP thought that counselling guidelines were helpful. The programme appears to be preparing patients well for ART. Counselling should be offered at every clinic visit. Counselling guidelines were a valuable tool and may be useful elsewhere. The evaluation helped to assess the quality of the programme and to suggest areas for improvement.

Adult↗
PubMed2004

Feasibility and acceptability of a specialist clinical service for HIV-infected mineworkers in South Africa.

Occupational settings offer an ideal opportunity to provide preventive health services for HIV-infected workers. A specialized clinic was established in a mining hospital in the Free State, South Africa, with the primary aim of delivering preventive therapy such as isoniazid to those at high risk of tuberculosis (individuals with HIV infection or silicosis), and cotrimoxazole to those at highest risk for opportunistic infections. The clinic design has taken regard of the importance of minimizing stigma, protecting confidentiality, monitoring potential side effects, supporting adherence and identification of prophylaxis failure. The clinic opened in April 1999 and, by August 2001, 1773 patients had attended at least once; 1762 are HIV-infected and 11 have silicosis. Of those with HIV infection, most were asymptomatic at their first visit. The clinic has achieved high acceptability: 99% of persons who were actively recruited to the service agreed to attend. The number still attending after a median of 13 months from recruitment was 1,270 (72%) and only 48 (2.7%) have declined continued attendance. Most losses were due to termination of employment unrelated to a medical condition. The clinic has already been successfully replicated in two other regions of the mining health service in South Africa and provides a model for workplace HIV clinical services that could be used for implementation of further interventions such as antiretroviral therapy.

AIDS-Related Opportunistic Infections↗
PubMed2002

Use of spoligotyping for accurate classification of recurrent tuberculosis.

The spoligotyping method has become an important tool for the tracking of Mycobacterium tuberculosis strains in different epidemiological settings. In this study, we demonstrate the ability of the spoligotyping technique to accurately determine the pathogenetic mechanism of recurrent disease. This methodology has advantages over conventional restriction fragment length polymorphism methods which may be useful in large-scale intervention studies.

Diagnostic Techniques and Procedures↗
PubMed2001

Persistent radiological changes following miliary tuberculosis in miners exposed to silica dust.

SETTING: Silicosis leads to increased susceptibility to tuberculosis, but it has also been suggested that tuberculosis may interact with intra-pulmonary silica to exacerbate fibrotic lung disease. OBJECTIVES: To investigate the possibility that silicosis developed due to or was exacerbated by tuberculosis. METHODS: In a case series of 15 miners presenting with culture-positive miliary tuberculosis, serial radiographs taken premorbidly, at presentation, and after 2 and 6 months of standard anti-tuberculosis treatment were graded for nodularity using the International Labour Organization system. RESULTS: Increased nodule profusion (compared to premorbid film) remained in 13 (87%) and eight (53%) patients after 2 and 6 months of treatment, respectively, despite clinical improvement in all and documented bacteriological cure in eight (53%). These phenomena, observed irrespective of human immunodeficiency virus (HIV) status, were most pronounced in men with minor premorbid changes. Abnormal pulmonary collagenisation related to silica particles was apparent at post-mortem in two men who died of HIV-associated cryptococcosis after completing TB treatment. CONCLUSIONS: Previous silica exposure appears to result in delayed and potentially incomplete radiological resolution of miliary TB. We postulate that the immune response in tubercles may evoke a 'bystander' fibrotic response, as cytokines play a central role in the pathogenesis of both TB and silicosis.

AIDS-Related Opportunistic Infections↗
PubMed1994

Indoor radon concentrations in Greek apartment dwellings.

Radon concentrations indoors were determined in 24 typical occupied apartments in the city of Thessaloniki, North Greece (40 degrees 38'N, 22 degrees 58'E), by means of 12 surveys, each 2 mo long, over a 2-y period starting October 1989. The ratio of the winter and summer averages for the first year of measurements was 1.8 +/- 0.78, and for the second year of measurements was 1.6 +/- 0.61. The indoor radon concentration in the summer (1990) period ranged between 8 and 81 Bq m-3, while in the winter (1989-1990) it ranged between 20 and 143 Bq m-3 for the first year of measurements or between 8 and 92 Bq m-3 in the summer (1991) period and between 12 and 119 Bq m-3 in the winter (1990-1991) for the second year of measurements. These results were obtained by type CN-85 alpha track detectors. Some parameters that influenced the concentrations, such as precipitation rates and use of fly ash in building materials, are discussed.

Air Pollution, Indoor↗
PubMed1989

Time-dependent radioactive concentrations of fallout following the Chernobyl reactor accident.

The levels of Chernobyl-derived 137Cs, 134Cs, 106Ru and 103Ru were measured at Thessaloniki, Greece, in air, rain, soil, grass and milk samples for more than 2 years after the accident. The data were analysed in conjunction with 7Be (produced in the atmosphere by cosmic rays) measurements and show that significant variations were observed, particularly in the spring and in the autumn measurements. In interpreting these variations we took into consideration the tropospheric, or possibly stratospheric, fallout injections into the atmosphere due to the Chernobyl accident, nuclear weapons testing or other releases from nuclear reactors operating world-wide. Useful information can be derived for determining the periodicity of global circulation of the fallout radionuclides.

Accidents↗
PubMed1988

Silver-110m and 125Sb in Chernobyl fallout.

Measurements of the two unusual nuclides 110mAg and 125Sb in soils and grass, derived from fallout, were made in Greece after the Chernobyl reactor accident. The 110mAg concentrations ranged from 4.5 to 46.1 Bq kg-1 (average 14.3 Bq kg-1) in soils and from 0.2 to 1.5 Bq kg-1 (average 0.8 Bq kg-1) in grass. The 125Sb concentrations ranged from 15.7 to 284.6 Bq kg-1 (average 105.0 Bq kg-1) in soils and from 1.1 to 19.6 Bq kg-1 (average 4.4 Bq kg-1) in grass.

Accidents↗
PubMed1985

Dose rate dependence on the response of CR-39 SSNT-detector.

The dose rate dependence on the response of CR-39 SSNT-Detector was examined. The dose rate region studied was 10(2)-10(6) rad/min for doses 0 up to 1 Mrad. For relatively low and high dose rates a drop in the response of the detector was observed. The behavior changes for low doses and above 1 Mrad. The contribution of recombination and degradation mechanisms on the observed behavior was discussed.

Dose-Response Relationship, Radiation↗
PubMed1985

The influence of regenerated thermoluminescence on low-dose dosimetry.

The contribution of regenerated thermoluminescence to low doses is studied for the case of CaF2-Dy (TLD-200). A component of 2 mrad was found for pre-irradiation doses of 70 rad, 1 krad and for 10 days' regenerating time. The results are discussed and the conclusion is that for measurements of extremely low dose it is better to use virgin crystals.

Calcium Fluoride↗
PubMed1984

On the escaping radioactivity from coal power plants (CPP).

The escaping radioactivity from Greek coal power plants (CPP) was studied. For the case studied the radioactivity is due to the uranium series. The major part (99%) escapes as very fine particles, while the rest is fly ash. The total escaping 226Ra activity is of the order of 40 Ci/yr. The particulate dispersion of fly ash in sites around the stacks of CPP is described. The hazards from the escaping radioactivity are evaluated.

Air Pollution, Radioactive↗
PubMed1984

A simplified procedure for the observation in situ of chromosome aberrations or sister chromatid exchanges and the estimation of the mitotic index in mammalian monolayer cell cultures.

Chinese hamster V-79 cells are widely used in short term screening for potential physical or chemical mutagens of the environment. A simplified version of the standard Giemsa protocol of Moorhead and the Feulgen plus Giemsa protocol of Wolff and Perry is given which permits the observations in situ of chromosome aberrations or sister chromatid exchanges and the estimation of the mitotic index in the Petri dishes for the culture of the V-79 cells.

Animals↗