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AIM OF STUDY: The largest population-based study for inflammatory bowel disease in Northwest Greece. MATERIALS AND METHODS: A retrospective survey for the years 1982-1997. RESULTS: Of 400 patients, 334 had ulcerative colitis, 43 Crohn's disease and 23 indeterminate colitis. CONCLUSIONS: Crohn's disease still remains rare in Northwest Greece.
OBJECTIVE: To evaluate the epidemiological correlation between age-related macular degeneration and pseudoexfoliation syndrome in the inhabitants of the island of Crete (Greece). SUBJECTS AND METHODS: A total of 777 persons (315 men and 462 women, aged 40-99 years), representing a randomized sample (1.43%) of the Cretan population, underwent slitlamp and fundus examinations according to protocol. The results were statistically analyzed. RESULTS: The prevalence of pseudoexfoliation was 16.1% (21.3% in men and 12.6% in women) and that of maculopathy, 7.9% (11.7% in men and 5.2% in women). The conditions were significantly correlated with each other (P = .002). Also, both displayed a significant direct correlation with age and altitude (for pseudoexfoliation, P<.001 and P = .002 for age and altitude, respectively; for age-related macular degeneration, P<.001 for age and for altitude) and an increase in bilateral incidence with progressing age. CONCLUSIONS: The observed prevalences of pseudoexfoliation and maculopathy were lower than those reported in the mainland of Greece and other Mediterranean regions. The correlation between age-related macular degeneration and pseudoexfoliation syndrome may be explained by the relationship of each disease with age and altitude.
Residential proximity to electrical power lines of different voltage in relation to childhood leukemia was investigated through a case-control study undertaken in Greece during 1993-1994. The study comprised 117 incident cases of childhood leukemia and 202 age-, gender- and place-of-residence-matched controls. Four measures of exposure to magnetic fields were developed, using data provided by the Public Power Corporation of Greece: Voltage (V) divided by the distance (d), V/d2, V/d3 and an adaptation of the Wertheimer-Leeper code. Conditional-logistic-regression modeling was used to adjust for potential confounding influences of 18 variables. No significant trends of childhood leukemia risk with increasing exposure levels were noted, nor were there statistically significant elevations of disease risk at the higher exposure levels in each measure of exposure. These results do not support a causal link between residential proximity to electrical high-voltage wires and childhood leukemia risk, but in themselves do not refute a weak empirical association.
During the five-year period between 1994 and 1998, a total of 217 clinical samples were assessed for the isolation of enteroviruses at the Enterovirus Reference Centre for South Greece. Fourteen enterovirus strains belonging to different serotypes were isolated. These field strains were detected by cell culture in appropriate cell lines. They were subsequently identified by neutralizing antibodies with the LBM (Lim-Benyesh Melnick) mixed antisera pools up to 1995 and RIVM (National Institute of Public Health and the Environment, Bilthoven, The Netherlands) pools from 1996 onwards. The isolated viruses included two strains of poliovirus type 2 Sabin-like, three strains of poliovirus type 1 non-Sabin-like, one Coxsackie B2 (CBV2) strain, one Coxsackie B5 (CBV5) strain, one Echo 5 (ECV5) strain, one Echo 7 (ECV7) strain, three Coxsackie A16 (CAV16) strains, and two currently enteroviral strains unidentified by RIVM pools. Reverse transcription-polymerase chain reaction (RT-PCR) using poliovirus-specific primers or poliovirus type-specific primers and enterovirus specific primers from the highly conserved 5'-UTR, the latter followed by RFLP, was also applied in 6 clinical isolates (3 strains of poliovirus type 1 non-Sabin-like, 1 polio type 2 Sabin-like, and 2 non-identified by RIVM pools enteroviruses). The advantages and the drawbacks of these assays against the conventional ones are discussed here. The isolations and the subsequent identification of the strains were carried out from fecal samples of clinical cases that included hand-foot-and-mouth disease, meningitis, and acute flaccid paralysis. The reappearance of non-Sabin-like poliovirus strains in Greece in 1996 after 14 years is considered to have an important medical and clinical value.
INTRODUCTION: Continuing medical education is not yet mandatory in Greece, but an increasing number of training courses is becoming available. In recent years, 32 training centers have been accredited. METHOD: A postal survey of a national sample of 500 National Health Service doctors, weighted towards hospitals with accredited training centers, was conducted. The response rate was 35%. RESULTS: Respondents, who represented all disciplines and all levels of the hierarchy, were highly qualified, widely read, and active participants in scientific and research activities. Sixty percent had attended training courses in the preceding 5 years. Five choices of desired topics were made, and scores were weighted according to preference. DISCUSSION: Handling emergency situations was most popular, followed by specialized therapies and public health topics. Current courses are considered to be too long and would be more attractive if held during working hours. The main difficulty for attendance was heavy workload. The researchers consider that the statutory base for continuing education should be developed in Greece, in line with other countries.
Thirty strains of adenovirus (Ads) associated with ocular disease have been isolated over a period of 4 years in Thessaloniki, Northern Greece. Eleven strains were isolated from sporadic patients with conjunctivitis or keratoconjunctivitis in Thessaloniki city between 1998 and 2000. Nineteen strains were isolated from patients with keratoconjunctivitis during an outbreak of Ads in the area of Thessaloniki (Thessaloniki and Serres cities) in 2002. PCR-sequence method using primers targeted against the hypervariable regions (HVRs) of hexon gene, as well as the neutralization test were used for typing the Ad isolates and assessing a possible relation among these strains, and their genetic variability. Ad4 with very close homology to variant Z-G 95-873 was the most frequent genotype causing sporadic conjunctivitis over a period of 4 years. Two other strains, one Ad2, and one Ad3 were similar to the prototype ones, and a third one shows close homology to the variant of prototype Ad15, the Morrison strain. The genome typing of twenty two Ad8 isolates showed very close homology in their amino acid and nucleotide sequences to the variant of Ad8, strain 1127 (accession no. X74663). Four were isolated from patients with keratoconjunctivitis in 1998, 1999, 2000 and 18 during the outbreak in 2002. As far as strain 1127 is concerned, all the Ad8 isolates showed the same changes in the HVR 1 and HVR 2 except one isolate in 1998, which showed some changes outside the HVRs. During the outbreak of Ad8 keratoconjunctivitis, it was not possible to identify the exact source of infection (nosocomial or/and outpatients). Finally, Ad4 variant Z-G 95-873 and Ad8 which is closely related to the strain 1127, were found to be the predominant adenoviruses circulating in Northern Greece during 1998-2002.
The olive fruit fly Bactrocera oleae (Gmelin) (Diptera: Tephritidae) is the most important pest of olives in countries around the Mediterranean basin. Its control has been based mostly on bait sprays with organophosphate insecticides (usually dimethoate or fenthion) for about 40 years. In the present study, the resistance status of olive fruit fly populations to dimethoate was examined in Greece and Cyprus over 2 years. Thirty-one populations from various regions of Greece, nine from Cyprus and one laboratory susceptible strain, which served as a control, were assayed by topical application of dimethoate. Considerable variation in the resistance levels to dimethoate was recorded in the populations of B. oleae, with resistance ratios ranging from 6.3 to 64.4 (ED(50) values 12.5-128.7 ng dimethoate per insect). The highest resistance ratios were found in populations from Crete, and the lowest in those from Cyprus. This variation could be attributed to different selection pressures from insecticidal applications among populations from the various regions. Migration of resistant genotypes, either autonomous or via commerce, may also be involved.
Intravenous heroin abusers comprise a high risk group for hepatitis B and C viruses (HBV and HCV) infection. Chronic alcoholics with liver disease (LD) also comprise a high risk group for HBV infection whereas the frequency of antibodies to HCV (anti-HCV) ranges from 27-42.6%. In this study, HBV and HCV infection markers were determined in alcoholic patients with (83 patients) or without LD (68 patients) in order to assess the prevalence of these markers (HBsAg, HBsAb, HBcAb and anti-HCV). The reason for the study was a lack of established data in this group of patients in Greece. The disease control groups consisted of 70 non-alcoholic hospitalized patients and 60 heroin addicts, whereas 1342 healthy blood donors were also investigated. Our results showed significantly increased prevalence of HBV infection markers in chronic alcoholic patients compared to healthy controls and non-alcoholic hospitalized patients. The findings were independent of the presence or absence of LD. In contrast to heroin addicts, where anti-HCV antibodies were observed in 90%, there was no difference in the prevalence of anti-HCV antibodies in chronic alcoholics (with or without LD), nonalcoholic hospitalized patients or healthy controls. In conclusion, we found that in this area of north-western Greece, chronic alcoholics, independent of the presence of LD, comprise a high risk group for HBV infection but very rarely have HCV infection. The latter finding may reflect technical or socio-economic differences regarding the lifestyle of our patients, and our population in general.
Twenty water samples collected from 6 hotels situated in various areas of Greece were examined for the presence of Legionella pneumophila and Legionella-like organisms. Five of the six hotels included in this investigation were associated with cases of legionellosis. Legionella pneumophila serogroups 1 and 8 were isolated from four of six hotels, mainly from the hot water supply system. This is the first isolation and identification of L. pneumophila in Greece.
INTRO: There was neither Clinical Pharmacy practice in Greece nor Hospital Formularies. Clinical Pharmacy (CP) services started experimentally during a 3-month period (February 1995-April 1995) at the 2nd surgical Department of "Apostle Paul-KAT" Hospital in Athens. Since then there has been a strategy plan for further CP development. Our aim is to give information about these first steps in introducing CP in Greece. METHOD: The work at the Department was based on the prescription monitoring of every patient, realizing the prescribing trends and giving priority to certain prescribing problems. Eventually there was a focus on antibiotics and respiratory system drugs. RESULTS: 250 patients 91 interventions for alternative drug treatment and the duration of antibiotic treatment 25 interventions for individualization of drug dosage. 15 cases of monitoring adverse effects. 12 discussions with patients consulting them about their drug treatment 4 educational presentations. High acceptance by the medical staff. Comparison of 2 months (pre and post CP services) revealed 50.7% reduction in antibiotics and respiratory system drugs. Total cost saving 1,034120 drs-->E 2,787 for one month. CONCLUSIONS: The results of the 1st experimental 3-month period are indicative for the consequences of CP services both for the quality of pharmaceutical care and pharmaco-economics. Implementation of CP services by organizing a CP dept or Unit will influence the pharmaceutical policy of the Hospital and lead to institutional changes, such as a Hospital Formulary.
The results are presented of the first surveillance study in Greece on resistance in strains of Haemophilus influenzae (n = 61) and Haemophilus parainfluenzae (n = 96) to six antibiotics. Strains were isolated in a three-month period in 1987 in most cases from sputum specimens from adult patients with lung infections. The overall rate of resistance to ampicillin was 28.3%, to chloramphenicol 2.7%, to cefaclor 2.7%, to tetracycline 10.6%, to erythromycin 38.1% and to cotrimoxazole 5.3%. It is evident that the resistance rate of Haemophilus spp. is steadily increasing in Greece as in other European countries. Regular surveys of resistance patterns for both older and newer antimicrobial agents are therefore necessary.
Between 40 and 43 Haemophilus influenzae isolates obtained from Greece, Lebanon, Israel and Morocco respectively (a total of 167 strains) were analysed for prevalence of resistance to six different drugs. Of these isolates 12.6% produced beta-lactamase and were resistant to ampicillin. All isolates, except a single strain from Greece, were susceptible to cefaclor. The frequency of resistance to chloramphenicol and tetracycline was below 2%. The frequency of isolates susceptible and resistant to erythromycin and cotrimoxazole varied from country to country.
During the period 1976-1990 fourteen cases of paralytic poliomyelitis were recorded in Northern Greece, which has a total population of 2.5 million. Twelve wild strains of poliovirus type-1 were isolated from an equal number of children with paralytic disease from 1976 to 1982. Also, three Sabin-like poliovirus vaccine strains were isolated from two infants with paralytic disease. Since 1985 no paralytic cases have been reported in Northern Greece.
Children and adolescents with the high bone turnover comprise a high risk population for vitamin D insufficiency. A sample of 178 clinically healthy children aged 3 to 18 years who came from public schools and lived in North West of Greece participated in the study. They were grouped into three age groups (I: 3-10, II: 11-14 and III: 15-18 years of age). Blood samples were taken during winter and summer months for determining calciotropic hormones, calcium, phosphate and biochemical markers of bone synthesis.A high percentage (47%) of the subjects aged 15-18 years was found to have 25OHD <10 ng/ml in winter but much less (13-14%) of the younger ages (13-14 years), while in the summer they were all >10 ng/ml. The prevalence was even higher in the girls of the older group accompanied by lower Pi concentrations again in winter (win:1.19+/-0.03, sum:1.93+/-0.03 mmol/l, p < 0.001). The 24,25(OH)(2)D levels were changing in parallel to 25OHD, but again in the older subjects, during winter, they were by 2/3 lower than the summer ones (0.73+/-0.10 vs. 2.41+/-0.20 ng/ml, p < 0.001). No significant differences were found between seasons and groups in the 1,25(OH)(2)D levels. The biochemical markers of bone synthesis, osteocalcin (OC) and total alkaline phosphatase (ALP), were found significantly lower in the girls of the older group both in winter and summer respectively. Even in a sunny country like Greece the adolescents living in an urban area are in high risk for vitamin D deficiency during winter. Supplementation with vitamin D of milk, of popular beverages and perhaps some foods would be of help.
The concentrations of persistent organic pollutants, such as DDT and its metabolites (DDTs), hexachlorocyclohexane isomers (HCHs), cyclodienes (Cycls), and polychlorinated biphenyls (PCBs), were measured in livers and subcutaneous fat tissues of six Accipitridae and four Falconidae bird species from different areas in Greece. This is the first report of persistent organochlorine (OC) pollutants in birds of prey tissues presented for Greece and the Eastern Mediterranean region. Accumulation patterns of OCs found in birds suggested that the predominant contaminants were p,p'-dichlorodiphenyldichloro-1,1-ethylene (DDE) and PCBs, whereas Cycls and HCHs occurred at low concentrations only. Concentration values of p,p'-DDE ranged from nondetected to 19,518.72 ng/g wet wt in livers and from nondetected to 2679.19 ng/g wet wt in fat. Total PCB levels ranged from 1.01 to 7419.43 ng/g and from 3.25 to 490.10 ng/g wet weight for liver and fat samples, respectively. Higher-chlorinated PCBs such as 118, 138, 153, and 180 predominated in both the liver and subcutaneous fat samples, a pattern comparable to that observed in birds from other European countries. No significant differences in mean concentrations of OCs are detected between species. Hepatic concentrations were in general higher than the fat concentrations showing depleted fat stores in most birds. Concentration ranges were also found in lower or similar levels to those reported for birds in other regions. Variation of OCs levels in bird tissues could be due to different causes of death, with a subsequent effect on body lipid levels, and different feeding and migration habits. The liver PCB levels reported in this study are below the concentrations currently believed to exert mortality or ecotoxicological effects. On the contrary, in some cases p,p'-DDE concentrations were higher than the reported effect values for birds of the same families and could be associated with sublethal effects.
UNLABELLED: Since no foods are vitamin D supplemented in Greece, vitamin D status was assessed in mothers at birth and their infants up to the first 6 months of life, while they were exclusively breast-fed. This was a prospective study. Full-terms (n =35) born during the summer-autumn months and their mothers were assigned to the summer group and the remainder (n =31) to the winter group. One week after birth, serum 25-hydroxyvitamin D (25OHD) was significantly lower in the winter-born than in the summer-born neonates (6.7+/-0.7 vs. 10.1+/-0.9 ng/ml, P <0.01). The respective levels of parathyroid hormone (iPTH) were 64.9+/-13.4 and 33.9+/-4.4 pg/ml (P <0.01). The mothers had serum 25OHD levels of 10.8+/-1.0 ng/ml and iPTH levels of 15.2+/-3.5 pg/ml in the winter and 12.9+/-1.3 ng/ml and 24.8+/-4.8 pg/ml in the summer. During the 6-month follow-up, a steady increase in circulating 25OHD (up to 19.4+/-2.8 ng/ml, P <0.0001) and a decrease in iPTH (to 26.8+/-3.5 pg/ml, P =0.10) were observed in the infants born in the winter. In the summer-born infants, serum 25OHD did not change but iPTH had increased significantly by the 3rd month (59.4+/-21.8, P <0.05). Serum calcium (Ca) increased within normal limits during the study period in both groups. Serum phosphorus (Pi) started higher in the winter group (7.43+/-0.38 vs. 6.27+/-0.23 mg/dl, P <0.01) but thereafter, it was similar in both groups. Total alkaline phosphatase (ALP) increased in both groups during the study (164+/-15 vs. 219+/-17 IU/l, P <0.05 and 189+/-14 vs. 288+/-35 IU/l, P <0.001, respectively). Serum osteocalcin (OC) decreased in the winter-born neonates (32.0+/-3.4 vs. 21.5+/-3.4 ng/ml, P <0.05) and did not change in the summer group (28.9+/-3.5 vs. 26.5+/-2.8 ng/ml). CONCLUSION: Neonates who are breast-fed exclusively during the first 6 months of life are in need of vitamin D supplementation irrespective of the season even in a sunny country like Greece where foods are not supplemented.
A pollen calendar has been constructed for the area of Thessaloniki and relationships between pollen transport and meteorological parameters have been assessed. Daily airborne pollen records were collected over a 15-year period (1987-2001), using a Burkard continuous volumetric pollen trap, located in the centre of the city. Sixteen allergenic pollen types were identified. Simultaneously, daily records of five main meteorological parameters (mean air temperature, relative humidity, rainfall, sunshine, wind speed) were made, and then correlated with fluctuations of the airborne pollen concentrations. For the first time in Greece, a pollen calendar has been constructed for 16 pollen types, from which it appears that 24.9% of the total pollen recorded belong to Cupressaceae, 20.8% to Quercus spp., 13.6% to Urticaceae, 9.1% to Oleaceae, 8.9% to Pinaceae, 6.3% to Poaceae, 5.4% to Platanaceae, 3.0% to Corylus spp., 2.5% to Chenopodiaceae and 1.4% to Populus spp. The percentages of Betula spp., Asteraceae (Artemisia spp. and Ambrosia spp.), Salix spp., Ulmaceae and Alnus spp. were each lower than 1%. A positive correlation between pollen transport and both mean temperature and sunshine was observed, whereas usually no correlation was found between pollen and relative humidity or rainfall. Finally, wind speed was generally found to have a significant positive correlation with the concentrations of 8 pollen types. For the first time in the area of Thessaloniki, and more generally in Greece, 15-year allergenic pollen records have been collected and meteorological parameters have been recorded. The airborne pollen concentration is strongly influenced by mean air temperature and sunshine duration. The highest concentrations of pollen grains are observed during spring (May).
Eighteen haemagglutinin (HA1) gene segments and eleven neuraminidase (NA) genes of human influenza type A (H3N2) viruses isolated from non-vaccinated individuals presenting severe influenza-like illness at peak influenza activity in Southern Greece during the surveillance period 1996-1999, were subjected to sequence and phylogenetic analyses following propagation in embryonated hen's eggs. The HA1 gene segment of the clinical isolates differed from the recent reference influenza type A (H3N2) vaccine strains in an Ile at residue 186, a Val at residue 194 and a Val at residue 226 for one, two and thirteen isolates of the 1996-1997 and 1996-1999 periods, respectively. The analogous differences in the NA gene were confined in an Asp to Asn substitution at residue 198 in one A/Wuhan/359/95 (H3N2)-like isolate of the 1996-1997 period, primarily. In addition, phylogenetic analysis revealed that an isolate of the 1997-1998 period was a recombinant with its HA1 gene segment being closely related to that of A/Wuhan/359/95-like viruses and its NA to viruses of the A/Sydney/5/97 (H3N2) lineage. These findings confirmed the profound genetic instability of influenza type A (H3N2) viruses and underscored the importance for periodic molecular surveys of HA and NA in the effective prevention and management of viral outbreaks. Most importantly, however, they contributed the first complete epidemiological material for influenza in Southern Greece, the archival nature of which constitutes valuable reference for future surveys.