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PubMed1983

Adipose tissue fatty acid composition of adolescents in a U.S.--Greece cross-cultural study of coronary heart disease risk factors.

Adipose tissue fatty acid composition was studied in 139 boys, a subgroup of 1521 subjects aged 8-16 participating in the United States (New York City)--Greece cross-cultural study of coronary heart disease risk factor development. Adipose tissue was obtained by an aspiration technique, followed by transmethylation of fatty acids and gas-liquid chromatographic analysis. Statistically significant differences were found among different cohorts in their adipose tissue content of saturated, monounsaturated and polyunsaturated fatty acids. All United States cohorts had significantly higher (p less than 0.0001) levels of saturated and polyunsaturated fatty acids and significantly lower (p less than 0.0001) monounsaturated fatty acids compared to the Greece cohorts. These relationships held for all three types of fatty acids whether the non-Greek cohort from New York City or the cohorts of adolescents of Greek descent who reside in New York City alone, were compared to the cohorts residing in Greece. The differences in the adipose tissue fatty acids between the cohorts may be an important expression of the biochemical milieu which contributes to the development of relatively low coronary heart disease rates in Greece compared to those in the United States.

Adipose Tissue↗

PubMed1994

Lead exposure of the child population in Greece.

Lead exposure of the child population was studied in three different areas in Greece: Kalamata which is a rural area of Southern Greece; Tavros, a district of Athens with a considerable industrial activity; and Lavrion, a small city near Athens where a lead-zinc mining and smelting industrial complex has existed for more than 90 years. The results were evaluated with respect to a number of individual, social and environmental variables (i.e. smelter, occupation of the father) especially those concerning the area of Lavrion which is the most heavily polluted area in Greece. The results of this study can be considered as an index for the extent of the lead pollution problem in the named areas of Greece.

Analysis of Variance↗

PubMed2006

Healthcare providers' priorities for cancer care: A Delphi study in Greece.

Cancer is a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health services provision is not located efficiently, resulting in few patients receiving high-quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home care and palliative care have aggravated the problem. The absence of a national cancer registry means that the extent of cancer incidence cannot be evaluated effectively. Dissatisfaction with the Greek NHS is well established, despite the reforms proposed by consecutive Greek governments. It remains that limited research exists in the area of cancer services and cancer care. The aim of this study was to identify the key areas of cancer care and services that needed to be developed or improved in Greece and their prioritisation within the Greek healthcare system. A Delphi technique was used to collect data from a sample of 30 healthcare providers, in three rounds. The response rate for each round was over 77%. The priorities for healthcare providers were focused on staff shortages, working conditions, pain management, home care, day units and communication. Based on the priorities provided by the participants and supporting literature, it is suggested that a national cancer registry, the employment of nurses to develop primary care, home care, day care and palliative care services need to be established. Furthermore, education in communication skills and the redistribution of the bio-medical technology are needed in order to provide more effective cancer services in Greece. More research is needed to validate the actual level of cancer services provided in Greece.

Attitude of Health Personnel↗

PubMed1999

The potential for long-range transport of air-pollutants into Greece: a climatological analysis.

A flow climatology using 5 years (1983-1987) of back trajectories has been created for the Aliartos meteorological-chemical station (Greece's EMEP-station phi = 38 degrees 13'N, lambda = 23 degrees 00'E) using the Air Resources Laboratory (ARL) trajectory model. Air mass back trajectories were analysed to quantify the contributions of major source areas to the air pollution concentration in the area of Greece. The trajectories were produced two times a day at the 850-hPa and 700-hPa pressure surface. The trajectories were classified and summarised in order to produce a long range trajectory climatology. The purpose of this paper is to use the above flow climatology to improve understanding to atmospheric transport pathways to Greece (and to the greater south-eastern area of Europe) and to evaluate the polluting potential of distant source regions outside the country. The limited chemical concentration data available from Aliartos are used to evaluate the conclusions reached from the flow climatology and emissions analysis. The results show that trajectories reach Greece from five major source areas: (i) Northwest Europe, (ii) west Europe, (iii) north Europe, (iv) Northwest Asia, and (v) Northwest Africa. Sector analysis of air pollution concentrations and emissions also showed that: (i) Most air pollutants transport from distances beyond 1800 km takes place, and the most probable source areas are the industrialised countries of Europe. (ii) Countries of west and north-central Europe emit the greater amounts of air pollutants (S and N). (iii) Sulphate and nitrate concentrations are similar among transport sectors.

Air Pollutants↗

PubMed2000

Mediterranean clone of penicillin-susceptible, multidrug-resistant serotype 6B Streptococcus pneumoniae in Greece, Italy and Israel.

In 1996, 19 isolates of serotype 6B Streptococcus pneumoniae with a unique resistance pattern were found in carriers attending daycare centres in Patras, Southwestern Greece. These isolates were penicillin susceptible but resistant to chloramphenicol, tetracycline, erythromycin, clindamycin and trimethoprim-sulphamethoxazole. Subsequently, isolates with the same characteristics were found in 23 additional carriers in central and southern Greece in 1997-98 as well as in 19 carriers in central Italy in 1997, and in seven carriers in southern Israel in 1998. Carriers were all children under 6 years of age, attending daycare centres or outpatient hospital visits. The relatedness of the isolates was determined on representative isolates from the three countries by pulsed-field gel electrophoresis of SmaI digests of chromosomal DNA. Most Greek isolates were identical to each other, while isolates from Italy and Israel showed one to three band differences, with all isolates being closely related to each other as well as to the isolates from Greece. We have therefore documented the presence of this unique clone of S. pneumoniae in these three countries and have named this the 'Mediterranean' clone. While isolates appear to have a common origin, their source and direction of spread are unknown. However, isolates from Italy showed the most diversity, suggesting that this clone had been present in that country for a longer period than it had been in Greece.

DNA, Bacterial↗

PubMed2003

Carriage of Neisseria meningitidis and Neisseria lactamica in northern Greece.

In response to an increase in the number of cases of invasive meningococcal disease (IMD) in northern regions of Greece, a survey was carried out to determine if there was an increase in carriage of Neisseria meningitidis, particularly in areas where there have been increases in immigrant populations from neighbouring countries. The second objective was to determine if there was an increase in the serogroup C:2a:P1.5,2 a phenotype associated with recent outbreaks or changes in antibiotic sensitivities. As carriage of Neisseria lactamica is associated with development of natural immunity to IMD, the third objective was to determine the carriage rate of N. lactamica in this population. Among 3167 individuals tested, meningococci were isolated from 334 (10.5%). Compared with our previous studies, the proportion of meningococcal carriers was significantly increased among children in secondary education (11.3%) (chi2=9.67, P<0.005) and military recruits (37.4%) (chi2=21.11, P<0.000). Only 5/334 (1.5%) isolates expressed the phenotype associated with the increase in IMD in Greece. N. lactamica was isolated from 146/3167 (4.6%) participants. It was isolated from 71/987 (7.2%) children attending primary or nursery schools; however, the highest proportion of carriers (11.3%) was found in the boarding school for young Albanian men. In the 21-59-year age range, the majority of N. lactamica isolates (22/25, 88%) were from women, probably due to closer or more prolonged contact with children in the primary school age range. Smoking was significantly associated with isolation of meningococci from men but not from women. Penicillin-insensitive strains (25/334, 7.5%) were identified in all four regions examined; the majority (14/25, 56%) were obtained from military personnel. We conclude that there was a higher proportion of carriers in the population of northern Greece; however, the increase in carriage rate was not associated with the influx of immigrants from neighbouring countries, and there was not a higher incidence of the C:2a:P1.5,2 strain responsible for increased disease activity in Greece in either the immigrant or local populations.

Adolescent↗

PubMed2000

Cervical cancer screening in Greece.

The aim of this study was to describe the state of the art in cervical cancer screening in Greece by presenting the two regionally organised screening programmes that currently operate in the country. Both programmes were initiated in 1991 and are partly funded by the European Union. The Ormylia screening programme covers the population of Halkidiki (Northern Greece), a predominantly rural area. The second programme covers the regions of Messinia and Ilia (Southern Greece). Both programmes are targeted at women aged 25-64 years of age and a Papanicolaou (Pap) smear test is recommended every 2-3 years. Electoral and municipal registries are used to identify the target population and personal invitations are sent to the eligible women in the screening programme. The Ormylia programme is based at the Centre 'Our Lady Who Loves Mankind', whereas mobile units are used by the Messinia and Ilia programme. Slide reading for the Ormylia programme is performed in the cytology laboratory of Alexandra Hospital in Athens and epidemiological support is provided by the Department of Hygiene and Epidemiology (Medical School, University of Athens). A specifically designed database is used for data recording. Over 80% of the target population in the region have already been screened. Communication of results is by means of a personal letter upon a negative result and in person upon a suspicious result. Quality assurance in both programmes is based on the European protocol. These two programmes are the sole organised cervical cancer screening activities in Greece in the absence of a national programme. They employ well-trained personnel, they use modern equipment and have strict quality assurance procedures.

Adult↗

PubMed2004

Use of contraception and abortion in Greece: a review.

Greece has one of the highest rates of abortions in Europe and a very low prevalence of contraceptive use apart from withdrawal and condoms. Based on limited data from the past 30 years, this paper describes the context in which Greek women make reproductive decisions, and the history of family planning and abortion policies and services in Greece. It shows that in spite of the persistence of the traditional importance placed on marriage and motherhood, the fertility rate in Greece is very low. Sex education is still not included in the school curriculum, and the lack of accurate information on contraception and the prevention of unwanted pregnancy, especially in adolescence, still have critical repercussions for women's life choices. Although the public sector has been required to provide family planning services since 1980, only 2% of women of reproductive age were accessing these services in 1990, based mainly in urban centres. In 2001, one in four women of reproductive age had had at least one unwanted pregnancy ending in abortion; the rate was one in ten in the 16-24 age group and one in three in the 35-45 age group. With an almost complete lack of preventive policies in Greece, women continue to have to rely on abortion to control births.

Abortion, Induced↗

PubMed2000

Genetic heterogeneity of HIV-1 in Greece.

The aim of this study was to detect and determine the genetic variation of HIV-1 in Greece and to analyze the phylogenetic relationships and transmission dynamics of identified variants. Eighty-six blood samples from HIV-1 seroconverted patients of different risk groups were collected from the AIDS clinic, AHEPA Hospital, Thessaloniki, Greece. Retroviral DNA was extracted from uncultured peripheral blood mononuclear cells. HIV-1 DNA sequences encoding a 500-bp fragment of the gp120 C2-C3 region were amplified from each study subject, and they were genetically subtyped by heteroduplex mobility assay and DNA sequencing. Genetic distances and phylogenetic relationships of DNA sequences were estimated using PHYLIP software. Our results revealed that 82 out of 86 (95.3%) subjects carried subtype B sequences, while four (4.7%) carried subtype A sequences. Subtype A in Greek individuals not having traveled abroad was documented. An average of intrasubtype B genetic divergence of 15% was noted. Our findings demonstrate the presence of at least two genetic subtypes of HIV-1 in northern Greece--subtype B and subtype A. The predominant subtype is subtype B, which was transmitted into Greece by multiple sources. Our observations lend support to the argument that the distribution of HIV-1 subtypes is determined by founder effects or other processes rather than any tropism for particular cell types or mode of transmission.

Adult↗

PubMed2006

Health economic evaluation in Greece.

OBJECTIVES: There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. METHODS: A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. RESULTS: The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. CONCLUSIONS: Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.

Costs and Cost Analysis↗

PubMed2004

Trends of mortality rates during the last thirty years in Greece.

General mortality rates and specific mortality rates by major causes of death (coronary disease, cancer, tuberculosis, traffic accidents, suicide, vascular disorders of central neural system) in Greece have been studied throughout the 30-year period 1967--1996 and time trends have being calculated by nonlinear models of trend analysis. The results confirm the general pattern of decrease of mortality in Greece during the particular period of time as a result of the combination of the impact of two controversial trends: on one hand the decrease of infant mortality and mortality from infectious disorders and on the other the relatively slower and more gradual increase in mortality rates by disorders related to the western lifestyle culture, such as cardiovascular disorders and cancer. During the period under study in Greece the impact of the second trend seems to inflict less severe implication in the formulation of the pattern of general mortality especially as women are concerned. This statistically significant and gradually increasing difference in mortality between men and women in Greece has been confirmed in general mortality time trends as well as in the evaluation of the relatively better pattern of mortality trends of women from particular "western lifestyle" disorders.

Accidents, Traffic↗

PubMed2003

Changing relative roles of hepatitis B and C viruses in the aetiology of hepatocellular carcinoma in Greece. Epidemiological and clinical observations.

Chronic infection with hepatitis B virus (HBV) has been reported in two-thirds of cases of hepatocellular carcinoma (HCC) in Greece from 1973 to 1995, while chronic hepatitis C virus (HCV) infection in 10% of them. We studied the roles of HBV and HCV in HCC in Greece between 1996 and 2000 compared with the past, and possible differences in clinical and laboratory characteristics of HBV- and HCV-related HCC. Complete clinical and laboratory data from 306 patients with HCC, diagnosed from January 1996 to December 2000, were analyzed. Chronic HBV and HCV infection were detected in 52.3 and 21.6% of the patients, respectively. The ratio of HBV- to HCV-related HCC was 2.42. Compared with the data prior to 1996, there was a 101.8% increase in the relative frequency of HCV (P < 0.0001) and an 11.8% decrease in that of HBV (P = 0.033), with a -56.3% change in the ratio of HBV- to HCV-related HCC cases. Statistically significant differences in the male/female ratio, median age and frequency of multifocal lesions were found in HBV- vs HCV-related HCC. Although HBV still represents the major aetiological factor of HCC in Greece, its role has significantly decreased in the last 5 years, while a more significant increase has occurred in HCV-related HCC. The two aetiological types of HCC differ in Greece in demographic, epidemiological and other features.

Carcinoma, Hepatocellular↗

PubMed1997

Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile.

BACKGROUND: Classic Kaposi's sarcoma (CKS) is not uncommon in Greece with a reported incidence of 0.20 per 100,000 per year. METHODS: Epidemiological, clinical and histological features of all CKS cases, diagnosed in 'A. Sygros' hospital, Athens, Greece during the years 1989-1994, have been recorded and studied prospectively. RESULTS: During the five-year period studied, 66 CKS patients have been diagnosed in our hospital. Incidence among dermatologic patients was 2.11 per 10,000 patients examined, representing 1.35% of total skin malignancies. Patients' age at diagnosis ranged from 53 to 94 years (mean 72 +/- 8.8). The male to female ratio was 2.47:1. A high proportion of the patients were born in Peloponnesos (42.42%) and were residing in Athens (51.51%) or in Peloponnesos (24.24%). Nodules and/or plaques were the most frequent type of lesion, most commonly located on the feet (43.93%) or the hands (28.78%). Accompanying edema was seen in 51.51% of the patients. There were 16 stage I patients (24.24%), 40 stage II (60.60%), 0 stage III and 10 stage IV (15.15%). Involvement of visceral organs was detected in seven patients (10.60%), while 10 had lymph node involvement (15.15%) and three, involvement of the underlying bones (4.54%). Second primary malignancy was diagnosed in 6 cases (9.09%), most often of the reticuloendothelial system (83.33%). CONCLUSIONS: CKS in Greece exhibits some special characteristics, including older age of onset; lower male to female ratio; endemic clustering; disseminated skin disease at diagnosis, often accompanied by lymphedema; not unusual visceral or lymph node involvement and association with second malignancies. We suggest that CKS in Greece possibly represents a distinct endemic subtype of CKS.

Age Factors↗

PubMed2002

Environmental surveillance of filamentous fungi in three tertiary care hospitals in Greece.

The environmental fungal load (FL) of three hospitals was studied in representative regions in Greece (Thessalonika, Northern Greece, Athens, Central Greece and Heraklion, Southern Greece). Air, surfaces and tap water from high-risk departments were sampled monthly during one year. Air FL was [median (range)] 10.6 (1.2-37), 5.5 (3-28.8) and 7.7 (3.1-12.1) cfu/m(3) at Thessalonika, Athens and Heraklion, respectively. Air FL was lower in winter and higher in summer and autumn but seldom above acceptable levels. Aspergillus spp. constituted 70.5% of the filamentous fungi isolated. Aspergillus niger was the most prevalent species in the air of all the hospitals followed by Aspergillus flavus and Aspergillus fumigatus. The least contaminated departments were the intensive care units, whilst most contaminated were the solid organ transplantation in Athens and haematology departments in Thessalonika. No correlation between fungal species, season, hospital or departments was observed. Sixty per cent of all surfaces examined yielded filamentous fungi and/or blastomycetes. While no fungi were recovered from water in Thessalonika and Athens, one-third of the samples in Heraklion (apart from those of ICU) yielded multiple fungal species. The higher air FL in Thessalonika and Athens was recorded in departments located close to renovation works. These findings suggest that the air and surface FL fluctuates over the year, is due to varying fungal species, but does not differ greatly among hospitals. The variation among hospitals, as well as the role of hospital water fungal contamination and appropriate measures to eliminate it, need further study.

Air Microbiology↗

PubMed2004

Nutrient dynamics in shallow lakes of Northern Greece.

UNLABELLED: GOAL, SCOPE, BACKGROUND: Shallow lakes display a number of features that set them apart from the more frequently studied deeper systems. The majority of lakes in Northern Greece are small to moderate in size with a relatively low depth and are considered as sites of high value of the wetland habitat. However, the water quality of these lakes has only been evaluated segmentally and occasionally. OBJECTIVE: The objectives of this study were to thoroughly investigate nitrogen and phosphorus speciation in lakes of a high ecological significance located in N. Greece, in order to evaluate their eutrophication status and possible nutrient limitation factors, and to investigate the main factors/sources that affect the water quality of these systems. METHODS: An extensive survey was carried out during the period from 1998-1999. Water samples were collected on a monthly basis from lakes Koronia, Volvi, Doirani, Mikri Prespa and Megali Prespa located in N. Greece. Water quality parameters (temperature, dissolved oxygen, pH and conductivity), organic indices (COD, BOD5), and N- and P-species (NO3(-), NO2(-), NH4(+), and PO4(3-), Kieldahl nitrogen and acid-hydrolysable phosphorus) were determined according to standard methods for surface water. Statistical treatment of the data was employed. RESULTS AND CONCLUSIONS: The physicochemical parameters determined in the lakes studied revealed a high temporal variation. The trophic state of the lakes ranged from meso- to hypertrophic. The nutrient limiting factor varied among lakes suggesting either P-limitation conditions or mixed conditions changing from P- to N-limitation throughout the year. Urban/industrial activities and agricultural runoff are the major factors affecting all lakes, although with a varying contribution. RECOMMENDATION AND OUTLOOK: This lake-specific research offers valuable information about water quality and nutrient dynamics in lakes of significant ecological value located in N. Greece that can be useful for an effective pollution control/management of these systems. Due to the large intra-annual variability of certain physicochemical parameters, a properly designed monitoring program of lake water is recommended.

Agriculture↗

PubMed2003

Genetic variation of Marchalina hellenica (Hemiptera: Margarodidae) sampled from different hosts and localities in Greece.

Random amplified polymorphic DNA (RAPD) analysis was applied to 120 individuals of Marchalina hellenica (Gennadius) representing six populations collected in northern, central and southern mainland Greece. One population was sampled on one species of fir tree and the others on two species of pine trees. Four random decamer primers were used to evaluate genetic variation among the populations examined. The results revealed intra- and interpopulation polymorphism both related to host type and region of origin. Phylogenetic analysis based on genetic distances estimated by the RAPD frequencies revealed an important genetic differentiation in samples collected on fir trees in southern Greece and to a lesser extent in samples from pine trees in central and northern Greece. Furthermore, considerable subdivision and restricted gene flow among the populations examined were observed. The results are discussed in relation to the biology and geographical distribution of M. hellenica in Greece.

Animals↗

PubMed2004

Practice of and attitudes toward breast self-examination (BSE): a cross-cultural comparison between younger women in Scotland and Greece.

Breast self-examination (BSE) is a method of early detection of breast cancer. Although BSE is recommended for all women, it is mostly suitable and readily available for younger women. BSE beliefs and practices of women in Scotland, a country with organised health campaigns about BSE, were compared with those of women in Greece, a country without such campaigns. Our sample consisted of 68 university students in Scotland and Greece, aged 18 to 26 years old. All participants completed a questionnaire assessing demographics, health history, knowledge, BSE practice, health beliefs, and health-related personality. BSE practice was found to be associated with different variables across the two cultural groups. Adherence rates were found particularly higher than previous reports and BSE practice did not differ significantly between women in Scotland and Greece. Nevertheless, the two groups differed significantly in their knowledge, attitudes toward BSE, and health-related personality. On the basis of these findings, cultural factors should be considered in organising BSE campaigns. Also the present findings identified BSE-related beliefs and practices specific to younger age groups. These could be considered and addressed in order to organise BSE campaigns in Greece and improve future UK programs especially tailored for this age group.

Adolescent↗

PubMed1980

Epidemiologic characteristics of hepatitis A virus infections in Greece.

The major epidemiologic characteristics of hepatitis A virus (NAV) infections in Greece were studied in a sample of 877 Air Force recruits, 19-25 years old coming from every geographic region of Greece. Antibodies to HAV (anti-HAV) were detected by solid phase radioimmunoassay in 83.8% of the recruits. Antibody frequency varied significantly in the various geographic regions of Greece and was inversely related to the size of the community. It was further shown that the prevalence of HAV infection was highly related to the recruit's social class and years of education as well as number of siblings and number of persons per room. These findings in accordance with previous reported data show that hepatitis A is hyperendemic and should be regarded as a childhood infection in Greece. Prevailing socioeconomic, hygienic living and housing conditions should be considered as the main epidemiologic determinants of HAV infections.

Adult↗