Epidemiological survey of cestode-larva disease in Greek sheep flocks.

The epidemiological status of hydatidosis, cysticercosis, and gid in sheep and the production practices of sheep farmers that increase the risk of exposure of sheep to infecting agents of these diseases were investigated in Thessaly, central Greece during 2002-2006. A total of 700 hoggets (sheep up to the age of 1 year) and 1500 adult sheep were examined randomly at an abattoir survey and the prevalences of hydatidosis and cysticercosis were found 39.32% and 29.41%, respectively. Hoggets had significantly lower prevalences of hydatidosis and cysticercosis compared to adult sheep (p<0.001). The distribution of parasitic cysts showed an overdispersion pattern mostly in the hogget population. The proportion of fertile hydatid cysts was significantly higher in hoggets compared to adult sheep (p<0.001). A cohort of 74 sheep flocks was observed during the same period in a prospective survey to assess the incidence of gid. A total of 57 sheep belonging to 15 flocks (20.27% of investigated flocks) developed clinical signs of gid at an annual rate of 11.40+/-4.77 (95% C.I.). In the infected flocks there were 3.80+/-0.92 (95% C.I.) gid cases per flock. The mean age of onset of clinical signs for all sheep was 11.86+/-1.33 months (95% C.I.) (range 5-22 months) while for hoggets was 8.48+/-0.73 (95% C.I.) (range 5-12 months) and for adult sheep 17.23+/-1.42 (95% C.I.) (range 13-22 months). A significant difference was observed in the prevalence of unilateral blindness between hoggets (31.42%) and adult sheep (4.54%) (p<0.05). The most common production practices identified in a questionnaire survey of sheep farmers that may increase the risk of exposure of sheep to hydatidosis, cysticercosis, and gid were the improper disposal of dead animals, the access of farm dogs to offal of slaughtered sheep, the carelessness of farmers to treat farm dogs with anthelmintics, and the grazing of flocks in fields where stray dogs have free access.

Study on the efficacy of cefaclor for the treatment of asymptomatic bacteriuria and lower urinary tract infections in pregnant women with a history of hypersensitivity to penicillin.

PURPOSE: The purpose of this study was to compare the efficacy and safety profile of twice daily versus the conventional three daily intake of cefaclor administrated orally for five to seven days in the treatment of asymptomatic bacteriuria or acute cystitis in pregnant women with a history of hypersensitivity to penicillin. METHODS: Between August 2003 and August 2004, 63 pregnant women with a positive urine culture and a history of suspicion of hypersensitivity to penicillin were randomly divided into two groups. The women in the first group received 500 mg of cefaclor while those in the second group received 750 mg of cefaclor for five to seven days. Laboratory and clinical results were assessed a week and a month after complettion of the therapy. RESULTS: Final therapy (bacteriologic eradication) succeeded in 93.7% (30/32) of the first group and in 90.3% (28/31) of the second group. CONCLUSION: Dosage of cefaclor at 750 mg is as effective as conventional cefaclor at 500 mg and better tolerated.

Tricyclic antidepressant-induced acute urine retention in a young woman with postpartum depression--case report.

A rare case of acute urinary retention in a young woman due to simultaneous use of a tricyclic antidepressant and anticholinergic drugs is presented along with the data from the current literature, including the pharmacological action of these drugs, mainly focused on urological patients.

Endometriosis of ureter-induced recurrent urinary tract infections in a premenopausal woman--case report.

Endometriosis of the urinary tract is infrequent. The ureters and kidneys are the least usual place of localization. Endometriosis of the ureter often leads to silent loss of renal function due to delayed diagnosis. We report a case of a premenopausal female with endometriosis of the left distal ureter, presenting an infection of the urinary tract and having reported previous incidents of menorrhagia and left flank renal pain with automatic recession. Pharmacological treatment was applied with a satisfactory outcome. A short review of the literature is presented.

Cervix cancer screening among Greek and immigrant women: the experience of a Greek District Hospital.

PURPOSE: To explore whether there are differences in Papanicolaou (Pap) smear screening between native and immigrant women that attended our outpatient clinic. METHODS: In this retrospective study, from January 2002 until December 2003 we examined age, nationality, marital status, economic status (self-reported family income per year) and previous Pap test screening frequency; 3,316 women were included in the study. RESULTS: The average age was 41.95 years. The majority of the women who had had a Pap test (58.4%) were Greeks and 41.6% immigrants. Regarding marital status a percentage of 61.2% were married, 13.7% were single and 24.9% were divorced. Regarding economic status 71.0% of the women had a low-income, 25.1% a middle-income and 3.8% a high-income. Of the women 24.99% had never had a Pap test in their lives. DISCUSSION/CONCLUSION: The possibility of having easy access to a clinic and to routine health care has a critical influence on the cancer screening habits of immigrant women. Opportunistic Pap smear screening as part of a pregnancy or family-planning checkup in local clinics is an acceptable strategy for poor immigrant women.

Delivery and immigration: the experience of a Greek Hospital.

INTRODUCTION: In this retrospective study we investigate the differences regarding the mode of delivery between Greek and immigrant women. MATERIAL AND METHODS: We collected data from the Birth Registry of the hospital delivery room for the period from March 1, 2000 to February 29, 2004. We assigned the women into two groups according to their nationality: Greeks and immigrants. We studied the following parameters: age, nationality, parity of women, mode of delivery instrumental delivery (ID), vaginal birth (VD), cesarean section (CS), the indications of CS, and gender and weight of the newborn; 3,071 women met the inclusion criteria. RESULTS: The average immigrant's age was 2.9 years lower than in the Greek group; 35.2% of the women were Greeks and 64.7% were immigrants. A significant difference was found in the percentage of multipara and the indications for CS--especially prolonged labor (significantly higher in the immigrants), and preeclampsia (significantly higher in the Greeks). There were no significant differences between the two groups referring to the rate of CS, ID or VD, the gender of the newborn, and the birth weight. DISCUSSION/CONCLUSION: We did not find any significant differences between the two groups regarding the rate of caesarean delivery. In exploring health-related differences between population groups, it is important to determine how race/ethnicity contributes to these differences. A statistically significant association between race or ethnicity and an undesirable health outcome does not by itself establish causality. Health outcomes usually have multiple causes that can be either direct or indirect and are often interrelated and interactive. Race/ethnicity and social class influence health through complex pathways.

A retrospective study of 32 borderline ovarian tumours: the experience of a non-specialized centre.

BACKGROUND: We evaluated the clinical features and treatment of patients with borderline ovarian tumors. METHODS: This was a retrospective review of the charts of 32 patients with borderline ovarian tumours that underwent surgery at the Department of Obstetrics and Gynaecology, Tzaneio General Hospital of Piraeus, over a 14-year period (1/1990-12/2003). RESULTS: Of the patients 62.5% were pre- or peri-menopausal. Mean age was 41.6 years. Five patients (15.63%) had undergone pelvic surgery (caesarean section not included) for unrelated reasons prior to the diagnosis of borderline tumour. Mean follow-up was 71.37 months and all patients showed up for their scheduled appointment during the first trimester of 2004. Pain was the presenting symptom in 37.5% (12/32) of patients. Twenty patients were diagnosed either by ultrasound (12.5%, 4/32) or during unrelated surgeries (50%, 16/32) and reported no relevant symptoms at the time of diagnosis. Treatment was conservative, comprised of either cystectomy (3/32), unilateral salpingo-oophorectomy (13/32), and unilateral salpingo-oophorectomy with myomectomy (1/32). Abdominal hysterectomy with bilateral salpingo-oophorectomy was performed in 15 patients for unrelated conditions (uterine pathology). Mucinous borderline tumours were identified in 11 patients (34.38%), serous borderline tumours in 17 patients (53.12%), and nonserous-mucinous borderline tumours in four patients (12.5%). Omentectomy was performed in two cases, biopsy of the controlateral ovary was performed in five cases and peritoneal washing in eight cases. Restaging surgery was performed at the Metaxa Anticancer Piraeus Hospital in 11 patients (34.38%). One patient who did not undergo a restaging operation had a recurrence of the disease. CONCLUSION: Suboptimal staging remains a major problem during the initial operation in non-specialized centres in gynaecologic malignancies.

Trichinella spiralis: enteric mucin-related response to experimental infection in conventional and SPF pigs.

Duodenal and jejunal responses to infection with Trichinella spiralis were compared in weaned piglets with a "normal dirty" vs. a "clean SPF" gut flora. Histochemical staining of neutral, acidic, sialylated, and sulphated residues was used to assess biosynthetic responses in mucin-secreting goblet cells. Peanut and Ulex lectins were also used to assess responses within the intestinal glycocalyx. Histomorphometric analysis was undertaken to evaluate the distribution and staining patterns of goblet cells in villi and crypts. Our analysis showed that stored mucin within goblet cells increased more in the infected conventional animals than in the infected SPF group. This was accompanied by changes in the pattern of sulphation and sialylation in the duodenum and jejunum. The thickness of the glycocalyx was increased in both duodenum and jejunum in both infected groups. However, this effect was greater for the infected SPF animals than the infected conventional animals. No significant differences were observed between uninfected conventional and uninfected SPF pigs.

Sex-induced cystitis--patient burden and other epidemiological features.

Although sexual intercourse has been established as an important risk factor for uncomplicated urinary tract infection (UTI) in women, the exact the rate of recurrent UTI due to sexual intercourse and its patient burden is unknown. According to our findings, sex-induced cystitis (SIC) accounts for almost 4% of lower urinary tract infections and for 60% of the recurrent cases. Is most frequent between 23 to 27 years and affect mainly women from low and median socioeconomic groups. Behavioral risk factors of SIC include frequency of sexual intercourse and the use of condoms, while the absence of a stable sexual companion does not add further risk. No seasonal variation has been observed in reinfections suspected of SIC. According to information obtained from our questionnaire each episode of this type of UTI in young women was shown to be associated with three to six days of symptoms and one to three days of restricted activity. E. coli was by far the most common pathogen accounting for 95% of primary UTI and 84% of recurrent SIC.

Efficacy of prophylaxis in women with sex induced cystitis.

UNLABELLED: Sexual intercourse has been established as one of the most important risk factors for both isolated and recurrent uncomplicated infections of the urinary tract. Prophylactic therapy requires only a small dose of an antimicrobial agent, which is generally given at bedtime for 6 to 12 months. An alternative method is to give an antimicrobial agent for six months post-intercourse. It is still unknown which of the two methods is most effective. A total of 123 women with suspected sexually induced recurrent cystitis (mean age 28 years, range 15 to 65) and a history of recurrent urinary tract infection (UTI) (the last one within the last six months) were subjected to prophylactic therapy for six months. Half of them were treated with low-dose trimethoprim-cotrimoxazole (TMP-SMX) and cefaclor given orally post-intercourse (spontaneous usage), while the other half were treated with low-dose TMP-SMX and cefaclor given at bedtime. The response to the prophylactic therapy was classified as continued cure in 106 cases (86.17%), failure in 13 cases (10.56%), and unknown in four cases (3.25%). TMP-SMX administered in continuous nightly prophylaxis showed similar efficacy and tolerability as cefaclor post-intercourse. OBJECTIVE: To determine the efficacy of prophylaxis in women with recurrent sex induced cystitis and compare the post-intercourse versus the conventional bedtime given long-term, low-dose use of prophylactic antimicrobials.

Abattoir condemnation due to parasitic infections and its economic implications in the region of Trikala, Greece.

The prevalence of parasitic infections responsible for the condemnation of carcasses and viscera during meat inspection, and their economic implication, was estimated in a year long abattoir survey of 10 277 slaughtered farm animals in the region of Trikala, Greece. The organs examined for the presence of parasitic lesions during meat inspection were: liver and lungs of all animals, rumen of cattle, small intestine of lambs and kids, and muscles of cattle and swine. The parasitic lesions observed in the lungs of cattle, sheep and goats were caused only by hydatid cysts. No hydatid cysts were observed in the lungs of swine. The parasitic lesions observed in the liver of cattle, sheep and goats were as a result of hydatid cysts and flukes of Fasciola hepatica and Dicrocoelium dendriticum, while those of swine were due to milk spots only. Moniezia sp. proglottids were found in the small intestine of lambs only. The prevalence of parasites responsible for the condemnation of marketable organs was low (0.26%). Parasites were responsible for 22% of the total of condemned organs, and their annual cost was 99, 00 GDR (approximately 292 Euros). The parasites most contributing to marketable organ condemnation were hydatid cysts (26%) and D. dendriticum flukes (26%).

Seasonal patterns of strongyle infections in grazing sheep under the traditional production system in the region of Trikala, Greece.

Ten 4-month-old female sheep of the Karagouniko dairy breed were used to monitor the seasonal fluctuations of strongyle infections in sheep during the first year of grazing under the traditional production system in the region of Trikala, Greece, where control of nematodes is currently based exclusively on the frequent use of anthelmintics which might contribute to the appearance of anthelmintic resistance. The sheep grazed communal pasture plots and did not receive any anthelmintic treatment during the entire study period. Faecal egg counts (epg), plasma pepsinogen levels, blood values, and genera of parasitic strongyles recovered from coprocultures were recorded monthly. Mean epg for strongyle-type eggs were significantly higher during summer. Mean plasma pepsinogen levels were significantly higher during spring and summer. The genera of parasitic strongyles recovered from the faecal cultures were Haemonchus, Ostertagia, Trichostrongylus, Cooperia, Nematodirus, Oesophagostomum, and Chabertia. The percentages of larvae for Haemonchus, Ostertagia, Cooperia, and Oesophagostomum were significantly higher during winter. The percentages of larvae for Trichostrongylus were significantly higher during summer. During summer, levels of RBC, HGB, and HCT were depressed and levels of MCV, MCH, and MCHC were elevated. Mean epg for strongyle-type eggs had a significant inverse correlation with RBC, HGB, HCT, and positive correlation with MCH, MCHC, and percentages of eosinophils in differential leucocyte counts. The seasonal pattern of infection observed in the present study indicates that it is possible to decrease the number of treatments to one per year, thus, reducing the possibility for the appearance of anthelmintic resistance.

Seasonal variation of gastrointestinal nematodes of sheep in the region of Joannina, Greece.

Parasitological and growth studies on two groups of naturally infected sheep, with or without anthelmintic treatment, from the age of 3 months to 2 years were carried out in the region of Joannina, Greece. A split-plot design was used so that each group, consisting of seven pure-bred Boutsiko and seven cross-bred Boutsiko with Karamaniko (F1) lambs, grazed separate parasitologically equivalent pasture plots. Faecal egg counts, pasture larval counts, plasma pepsinogen levels and live weight were recorded monthly. Infective larvae on each pasture plot increased during autumn and winter. Mean faecal egg counts for strongyle-type eggs were higher in the non-treated than the treated group and in the cross than the pure-bred sheep. Mean plasma pepsinogen levels were higher during autumn of the second year of the study. The results of the study suggest that the factors affecting the epidemiology of gastrointestinal nematodes of naturally infected sheep during grazing in the region of Joannina include anthelmintic treatment, host genotype and season, while the effectiveness of anthelmintic treatment in this study, as applied in the area, was questionable.

The effect of dietary protein levels before turnout on subsequent faecal nematode egg output of grazing sheep in the Joannina region of Greece.

The effect of dietary protein levels before turnout on the subsequent faecal egg output of gastrointestinal nematodes was examined in two genotypes of grazing sheep, with or without anthelmintic treatment. Lambs were given a low protein (LP) or a high protein (HP) diet for three months (December to March) until grazing started. Half of the animals in each diet group were given anthelmintic treatment (AT) in March and June. The four groups (LP-AT, LP-NT, HP-AT and HP-NT) each consisted of pure-bred Butsiko and cross-bred Butsiko/Karamaniko lambs and grazed separate plots that were initially parasitologically and nutritionally similar. Faecal egg counts were recorded monthly until the experiment ended in July. Mean faecal counts for strongyle-type eggs were higher in the LP-NT group than all the other groups and higher in the LP than the HP groups indicating that faecal egg counts during grazing were influenced by levels of dietary protein before turnout. This effect was intensified in the absence of anthelmintic treatment. No genotype differences were detected.

Metropolitan concentration in developing countries.

"We examine the economic, political and cultural determinants of urban concentration in developing countries using a sample of 53 countries. We find that as countries develop, urban concentration, measured as the largest city's share of the population, at first increases and then decreases. We also find that foreign investment influences concentration in a similar way since foreign investors tend to locate in the main city at low levels of development but are willing to locate outside the center in more developed countries. Political and cultural factors such as lack of democracy, government instability and religiously and [ethnically] homogeneous populations all contribute to high levels of urban concentration. For many developing countries these non-economic factors have led to primate cities whose size far exceeds what would be justified by economic considerations." (SUMMARY IN FRE AND GER)