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PubMedDate not supplied

Diphtheria immunity of Albanian and other eastern European immigrants in Greece compared with the local population--the risk of reemergence in Greece.

A large number of immigrants have come to Greece from diphtheria-endemic countries during the past 8 years. Information on the immune status against diphtheria among immigrants from Albania and the New Independent States (NIS) of the former USSR, as well as the Greek population, is essential in planning public health control measures. The main objective of the study was to determine the risk of the spread of diphtheria if new cases arrived in the country. Diphtheria antitoxin (DAT) in sera from 185 healthy individuals from northern Greece and 227 immigrants from Albania and the NIS was titrated using a quantitative ELISA test. The participants were adults aged 22 to 46 years. Titers were considered as protective when DAT levels were higher or equal to 0.1 IU/ml. Albanian immigrants exhibited the highest rates of protective titers (99 of 167, 59.3%), while lower immunity rates were detected among immigrants from the NIS (20 of 60, 33.3%) (1.5 < OR = 2.9 < 5.4, p = 0.0007) as well as among Greek participants (47 of 185, 25.4%) (2.8 < OR = 4.4 < 7.0, p = 0.00001). Immunity rates did not differ between Greek and NIS participants. DAT levels of persons with protective titers differed between the three population groups (analysis of variance, p = 0.0005), with the highest mean DAT values detected among NIS immigrants (0.613 IU/ml). Lower values were found among protected Albanians (0.482 IU/ml) and Greeks (0.314 IU/ml). There was no significant age- and sex-related difference in immunity rates and DAT levels among the groups. The low immunity rates among Greek adults might suggest that they have had no natural contact with toxigenic strains of corynebacteria. A booster dose of diphtheria toxoid for local adults is recommended, to reduce their risk of acquiring toxigenic strains from individuals who may carry the bacteria without exhibiting clinical disease.

Adult↗
PubMed1999

Nested clade and phylogeographic analyses of the chub, Leuciscus cephalus (Teleostei, cyprinidae), in Greece: implications for Balkan Peninsula biogeography.

Phylogenetic relationships among Greek populations of the chub, Leuciscus cephalus, were investigated using 600 bp of the cytochrome b gene. The aim of this study was to test the assumption that the main difference in ichthyological composition between both sides of the Balkan Peninsula is directly linked to differences in the dispersion mechanisms used by fish in order to extend their distribution range. Phylogenetic and nested clade analyses clearly showed that populations in Greece are significantly differentiated. Greek populations were found to descend from three lineages in three geographical provinces: Western, Central, and Eastern Greece. The chub reached Western Greece at the beginning of the Pleistocene and Eastern Greece during the mid-Pleistocene. Chub dispersion occurred mainly by river confluence due to sea level lowering and river capture in Western Greece and sea dispersal with low-salinity conditions within the Aegean Sea in Eastern Greece. However, in Central Greece, the original mtDNA lineage has presumably been lost owing to a genetic introgression following a second invasion from the Danube during the final stage of the last glaciation. This study provides new elements for a better understanding of the composition of the contemporary ichthyofauna in Greece and highlights possible evolutionary mechanisms responsible for the high endemism rate in the Western Greek biogeographic province.

Animals↗
PubMed2002

A heuristic expert system for forest fire guidance in Greece.

Forests and forestlands are common inheritance for all Greeks and a piece of the national wealth that must be handed over to the next generations in the best possible condition. After 1974, Greece faces a severe forest fire problem and forest fire forecasting is the process that will enable the Greek ministry of Agriculture to reduce the destruction. This paper describes the basic design principles of an Expert System that performs forest fire forecasting (for the following fire season) and classification of the prefectures of Greece into forest fire risk zones. The Expert system handles uncertainty and uses heuristics in order to produce scenarios based on the presence or absence of various qualitative factors. The initial research focused on the construction of a mathematical model which attempted to describe the annual number of forest fires and burnt area in Greece based on historical data. However this has proven to be impossible using regression analysis and time series. A closer analysis of the fire data revealed that two qualitative factors dramatically affect the number of forest fires and the hectares of burnt areas annually. The first is political stability and national elections and the other is drought cycles. Heuristics were constructed that use political stability and drought cycles, to provide forest fire guidance. Fuzzy logic was applied to produce a fuzzy expected interval for each prefecture of Greece. A fuzzy expected interval is a narrow interval of values that best describes the situation in the country or a part of the country for a certain time period. A successful classification of the prefectures of Greece in forest fire risk zones was done by the system, by comparing the fuzzy expected intervals to each other. The system was tested for the years 1994 and 1995. The testing has clearly shown that the system can predict accurately, the number of forest fires for each prefecture for the following year. The average accuracy was as high as 85.25% for 1995 and 80.89% for 1994. This makes the Expert System a very important tool for forest fire prevention planning.

Conservation of Natural Resources↗
PubMed1998

Hepatitis B immunization programme: lessons learnt in Greece.

Historically, Greece has had the highest burden of hepatitis B virus (HBV) infection in the European Union (EU). Heterosexual contact is the primary means of HBV transmission in Greece, accounting for approximately 30% of acute cases in adult males and 50% of acute cases in women of reproductive age [Kattamis C, Papevangelou G. Workshop Group: Greece. Vaccine 1995;13:S97-S98.]. In 1982, Greece implemented a hepatitis B prevention programme aimed at high-risk groups; unfortunately, this approach had little impact on disease incidence or prevalence. At the recommendation of the WHO and the World Health Assembly and after sustained lobbying by several scientific and medical associations in Greece, the Greek government decided to implement a national prevention programme for hepatitis B. The programme, in effect from early 1998, includes the screening of pregnant women, universal infant and adolescent immunization and immunization of high-risk groups.

Adolescent↗
PubMed1999

Increase in congenital rubella occurrence after immunisation in Greece: retrospective survey and systematic review.

OBJECTIVE: To describe the events leading to the epidemic of congenital rubella syndrome in Greece in 1993 after a major rubella epidemic. DESIGN: Retrospective survey and systematic review. SETTING: Greece (population 10 million), 1950-95. SUBJECTS: Children, adolescents, and women of childbearing age. RESULTS: Around 1975 in Greece the measles, mumps, and rubella vaccine started being given to boys and girls aged 1 year without policies to attain high vaccination coverage and to protect adolescents and young women. During the 1980s, vaccination coverage for rubella remained consistently below 50%, and the proportion of pregnant women susceptible to rubella gradually increased. In 1993 the incidence of rubella in young adults was higher than in any previous epidemic year. The epidemic of congenital rubella that followed, with 25 serologically confirmed cases (24.6 per 100 000 live births), was probably the largest such epidemic in Greece after 1950. CONCLUSIONS: With low vaccination coverage, the immunisation of boys and girls aged 1 year against rubella carries the theoretical risk of increasing the occurrence of congenital rubella. This phenomenon, which has not been previously reported, occurred in Greece.

Adolescent↗
PubMed1997

Surgery in Greece.

The expenditure on health care reached 7.8% of the gross domestic product in Greece in 1991. Almost 9000 specialized surgeons in 11 recognized specialties provide services to more than 10 million people living in Greece and 2 million visitors annually. Medical studies comprise a 6-year course of 5000 to 5500 teaching hours in 7 medical schools and are free. Organizational reform of the health care system in vital and long overdue to move the system into the 21st century. The quality of surgical services provided is high by international standards; cardiac surgery, organ transplantation, surgical oncology, and anesthesiology are some areas of excellence. In addition, Greece has a good record in medical technology and instrumentation. Research activities cover a range of subjects, and the number of clinical medicine articles from Greece that appear in peer-reviewed journals compares favorably with other larger countries. Reforms in the postgraduate training system and ongoing education are necessary.

Delivery of Health Care↗
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↗
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↗