Hepatitis B, C and human immunodeficiency virus knowledge among the general greek population: results from the Hprolipsis nationwide survey.

BACKGROUND: Although several studies on hepatitis B (HBV), C (HCV) and human immunodeficiency virus (HIV) infection have been conducted in Greece, little is known on the knowledge level of the Greek population towards these three infections. Our aim was to assess the knowledge level of the adult Greek general population about the HBV, HCV and HIV. METHODS: Data were derived from the first general population health survey, Hprolipsis. The sample was selected by multistage stratified random sampling. A standardized questionnaire was administered by trained interviewers during home visits. A knowledge score was constructed based on responses to 17 per infection selected items and categorized in three levels; high (12-17 correct replies) medium (6-11) and low (0-5). Among 8,341 eligible individuals, 6,006 were recruited (response rate: 72%) and 5,878 adults (≥ 18 years) were included in the analysis. The statistical analysis accounted for the study design. RESULTS: Only 30.4%, 21.6%, and 29.6% of the participants had a high overall knowledge level of HBV, HCV and HIV, respectively. These low percentages were mainly attributed to the high levels of misconception about transmission modes (65.9%, 67.2%, and 67.9%, respectively). Results showed that increasing age and living out of the big metropolitan cities were associated with decreased odds of having higher knowledge. Female gender, higher education level, higher monthly family income, higher medical risk score, history of testing and being born in Greece or Cyprus, were associated with increased odds of having higher knowledge. CONCLUSIONS: There are significant knowledge gaps in the Greek general population regarding modes of transmission, preventive measures and treatment availability for HBV, HCV and HIV. There is an urgent need for large scale but also localized awareness activities targeted to less privileged populations, to fill the gaps in knowledge and increase population engagement in preventive measures.

Thyroid dysfunction in Greece: Results from the national health examination survey EMENO.

BACKGROUND: Nationwide data on thyroid disease prevalence in Greece is lacking. Using the national health examination survey EMENO data resources, we aimed to estimate the prevalence of hypothyroidism and hyperthyroidism and associated risk factors in adults living in Greece. METHODS: A random sample of the adults (≥18 years) living in Greece was drawn by multi-stage stratified random sampling based on the 2011 census. During home visits, trained interviewers administered a standardized questionnaire to study participants. All participants answered questions concerning demographic parameters (e.g., age, sex, degree of urbanization, income) and questions concerning smoking habits, alcohol, dietary habits and psychological parameters such as anxiety and thyroid disease. Weighted logistic regression models were fitted to assess factors associated with thyroid disease. RESULTS: In total, 6006 individuals were recruited in the Greek Health Examination Survey EMENO (response rate 72%) of whom 5981 were eligible for this study. The prevalence of thyroid disease was 9%, where 0.4% was related to hyperthyroidism and 8.6% to hypothyroidism. The prevalence of thyroid disease was higher in women (14.9%) than men (2.7%) (p<0.001). The highest rates of thyroid disease were observed in former iodine-deficient areas. A decrease in the prevalence of thyroidopathies with increasing alcohol consumption was found. Thyroid disease was associated with anxiety in men. Multivariable regression analysis showed that age, geographic area, and smoking were related to thyroid disease. CONCLUSION: The prevalence of thyroid disease in Greece is higher in women. Age, habits, and characteristics of geographic areas determine the distribution of thyroidopathies in Greece.

High prevalence of cardiovascular risk factors in adults living in Greece: the EMENO National Health Examination Survey.

BACKGROUND: Nationwide data on cardiovascular risk factors prevalence is lacking in Greece. This work presents the findings of the national health examination survey EMENO (2013-2016) regarding the prevalence of hypertension, hypercholesterolemia, diabetes, obesity and smoking. METHODS: A random sample of adults (≥18 years) was drawn by multistage stratified random sampling based on 2011 Census. All EMENO participants with ≥1 measurement of interest [blood pressure (BP), fasting glucose, HbA1c, total cholesterol (TC), Body Mass Index (BMI)] were included. Hypertension was defined as BP ≥ 140/90 mmHg and/or antihypertensive treatment; diabetes as fasting glucose≥126 mg/dL and/or HbA1c ≥ 6.5% or self-reported diabetes; hypercholesterolemia as TC ≥ 190 mg/dL. Sampling weights were applied to adjust for study design and post-stratification weights to match sample age and sex distribution to population one. Non-response was adjusted by inverse probability weighting. RESULTS: Of 6006 EMENO participants, 4822 were included (51.5% females, median age:47.9 years). The prevalence of hypertension was 39.2%, higher in men (42.4%) than in women (36.1%); of hypercholesterolemia 60.2%, similar in men (59.5%) and women (60.9%); of diabetes 11.6%, similar men (12.4%) and women (10.9%); of obesity 32.1%, higher in women (33.5% vs 30.2%), although in subjects aged 18-40 year it was higher in men; of current smoking 38.2%, higher in men (44.0%) than in women (32.7%). The prevalence of all risk factors increased substantially with age, except smoking, which followed an inverse U shape. CONCLUSIONS: The burden of cardiovascular risk factors among Greek adults is alarming. There is considerable preventive potential and actions at health care and societal level are urgently needed.

Trastuzumab combined to neoadjuvant chemotherapy in patients with HER2-positive breast cancer: a systematic review and meta-analysis.

PURPOSE: To perform a meta-analysis in order to quantify the actual cumulative randomized evidence for the benefit and toxicity of trastuzumab combined with neoadjuvant chemotherapy in HER2-positive breast cancer. METHODS: Potentially eligible trials were located through PubMed and Cochrane Library searches and abstracts of major international conferences. The endpoints that we assessed were pathologic complete response (pCR) rate, breast-conserving surgery (BCS) rate and toxicity. RESULTS: Five trials were identified with 515 eligible patients. The probability to achieve pCR was higher for the trastuzumab plus chemotherapy arm (RR 1.85, 95% CI: 1.39-2.46; p-value < 0.001). No significant difference in terms of breast-conserving surgery between the two treatment arms was observed (OR: 0.98, 95% CI: 0.80-1.19, p-value = 0.82). Regarding toxicity, the addition of trastuzumab did not increase the incidence of neutropenia, neutropenic fever, and cardiac adverse events. CONCLUSION: The addition of trastuzumab in HER2-positive breast cancer in the neoadjuvant setting improves the probability of achieving higher pCR with no additional toxicity. Based on the available evidence, the use of trastuzumab combined with neoadjuvant chemothetherapy in patients with HER2-positive breast cancer seems to offer substantial benefit in terms of pCR.