Enlarging the gene-geography of Europe and the Mediterranean area to STR loci of common forensic use: longitudinal and latitudinal frequency gradients.

BACKGROUND: Tetranucleotide Short Tandem Repeats (STRs) for human identification and common use in forensic cases have recently been used to address the population genetics of the North-Eastern Mediterranean area. However, to gain confidence in the inferences made using STRs, this kind of analysis should be challenged with changes in three main aspects of the data, i.e. the sizes of the samples, their distance across space and the genetic background from which they are drawn. AIM: To test the resilience of the gradients previously detected in the North-Eastern Mediterranean to the enlargement of the surveyed area and population set, using revised data. SUBJECTS AND METHODS: STR genotype profiles were obtained from a publicly available database (PopAffilietor databank) and a dataset was assembled including >7000 subjects from the Arabian Peninsula to Scandinavia, genotyped at eight loci. Spatial principal component analysis (sPCA) was applied and the frequency maps of the nine alleles which contributed most strongly to sPC1 were examined in detail. RESULTS: By far the greatest part of diversity was summarised by a single spatial principal component (sPC1), oriented along a SouthEast-to-NorthWest axis. The alleles with the top 5% squared loadings were TH01(9.3), D19S433(14), TH01(6), D19S433(15.2), FGA(20), FGA(24), D3S1358(14), FGA(21) and D2S1338(19). These results confirm a clinal pattern over the whole range for at least four loci (TH01, D19S433, FGA, D3S1358). CONCLUSIONS: Four of the eight STR loci (or even alleles) considered here can reproducibly capture continental arrangements of diversity. This would, in principle, allow for the exploitation of forensic data to clarify important aspects in the formation of local gene pools.

Do men have rights in abortion? The Greek view.

AIM: We have examined from a legal perspective the father's role in the decision to abort a pregnancy in western society. Furthermore, we have taken a closer look into the inadequacies the Greek legal framework on this issue, from a legal and social point of view. METHODS: Literature in the Greek and English language. RESULTS: One of abortion's many victims is the father of the child. In most European countries and the United States of America, the law does not give any rights to the father on the issue of an abortion. Quite simply, men have no legal rights when it comes to abortion. Legally, an abortion is a private matter between a woman and her doctor, even if she is married. Greece was one of the last countries in Europe to legalize abortion after a long debate in Parliament and the publication of numerous declarations by women's rights organizations. However, despite the liberalization of abortion, which followed the ratification of L 1609/86, the legal framework in which abortions are carried out is not entirely satisfactory. One of the areas that require clarification is the role of father. L 1609/86 does not specify men's rights in abortion. Post-abortion counseling services are dealing with an increasing number of men coming forward, grieving their aborted children. CONCLUSION: A more careful approach is required and a possible review of the law on abortion may be useful. Counselling for women and their male partners should be offered by state organisations. Clarity of thinking, sympathy and understanding are prerequisites in order for a solution respecting the personality of both the woman and her male partner to be reached.

The impact of the Daubert case on modern litigation.

Numerous product liability and toxic tort verdicts were arguably unjustly made on the basis of "junk science" threatening not only justice but the workings of the American economy. This problem was expected to be solved with the application of Daubert criteria, which require the courts to determine whether an expert's testimony reflects scientific knowledge, whether his/her findings are derived by the scientific method, and whether the work product is based on good science. Moreover, the Daubert criteria were expected to have an extraordinary impact on criminal litigation because there is rarely a criminal trial that does not rely on some form of expert testimony. However, there has been some debate on how such standards should be applied to cases involving relatively new product technologies, which only recently have been approved for a specific use, when an incident occurs and for which no published articles or other peer review summaries exist. Additionally, because most violent crimes are committed by the poor and their court appointed advocates, who are overworked and under-financed, are not up to the challenge. Therefore, with the Daubert standards for the admissibility of scientific evidence in the courts alone no significant improvement is expected. The presence of a system of effective representation in criminal cases along with efforts to educate judges and courts to understand ranges of scientific evidence and to recognise the reasonableness of scientific disagreements in civil and criminal cases are of paramount importance.

A finely resolved phylogeny of Y chromosome Hg J illuminates the processes of Phoenician and Greek colonizations in the Mediterranean.

In order to improve the phylogeography of the male-specific genetic traces of Greek and Phoenician colonizations on the Northern coasts of the Mediterranean, we performed a geographically structured sampling of seven subclades of haplogroup J in Turkey, Greece and Italy. We resequenced 4.4 Mb of Y-chromosome in 58 subjects, obtaining 1079 high quality variants. We did not find a preferential coalescence of Turkish samples to ancestral nodes, contradicting the simplistic idea of a dispersal and radiation of Hg J as a whole from the Middle East. Upon calibration with an ancient Hg J chromosome, we confirmed that signs of Holocenic Hg J radiations are subtle and date mainly to the Bronze Age. We pinpointed seven variants which could potentially unveil star clusters of sequences, indicative of local expansions. By directly genotyping these variants in Hg J carriers and complementing with published resequenced chromosomes (893 subjects), we provide strong temporal and distributional evidence for markers of the Greek settlement of Magna Graecia (J2a-L397) and Phoenician migrations (rs760148062). Our work generated a minimal but robust list of evolutionarily stable markers to elucidate the demographic dynamics and spatial domains of male-mediated movements across and around the Mediterranean, in the last 6,000 years.

Associations between coronary heart disease, obesity and histological prostate cancer.

OBJECTIVE: The present study investigates the possible associations between coronary heart disease and histological prostate carcinoma in autopsy material. MATERIAL AND METHOD: The material of our study, were 116 men between 55 years and 98 years of age, who died in the period of August 2002-January 2005. The initial segment of the aorta and the prostate glands of all cadavers were removed while the initial 30 mm of the left and right coronary arteries and the peripheral zone of the prostate gland underwent pathologic examination. RESULTS: Of all subjects examined 71.8% had pathological findings suggesting advanced coronary heart disease. Twenty out of 116 cadavers were found with histological carcinoma in their prostate specimen. Among subjects positive for prostate cancer, 12 had died of cardiovascular diseases, while 16 had macroscopic evidence of advanced coronary artery obstructive disease, a finding that was confirmed on pathologic examination. Although most of the subjects had atheromatous lesions on the coronary arteries, the percentage of men with prostate cancer, which had advanced atheromatosis, was greater when compared to those of subjects without prostate cancer. The relation between the coronary artery obstructive disease severity and the presence of latent prostate cancer was statistically significant (P = 0.02). No statistically significant correlation was obtained between body mass index and the presence of prostate cancer. CONCLUSIONS: Our results indicate that there could be an association between coronary artery obstructive disease and prostate cancer, however due to the relatively low sample further studies are needed in order to confirm such findings.

Screening mammography, public perceptions, and medical liability.

PURPOSE: To outline the most common sources of raising malpractice claims in screening mammography and to discuss the related medical litigation issues in the light of the evidence-based medicine. METHODS AND MATERIAL: Electronic and manual search of the relevant literature. RESULTS: The most common cause of malpractice is the delayed diagnosis of breast cancer. The plaintiff must establish that the radiologist was negligent and the delay in diagnosis caused injury to the patient. Literature shows that mammography does not always detect breast cancer, and even skilled radiologists may periodically miss malignant lesions. Also, delay in diagnosis does not always affect treatment and prognosis. Over-promotion of screening mammography has made disproportionately difficult for a defendant radiologist to prevail in a malpractice lawsuit. Thus, screening mammography is at stake, although it saves lives. The public and legal system should be educated about biological processes, medical practice, and the limitations of screening mammography. CONCLUSION: If mammography is to survive medical litigation and continue to save lives a major reform in public perception, in the stance of the mass media, and in the ability of legal system to understand medicine is required. Physicians and medical associations have an important role to play.

Consent for organ and tissue retention in British law in the light of the Human Tissue Act 2004.

The experience from the scandals in hospitals at Liverpool and Bristol in the UK where retention of tissue and organs was undertaken without the consent of the parents and relatives raised serious concerns regarding the efficacy of the existing Human Tissue Act 1961, in England and the operation of the law by medical practitioners. In the aftermath of these damaging scandals a combination of public distrust and government overreaction has led to the enactment of new legislation, the Human Tissue Act 2004, which is aiming to prevent any further instances of the retention of organs and tissue from dead children or adults without their next of kin's consent or knowledge. However, scientists have expressed concerns that such changes might seriously endanger several medical research programmes, and also tissue and organ donation for transplantation. The aim of this article is to highlight important issues raised by existing practice in the post-mortem examinations in the UK and the lessons learnt from this and to discuss the benefits and the potential problems arising from the new Act.

Spatially Explicit Models to Investigate Geographic Patterns in the Distribution of Forensic STRs: Application to the North-Eastern Mediterranean.

Human forensic STRs used for individual identification have been reported to have little power for inter-population analyses. Several methods have been developed which incorporate information on the spatial distribution of individuals to arrive at a description of the arrangement of diversity. We genotyped at 16 forensic STRs a large population sample obtained from many locations in Italy, Greece and Turkey, i.e. three countries crucial to the understanding of discontinuities at the European/Asian junction and the genetic legacy of ancient migrations, but seldom represented together in previous studies. Using spatial PCA on the full dataset, we detected patterns of population affinities in the area. Additionally, we devised objective criteria to reduce the overall complexity into reduced datasets. Independent spatially explicit methods applied to these latter datasets converged in showing that the extraction of information on long- to medium-range geographical trends and structuring from the overall diversity is possible. All analyses returned the picture of a background clinal variation, with regional discontinuities captured by each of the reduced datasets. Several aspects of our results are confirmed on external STR datasets and replicate those of genome-wide SNP typings. High levels of gene flow were inferred within the main continental areas by coalescent simulations. These results are promising from a microevolutionary perspective, in view of the fast pace at which forensic data are being accumulated for many locales. It is foreseeable that this will allow the exploitation of an invaluable genotypic resource, assembled for other (forensic) purposes, to clarify important aspects in the formation of local gene pools.

Physicians' liability in obstetric and gynecology practice.

PURPOSE: Litigation in obstetric and gynecologic practice has arisen as an important issue. This article aims to highlight issues related to malpractice in obstetrics and gynecology in order to point out several important aspects of medical practice, which may offer adequate professional protection. METHODS AND MATERIAL: Search of the current relevant literature. RESULTS: The four most common clinical causes of medical litigation in obstetrics and gynecology are cases involving fetal distress, uterine rupture after a vaginal birth in a woman with a previous Cesarean section, shoulder dystocia, and misdiagnosis of breast cancer. Litigation raised in most of the cases is driven by bad outcomes and not by malpractice. Additionally, both juries and the public often expect perfection as the natural result of pregnancy and any deviation from this expectation has to be the result of someone's negligence. For this reason it has become mandatory for doctors in hospitals and private practices to acquire a sufficient knowledge relating to modem management, to document carefully in writing their procedural and management plans and to become familiar with the legal aspects of medical practice. Adequate communication and a written patient's consent form are of paramount importance. CONCLUSION: Maintenance of high standards in daily practice with continuous training, clear communication and a signed Patient's Informed Consent Form along with the appropriate documentation of any procedure carried out may provide professional safety to practicing obstetricians and gynecologists in case of medical litigation.

Moral arguments on the use of ovarian tissue from aborted foetuses in infertility treatment.

The possibility of using eggs from an aborted foetus in IVF treatment has recently arisen after researchers presented work in which they managed to keep alive in the laboratory ovarian tissue taken from second and third trimester aborted foetuses for several weeks. Several ethical concerns and arguments have been raised. Some of them are general anti-abortion arguments while others relate to the use of eggs or ovarian tissue of aborted female foetuses in infertility treatment. In this article we will argue that most of the arguments for prohibiting the use of ovarian tissue from aborted foetuses in fertility treatment are not sufficient to provide ethical grounds for banning such a practice.

Physicians' liability in interventional radiology and endovascular therapy.

INTRODUCTION/OBJECTIVE: Modern practice in Radiology has rapidly changed over the last decades incorporating invasive techniques. Additionally, litigation in medical practice has arisen as an important issue. This article aims to highlight issues related to malpractice in interventional radiology and endovascular therapy in order to point out the importance of the written informed consent. METHODS AND MATERIAL: Search of relevant literature from the Pubmed. RESULTS: The role of radiologist has been greatly transformed over the last decades. He is not only entitled to participate in the diagnosis but also he undertakes therapeutic procedures, either alone or as a member of a team. Thus the radiologist is now more exposed to actions that maximize litigation risk. Adequate communication and a written consent form seem to be mandatory before any invasive radiological procedure. Patient should know in detail the benefits and the risks of the scheduled procedure and whether the proposed therapy is a new form of treatment or part of a randomized trial. DISCUSSIONS AND CONCLUSION: Interventional radiologist or physician is exposed to high litigation risk. This certainly requires an urgent adaptation of his practice and attitude to the new reality. Written patient's informed consent remains an integral part of the communication between physicians and patients, and importantly is offering professional protection along these lines.

Adolescence and abortion in Greece: women's profile and perceptions.

PURPOSE: To investigate the individual and social profile of the adolescents seeking abortion in Greece. PROCEDURES: Questionnaires were distributed from the obstetricians practicing in the capital and two major cities in Greece to adolescent pregnant women who were seeking for abortion and collected anonymously. MAIN FINDINGS: From 150 consecutive pregnant adolescents, 38 refused to participate and from 112 who accepted to participate only 74 (66%) replied. Most of the respondents lived in a city (65%), were unmarried (73%), 62% had sex first time after the age of 15, and the educational status of their parents was rarely at higher degree (father: 20%, mother: 16%). Among them, 74% declared that they had received information on contraception (64% from friends, 47% from doctors, 36% from the media). Overall, withdrawal (49%) and male condom (28.5%) were the popular contraceptive precautions. Abortion was adolescents' decision in 65%, while the partner's influence in the case of a shared decision was as high as 73%. Most adolescents (91%) knew about the potential risks of abortion mainly by their doctor (87%) and socio-economical reasons (89%) were mostly claimed. Their parents were rarely aware about their pregnancy (28%) and decision for abortion (28%). In most cases it was the first abortion (78%) and adolescents declared that were aware about the Greek Church's opposition (89%) and the existence of an abortion law (86%). PRINCIPAL CONCLUSION: In Greece, the poor education on the issue of contraception still remains a major problem among teenagers contributing to the increased prevalence of undesired pregnancies and abortions.

Legal aspects related to marketing and use of medicinal products in Greece.

Drugs and all medicinal products are in a special category. The manufacturing, marketing authorization and the distribution of them within the market, require fulfillment of particular conditions compared with other consumer goods. Additionally, the safety of drug use is an important issue for the public health, involving State and insurance authorities, physicians, pharmacists and drug companies. In today's health care environment, any authority involved in therapeutic interchange issues should be knowledgeable about the legal and medical issues associated with this practice. The aim of this study was to provide an analysis of Greek pharmacy legislation and an insight into the infrastructure of the Greek system that is responsible for the safety of the use of medicinal products from the Public Health Standpoint.

The abuse of children in Greece.

Children are being abused in Greece at an alarming rate. This article aims to clarify the magnitude of the child abuse issue in Greece and to highlight medical and legal aspects that may play a contributory role in the existing defects in the revelation, prevention, and punishment of this type of crime.

Medical litigation in cosmetic plastic surgery.

AIM: This article aims to highlight issues related to malpractice in plastic surgery and to point out the importance of good understanding of the law and the value of a patient's written informed consent as measures of professional protection. METHODS AND MATERIAL: Search of relevant literature from PubMed. RESULTS: The demand for cosmetic plastic surgery increases despite the increasing cost, in contrast to other traditional goods for which demand typically declines as price increases. Cosmetic plastic surgery has moved beyond the stage of being an exclusive privilege of the rich and famous. Nevertheless, cosmetic plastic surgery is one of the medical specialties exposed to a substantially high risk of malpractice claims. Most malpractice claims in cosmetic plastic surgery are not consequences of technical faults but because of inadequate patient selection criteria and lack of adequate communication between patient and surgeon. Proven efficient training, careful utilization of computer imaging techniques in association with the adoption of simple precautions and guidelines and adequate communication along with a completed patient's consent form are important essentials in case of medical litigation. CONCLUSIONS: In today's litigious society, maintenance of high standards in daily practice with continuous training and appropriate documentation of every procedure are all a sufficient defense of the plastic surgeon in case of medical litigation. Written patient's informed consent remains an integral part of the communication between physicians and patients, and importantly is facilitating professional protection.

A review of Greek law on human cloning.

The creation of Dolly, a cloned lamb from adult cells was a major scientific breakthrough, which opened new avenues for many research fields such as reproductive medicine, transplantation and biotechnology. However this achievement brought to public attention the theoretical possibility of human reproductive cloning. Inevitably heated debate occurred on several ethical and legal consequences of the prospect of human cloning. At the present time there is no legal framework in any country to respond to this challenge in a pragmatic way in order to protect human rights and at the same time to allow science to work for the best interests of mankind. Greece is a European Union country with its own traditions, history, culture and beliefs but without political and legislative experience in the handling of medical and biotechnological matters. This paper aims to discuss the legal issues likely to be raised by the prospect of human reproductive cloning in relation to the current state of the Greek legal system.

Abortion under Greek law: parental consent for a minor's abortion.

As medical abortion becomes more widely used and available in Greece, several issues are emerging and require clarification. Health care providers often face a dilemma when dealing with an adolescent requesting abortion. Parents' consent is mandatory before delivering any kind of treatment to minors. However, as it appears in the case presented here, the circumstances are not always straightforward. A critical review of the Greek legal framework in relation to the current social context is attempted through an interesting case aiming to elicit potential defects of the law that should be addressed by the legislator.

Confidentiality of health information in Greece, the birthplace of Hippocrates.

It is a doctor's duty to observe the rules of professional secrecy strictly by refraining from disclosing voluntarily to any third party information concerning a patient, that he has learned in the course of his professional practice. Greece is a European Union country with its own tradition, history, culture and beliefs but without political and legislative experience in the statutory handling of medical matters. This paper aims to give emphasis to the obligation of confidence in the area of medical practice and to discuss the legal issues likely to be raised in relation to the current state of Greek legal order.

Bioethics as a scientific enterprise.

The authors of this article attempt to look at the manner in which the field of bioethics has emerged to represent an entirely new science. The article does this by first looking at various developments in the field of medicine and science. Specifically, the authors point to the developments in pharmacology, biology, and in genetics, as the stimuli for the field of bioethics. Since these three fields of study directly deal with human beings and their respective environment, new developments in these respective areas of science have questioned what society has traditionally held concerning these two concepts. In an effort to help answer such questions, the field of bioethics has emerged. The authors argue that bioethics represents more than just a theoretical field. Instead, bioethics, as an entirely new science in itself, has the ability to provide answers to the question, and moral dilemmas that new developments in other sciences raise. The article attempts to show that science/medicine has direct links to proper therapy and procedures. The authors do this by making a direct connection between ethics and medicine, as Hippocrates understood. For Hippocrates, medicine and science should be distinguished from religion, but not from proper ethos. Therefore, the authors argue that the field of bioethics has gained its status as a scientific enterprise since it provides the ability for scientists and physicians to conduct their work in an ethos that aims to protect the human person.

Bioethics and the determination of personhood.

In today's technological world, humanity continuously surpasses the limits set by previous achievements. Although evidence of such progress exists in several fields of study, one clearly sees this in the medical and biotechnological fields. Despite the countless opportunities for longer, more productive lives, medicine and science have regressed in their conception of the human person. In an effort to overcome any moral and legal ramifications that research and medical practices entail, physicians and researchers have come to reduce personhood to only a matter of biological qualities and functioning. This essay attempts to show, first of all, the classical Christian understanding of the person, currently held by the Orthodox Church. It then looks at three fields of bioethical discussion; namely, abortion, brain death, and human embryonic cloning, and shows how each issue reduces the human person to his or her biological components. The essay concludes by suggesting a return to an understanding of personhood based on personal and communal levels of relationships.