Michalis Leotsinidis

Incidence of human brucellosis in a rural area in Western Greece after the implementation of a vaccination programme against animal brucellosis

BackgroundBrucellosis continues to be an important source of morbidity in several countries, particularly among agricultural and pastoral populations. The purpose of this study was to examine if there is an effect on the incidence of human brucellosis after the implementation of an animal brucellosis control programme.MethodsThe study was conducted in the Municipality of Tritaia in the Prefecture of Achaia in Western Greece during the periods 1997–1998 and 2000–2002. Health education efforts were made during 1997–1998 to make the public take preventive measures. In the time period from January 1999 to August 2002 a vaccination programme against animal brucellosis was realised in the specific region. The vaccine used was the B. melitensis Rev-1 administered by the conjuctival route. Comparisons were performed between the incidence rates of the two studied periods.ResultsThere was a great fall in the incidence rate between 1997–1998 (10.3 per 1,000 population) and the period 2000–2002 after the vaccination (0.3 per 1,000 population). The considerable decrease of the human incidence rate is also observed in the period 2000–2002 among persons whose herds were not as yet vaccinated (1.4 vs. 10.3 per 1,000 population), indicating a possible role of health education in the decline of human brucellosis.ConclusionThe study reveals a statistically significant decline in the incidence of human brucellosis after the vaccination programme and underlines the importance of an ongoing control of animal brucellosis in the prevention of human brucellosis. The reduction of human brucellosis can be best achieved by a combination of health education and mass animal vaccination.

Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece

A case–control study was conducted in a rural area of Achaia in western Greece to examine the risk factors of brucellosis. The participants in the study were 414 (7.5% of the whole population of the investigated municipality). The cases (n = 140) were defined by clinical symptoms and confirmed by a positive standard agglutination test (SAT). All cases have been diagnosed between January 1997 and March 1999 either by physicians of the Local Health Center or by private practitioners. Two criteria were basic to establish the disease. The first one was clinical symptoms such as fever, fatigue, arthralgia and generalized aches and the second was a titer of SAT at least 1:160. Controls (n = 274) were matched with cases for age and gender in a 1:2 ratio. Approximately collection of controls was performed among those presented to the local Health Center for other diseases. Data were collected by the same physician via a personal interview and analyzed by logistic regression models. The overall incidence of the disease in the region was found to be 1110/100,000. Taking ‘no ownership of animals’ and ‘no contact of animals’ as the reference category, the strongest risk factor was trauma during animal delivery with an odds ratio (OR): 24.3; 95% confidence interval (CI): 8.8–67.5 following by absence of stables (OR: 14.4; 95% CI: 4.7–44.1). After application of multivariate stepwise analysis the adjusted risk factors remaining in the model were the place of residence (OR: 1.8; 95% CI: 1.1–3.1), professional occupation with animals (OR: 2.4; 95% CI: 1.2–4.8), absence of stables (OR: 9.1; 95% CI: 2.2–38.7) and trauma during animal delivery (OR: 11.2; 95% CI: 3.2–39.1). Consumption of cheese from pasteurized milk or consumption of cheese matured for over 3 months was found to be a protective factor (OR: 0.27; 95% CI: 0.11–0.67). The detection of brucellosis in animals is essential for the prevention of the disease. In addition efficient preventive measures should be established in order to eliminate the disease.

Prevalence and Incidence of Multiple Sclerosis in Western Greece: A 23-Year Survey

Background: The frequency of multiple sclerosis (MS) in Greece remains speculative, as data from many parts are still lacking. Objective: To estimate trends in MS prevalence and annual incidence in western Greece from January 1, 1984 to December 31, 2006. Methods: Patients were identified from the patient records of the Department of Neurology at Patras University Hospital in Rion-Patras. Only patients with a definite MS diagnosis according to Poser’s criteria and retrospective application of the McDonald’s criteria were included. We calculated age- and sex-specific prevalence rates for patients living in the study area on December 31, 2006. Annual incidence rates were calculated for the period 1984–2006. Results: The crude prevalence rate of definite MS cases increased significantly in 23 years from 10.1/100,000 recorded in northeastern Greece in 1984 to 119.61/100,000 on December 31, 2006 in western Greece for the 780 cases still alive. The mean annual incidence rate increased from 2.71/100,000 recorded during the period 1984–1989 to 10.73/100,000 in the 5-year period of 2002–2006. Conclusion: The prevalence rates were higher than expected, but closer than in previous surveys conducted in Greece to those reported recently in Sicily and Istanbul. These findings place the area in the high-risk zone.

Arsenic and antimony removal from drinking water by adsorption on granular ferric oxide

Arsenic and antimony occur in drinking water due to natural weathering or anthropogenic activities. There has been growing concern about their impact on health. The aim of this study was to assess the efficiency of a granular ferric oxide adsorbent medium to remove arsenic and antimony from drinking water via rapid small-scale column tests (RSSCTs). Three different water matrices - deionized, raw water treated with a reverse osmosis domestic device and raw water - were spiked with arsenic and/or antimony to a concentration of 100 μg L⁻¹. Both elements were successfully adsorbed onto the medium. The loadings until the guideline value was exceeded in the effluent were found to be 0.35-1.63 mg g⁻¹ for arsenic and 0.12-2.11 mg g⁻¹ for antimony, depending on the water matrix. Adsorption of one element was not substantially affected by the presence of the other. Aeration did not affect significantly the adsorption capacity. Granular ferric oxide could be employed for the simultaneous removal of arsenic and antimony from drinking water, whereas full-scale systems should be assessed via laboratory tests before their implementation.

Expression patterns of SDF1/CXCR4 in human invasive breast carcinoma and adjacent normal stroma: Correlation with tumor clinicopathological parameters and patient survival

SDF-1/CXCR4 axis is involved in various steps of breast tumorigenesis such as tumor growth, angiogenesis and metastasis. The goal of the present study is to demonstrate in detail the immunohistochemical distribution of SDF-1 and CXCR4 in invasive breast carcinomas and identify possible correlation of their expression patterns with clinicopathological parameters and patients survival. We investigated the immunoexpression of CXCR4 and SDF1 in 76 invasive breast carcinomas. Both SDF-1 and CXCR4 had statistically significant higher expression in carcinomas compared with adjacent normal breast tissue. Furthermore the expression of CXCR4 in intratumoral fibroblasts had a positive correlation with overall and disease-free survival, while SDF1 membranous immunopositivity in normal breast epithelial cells was a risk factor for relapse. In addition, expression of SDF1 in fibroblasts of normal breast tissue was positively associated with tumor grade. Overall, our results suggest that the differential expression of CXCR4 in intratumoral stroma and SDF1 in adjacent normal mammary cells may predict clinical outcome in breast cancer patients.

Chromium in drinking water: association with biomarkers of exposure and effect.

An epidemiological cross-sectional study was conducted in Greece to investigate health outcomes associated with long-term exposure to chromium via drinking water. The study population consisted of 304 participants. Socio-demographics, lifestyle, drinking water intake, dietary habits, occupational and medical history data were recorded through a personal interview. Physical examination and a motor test were carried out on the individuals. Total chromium concentrations were measured in blood and hair of the study subjects. Hematological, biochemical and inflammatory parameters were determined in blood. Chromium in drinking water ranged from <0.5 to 90 μg·L−1 in all samples but one (220 μg·L−1), with a median concentration of 21.2 μg·L−1. Chromium levels in blood (median 0.32 μg·L−1, range <0.18–0.92 μg·L−1) and hair (median 0.22 μg·g−1, range 0.03–1.26 μg·g−1) were found within “normal range” according to the literature. Personal lifetime chromium exposure dose via drinking water, calculated from the results of the water analyses and the questionnaire data, showed associations with blood and hair chromium levels and certain hematological and biochemical parameters. Groups of subjects whose hematological or biochemical parameters were outside the normal range were not correlated with chromium exposure dose, except for groups of subjects with high triglycerides or low sodium. Motor impairment score was not associated with exposure to chromium.

Plasma retinol and tocopherol levels in Greek elderly population from an urban and a rural area: Associations with the dietary habits

Data on plasma concentrations of retinol and α-tocopherol in elderly (over 65 years) living in the Mediterranean countries are sparse. In the current study, plasma retinol and α-tocopherol concentrations were determined in 200 healthy subjects (82 men and 112 women) residing in an urban and in a rural area in South Western Greece. High prevalence of low plasma retinol concentration was observed for both sexes in each area. The 16.7% of males in urban and 25.4% in rural area had plasma retinol levels below 0.3 mg/l. The corresponding values for female subjects were 26% and 20.3%. Plasma α-tocopherol was found to be within normal range in the rural area (only one male had plasma α-tocopherol below 5 mg/l) while in the urban area 68.3% of men and 62% of women had plasma α-tocopherol values below 5 mg/l. Differences in dietary habits between subjects living in the rural and in the urban area were revealed through a weekly food frequency questionnaire. This could partly explain the difference in α-tocopherol concentrations between the two areas. The results of this study revealed high risk of vitamin A and E deficiency and suggests that the health care system in Greece should pay more attention on the social and health status of its elderly population.

Interrelationships of pollution load index, transfer factor, and concentration factor under the effect of sludge.

A greenhouse experiment was conducted during 2010–2011. A complete randomized blocks design was used including seven treatment levels of sludge(tons per hectare), i.e., 0, 6, 12, 18, 24, 30, and “30+ treated wastewater”, in four replications. Lettuce (Lactuca sativa L var longifolia) was chosen as a test plant. The purpose of the experiment was to study the relationships between soil Pollution Load Index, heavy metal transfer factor, and concentration factor and to determine optimum concentration factor values. The following were found: several mathematical relationships were established between the above parameters that could be used for the study of heavy metal accumulation in soils and plants under the effect of the applied sludge. They can be also used for the calculation of one of the above parameters as a function of the others. Based on the experimental data, the optimum concentration factor for several heavy metals were determined by multiple linear regression analysis, expressing the concentration factor as a function of the maximum dry lettuce matter yield, and of optimum/minimum heavy metal content of plant dry matter. The mean value of the calculated concentration factor obtained for each separate metal was: Zn, 2.93; Cd, 0.39; Co, 1.47; and Ni, 0.52.

Does farming have an effect on health status? A comparison study in west Greece.

Investigating the health status of agricultural workers is a challenging goal. Contradictory outcomes concerning farmers’ health are reported in the literature. In this cross-sectional study, certain clinical and neurobehavioral health outcomes were compared between farmers and non-farmers living in the same rural area. Farmers (328) and non-farmers (347), matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Sociodemographic, personal medical, nutritional and lifestyle data were recorded. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase’s activity were found to be lower among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non-farmers, while these findings were reversed in older ages. Odds Ratios were calculated through multivariate logistic regression models. Factors affecting these impairments remain to be clarified.

Assessing quality of raw milk in southern Greece in the aspect of certain benzimidazole residues.

Benzimidazoles are veterinary drugs widely used against endoparasites in food-producing animals. Albendazole (ABZ), a benzimidazole, is believed to cause embryotoxicity, teratogenicity and other adverse health effects. This study assessed the residue levels of ABZ and its two major metabolites, the sulfoxide (ABZ-SO) and sulfone (ABZ-SO2), in raw milk samples collected from farms in southern Greece during the spring and autumn of 2008. Analysis was performed by HPLC using a diode array detector. A total of 16% of the 89 samples examined were positive for ABZ metabolites in the range 11–70 ng ml−1, but the parent compound was not detected in any sample. A geographical variation in positive samples was observed, but season or milk type (ovine, bovine, goat) was unrelated to the presence of residues. Considering the lipophilic character of these substances and the possibility of higher concentrations in dairy foods, we suggest greater controlled usage of these drugs.