Kyriakos P. Kyriakis

Experience with low-dose thalidomide therapy in chronic discoid lupus erythematosus

Background Low‐dose thalidomide therapy (median dose 100 mg/day, 50–200 mg/day) in chronic discoid lupus erythematosus was studied with regard to efficacy, tolerance, and toxicity in 22 patients. Intense contraceptive precautions were taken in women patients of childbearing age.

Multidrug-Resistant Strains of Neisseria gonorrhoeae in Greece

ABSTRACT Eighty-seven out of 575 gonococci isolated in Greece from 1991 to 1998 belonged to serovar Bropyst and exhibited resistance to penicillin, tetracycline, erythromycin, and chloramphenicol. Conventional and molecular typing showed three clusters, A, B, and C, that were associated with networks of high- frequency transmitters (cluster A with homosexuals and clusters B and C with refugees from Eastern Europe). Study of one isolate revealed mutations in the penA, mtrR, and porB genes that may explain the multidrug-resistant phenotype.

Case detection rates of vitiligo by gender and age

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Environmental factors influencing the biologic behavior of patterns of pemphigus vulgaris: epidemiologic approach.

Background. Pemphigus vulgaris is an autoimmune disorder, in which environmental factors seem to play a role, both in the pathogenesis and the activity of the disease. The purpose of the study was to correlate the biologic activity of pemphigus vulgaris with sun exposure and air temperature.

Epidemiologic aspects of male gonococcal infection in Greece.

OBJECTIVE To report male gonorrhea incidence trends between the years 1974 and 1996 and compare the epidemiologic characteristics of the affected population during periods of high and low incidence of the disease. STUDY DESIGN Retrospective study of all available data for male gonorrhea cases recorded annually in a major STD hospital in Greece since 1974. RESULTS An abrupt drop in gonorrhea relative incidence occurred in 1986, followed by low rates thereafter. In the context of the overall decline in the incidence of the disease, a shift to older ages, longer time elapsed before seeking medical assistance, and higher proportion of disease repeaters was noticed among the patients. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence presented erratic time fluctuations, indicating that they have not been established as endemic in the Greek population. CONCLUSION The core group hypothesis in terms of nighttime sociosexual activity can be used to interpret most of the findings.

HIV-1 infection-associated risk factors among sexually transmitted disease patients in Athens, Greece: 1990 to 1996.

Objective: To determine trends in HIV seroprevalence and related risk factors among patients with sexually transmitted diseases (STDs) and to report the respective epidemiologic history characteristics. Methods: A cross‐sectional seroepidemiologic study conducted from 1990 to 1996 among 5,669 symptomatic STD cases was carried out. Results: The overall HIV test acceptance was 98.9%, and 1.2% patients (n = 66) were seropositive. Highest rates were detected among those who were born or resided in Sub‐Saharan Africa. Seropositivity fluctuates significantly by age, and is excessive in persons 45 years and older (2.6%). A significant decreasing trend in STD incidence and HIV seroprevalence among patients younger than 25 years was detected. Male homosexuals and bisexuals (MSM) exhibited the highest overall rate of infection (5.8%) followed by intravenous drug users (2%). Highly promiscuous STD patients (ie, those who had more than 10 partners during the past 6 months) presented a significantly increased HIV seroprevalence when compared with patients of the same sexual orientation. STD patients infected with HIV mostly belonged to notable risk categories of AIDS (men who have sex with men, 72.7%). Awareness of serostatus was low (13.6%). In male patients, the HIV seropositivity rate was significantly higher among early syphilis and proctitis cases, whereas in females this higher rate occurred with herpes genitalis. Conclusions: Promiscuity and sexual orientation significantly influence the seroprevalence rate. Exposure to HIV remained stable despite the above declining time trends, which implies the need for additional preventive interventions targeted to the real health and illness behavior of the partner.

Antimicrobial susceptibility and types of Neisseria gonorrhoeae in Greece. Data for the period 1990 to 1993.

Background: Surveillance of the rapidly changing patterns of antimicrobial resistance of Neisseria gonorrhoeae is imperative for monitoring gonococcal infection. Goal: To describe the types and the antimicrobial susceptibility profile of a representative sample of gonococci isolated in Greece between 1990 and 1993. Study Design: The antimicrobial susceptibilities, serovar/auxotypes classes, and plasmid contents of 263 consecutive isolates of N. gonorrhoeae, recovered from cases of male gonococcal urethritis, were determined. Results: Penicillinase‐producing N. gonorrhoeae (PPNG) were isolated at a rate 6.1% and were mostly from imported cases of infection. Six (2.3%) of the isolates (one PPNG and five non‐PPNG) were highly resistant to tetracycline, and one PPNG strain was resistant to norfloxacin and ciprofloxacin. Strains with chromosomal resistance to penicillin, tetracycline, erythromycin, and chloramphenicol accounted for 18.5%, 12.5%, 19%, and 16% of the isolates, respectively; much higher proportions of strains were intermediately susceptible to these antibiotics. Spectinomycin and cefotaxime were active against all gonococci studied. A shift to IB serovars and to sporadic types of strains was noted from previous years among the non‐PPNG isolates. This is compatible with the marked increase in the rate of imported cases of infection caused by non‐PPNG strains. Conclusions: The emergence of high‐level resistance to tetracycline and resistance to fluoroquinolones was ascertained. At the present, however, the main problem with gonococcal resistance in Greece seems to ensue from the increasing rates of chromosomally resistant strains. Moreover, the increasing frequency of imported gonococci underlines the necessity for continuous epidemiologic surveillance.

Immune response to hepatitis A vaccination in HIV-infected men in Greece

HIV-infected patients are at increased risk for acquiring hepatitis A virus (HAV) infection. We evaluated the seroconversion rate (anti-HAV antibodies ≥ 20 mIU/ml) and the geometric mean antibody titres (GMTs) in a group of 351 HIV infected men, who had received two doses of a hepatitis A vaccine. We analysed blood samples collected at one, six, 12 and 18 months following the administration of the second dose of the vaccine. The seroconversion rate one month after the second dose of the vaccine was 74.4% (260/351). At month 18 after the end of vaccination, 56.1 % of the subjects remained seropositive. GMTs were 315, 203,153 and 126 mIU/ml at months 1,6, 12, and 18, respectively. Logistic regression revealed that the CD4 count is the only factor affecting response to vaccination (P = 0.019). A higher response rate and higher GMTs were observed in patients with CD4 counts ≥500 cells/mm3 (76.6%) than in patients with CD4 counts 200–499 cells/mm3. In conclusion, even in patients with near-normal CD4 counts, the response to the hepatitis A vaccine is impaired.

Incidence determinants of gonorrhea, chlamydial genital infection, syphilis and chancroid in attendees at a sexually transmitted disease clinic in Athens, Greece

Objective  To determine the specific impact on the incidence rate of some demographic and behavioral characteristics in outpatients with four bacterial sexually transmitted diseases (STDs).

Determinants of genital wart case detection rates among STD clinic attendees in Athens, Greece

Background and objective  To report significant sociodemographic and behavioral outpatient characteristics associated with the diagnosis of genital warts.