Papers by Giagkos Lavranos
Preventive vaccination against human papillomavirus is the new practice in the treatment of cervi... more Preventive vaccination against human papillomavirus is the new practice in the treatment of cervical cancer. The successful vaccination programs include the use of three vaccines, capable of causing neutralization of antibodies from the virus particles, together with their envelope: the bivalent, quadrivalent and ninevalent HPV vaccines. Following administration of the vaccines, the immune system is being stimulated, producing antibodies to the HPV particles that protect against infection and disease. The safety profile of licensed HPV vaccines based on clinical and post-marketing data is reassuring.
European journal of public health, Nov 1, 2019
as the sole determinant of health to reflect the impact of migration on health is insufficient. K... more as the sole determinant of health to reflect the impact of migration on health is insufficient. Key messages: Migration background is not per se associated with a poorer health status. Socioeconomic status and parents' length of stay are derminants associated with poorer health outcomes among children and adolescents with migration background.
European journal of public health, Oct 20, 2017
Εισαγωγή:Ο υποδοχέας των οιστρογόνων αποτελεί ένα κυτταροπλασματικό υποδοχέα της οικογένειας των ... more Εισαγωγή:Ο υποδοχέας των οιστρογόνων αποτελεί ένα κυτταροπλασματικό υποδοχέα της οικογένειας των στεροειδών με ισχυρή, αλλά όχι απόλυτη εξειδίκευση για τα οιστρογόνα. Η έκφρασή του είναι σχεδόν καθολική στους ιστούς και τα όργανα του ανθρωπίνου σώματος, ενώ επίσης εντοπίζεται και σε διαλυτή μορφή σε βιολογικά υλικά, όπως το σπέρμα (σπερματικό πλάσμα). Είναι μια ισχυρά εξελικτικά συντηρημένη δομή που μεταβλήθηκε δυναμικά, σε απάντηση σε περιβαλλοντικά ερεθίσματα. Ωστόσο, εξελικτικά νεώτεροι ορμονικοί και αυξητικοί παράγοντες έχουν, σε πολλά όργανα, απωθήσει τον υποδοχέα των οιστρογόνων σε ένα βοηθητικό-υποστηρικτικό ρόλο. Αν πράγματι έτσι έχουν τα πράγματα, τότε θα περίμενε κανείς η απόσυρση των παραγόντων αυτών να επιτρέψει την ανάδειξη των οιστρογόνων και του υποδοχέα τους ως ενός συντηρημένου εφεδρικού συστήματος επιβίωσης.Σκοπός:Να εξεταστεί η υπόθεση ότι ο υποδοχέας των οιστρογόνων αποτελεί μηχανισμό επιβίωσης είτε σε συνεργασία με άλλες ορμόνες (συνέργεια) είτε όταν αυτές απουσιάζουν (εφεδρεία)Υλικό και μέθοδος:Επιλέχθηκαν 2 πειραματικά μοντέλα εργασίας σε αρσενικούς επίμυες Wistar:1.Μελέτη της έκφρασης του ER alpha στον προστάτη αδένα ενηλίκων και γηραιών ατόμων πριν και μετά ευνουχισμό (πρότυπο οξείας και χρόνιας στέρησης ανδρογόνων)2.Μελέτη της έκφρασης του ER alpha στο αναγεννώμενο ήπαρ αρσενικών αρουραίων μετά ηπατεκτομή πριν και μετά χορήγηση οκτρεοτίδης (πρότυπο στέρησης σωματομεδινών)Το πρώτο μοντέλο αξιοποιήθηκε για 2 επιμέρους πειραματικές διατάξεις.Για την πρώτη τα πειραματόζωα τυχαιοποιήθηκαν σε ομάδα μαρτύρων και ομάδα ευνουχισμού και τα δεύτερα υποβλήθηκαν σε αμφοτερόπλευρη ορχεκτομή την 6η ημέρα ζωής. Ακολούθως, τα ζώα θυσιάστηκαν στις 42 και 56 ημέρες ανάπτυξης. Για τη δεύτερη διάταξη τα ζώα υπέστησαν ευνουχισμό σε ηλικία 14 ημερών, 6 ή 12 μηνών αντίστοιχα και ακολούθως θυσιάστηκαν 14 ημέρες αργότερα. Σε όλες τις περιπτώσεις αφαιρέθηκε ο προστάτης, διαχωρίστηκαν οι λοβοί και δείγμα από 15 ζώα ανά ομάδα χρησιμοποιήθηκε για την ανοσοϊστοχημική εντόπιση του ER alpha. Στο δεύτερο μοντέλο αρσενικοί ενήλικες αρουραίοι Wistar υπεβλήθησαν σε ευρεία ηπατεκτομή και ακολούθως τους χορηγήθηκε παρεντερικά είτε φυσιολογικώς ορός είτε οκτρεοτίδη σε δόση 50 mg/kg βάρους σώματος διαλυμένη σε 1ml φυσιολογικού ορρού. Τα ζώα θυσιάστηκαν 168 ή 1440 ώρες μετά την ηπατεκτομή, μετρήθηκε το βάρος του εξαιρεθέντος ήπατος και ακολούθως ιστοί από 15 ζώα ανά ομάδα χρησιμοποιήθηκαν για την ανοσοϊστοχημική εντόπιση του ER alpha.Για τη στατιστική ανάλυση όλες οι κατανομές θεωρήθηκαν κανονικές και εφαρμόστηκε η δοκιμασία του student (t-test) με όριο στατιστικής σημαντικότητας το 95%.Αποτελέσματα:Στον αναπτυσσόμενο προστάτη, η στέρηση των ανδρογόνων συνεπάγεται καταστολή της έκφρασης του ER άλφα στο επιθήλιο και το στρώμα και στις 2 ηλικίες που εξετάστηκαν. Στο μοντέλο της γήρανσης, παρατηρήθηκε διαχρονική αύξηση στη σήμανση για τον ER άλφα τόσο στα επιθηλιακά, όσο και στα στρωματικά κύτταρα, με τα δεύτερα να υπερέχουν σε όλες τις οριζόντιες συγκρίσεις. Τέλος, στην ηπατική αναγέννηση, η χορήγηση οκτρεοτίδης καταστέλλει την έκφραση του ER alpha και καταργεί τη φυσιολογική διαχρονική της αύξηση.Συμπεράσματα:Ο υποδοχέας των οιστρογόνων εμπλέκεται πράγματι σε μηχανισμούς εξασφάλισης της κυτταρικής επιβίωσης, τόσο μέσω επιστράτευσης (ανδρογονοπενικός προστάτης) όσο και μέσω συνέργειας με αυξητικούς παράγοντες και άλλες ορμόνες (ηπατική αναγέννηση
Background: The aim of this study is to assess the importance of the role of the Health Education... more Background: The aim of this study is to assess the importance of the role of the Health Education among young adolescents, regarding the level of knowledge about the HPV and the acceptance of the HPV vaccination, in order to increase the vaccination coverage, both in young adolescents and young teenagers in the area of Trikala, in Central Greece. Methods: The methodological tools of the study were questionnaires. The completion of the questionnaires was gained after the informed and written consent of the parents-guardians. Ethical approval was obtained of the Ministry of Education, Research and Religions. Students of the 1st Gymnasium, randomly chosen by drawing among all school groups of the area. In the rst phase of the study, the questionnaires were completed by the entire study population. During the second and third phases, the completion of the questionnaires concerned the population under study, immediately after the interactive seminar and three months later, respectively. The IBM SPSS 20.0 statistical program was used for analyzing the data and extracting the results. Results: A total of 434 female students, who met the criteria for participation in the study, completed the questionnaire (response rate 76.26%). Most participants (66.6%) were girls. From the nal analysis of the results we observed a rapid change in the level of awareness about the HPV virus, between the three phases of the study. The percentage of the participants who stated that they "do not know" what HPV is, decreased from 44.4%, before the informative interactive intervention in students (rst phase), to1.6% and 8.1%immediately after the intervention (second phase) and 3 months later (third phase), respectively. Similarly, the willingness of young students to be vaccinated against the HPV was increased from 71% during the rst phase of the study, to 89.1% and 83.5% after the second and third phases, respectively. Conclusion: Young teens are poorly informed about the HPV and HPV vaccination. However, with the use of targeted interactive informational interventions in the school environment, a statistically signi cant increase in both the level of knowledge about the HPV and the infection caused by it, is recorded, as well as in the willingness of young adolescent students to be vaccinated against the cervical cancer.
Reproductive Toxicology, Sep 1, 2018
Introduction: Mercury is a ubiquitous, bioaccumulating global pollutant. Depending on dosage and ... more Introduction: Mercury is a ubiquitous, bioaccumulating global pollutant. Depending on dosage and timing, acute and chronic prenatal exposure to mercury has multiple adverse effects including neuro-nephro-and immunotoxicity. Methylmercury (MeHg) is a highly fat-soluble agent and, therefore, placenta, normally offering a blood-maternal barrier, cannot act as a barrier for Methylmercury compounds [1]. Thus, even in very low concentrations, MeHg can cause neurodevelopmental abnormalities including microcephaly, mental retardation, ataxia, impaired visual spatial abilities, vision and hearing loss. This review aims to explain the increased baseline levels of mercury in Cyprus environmental and biomonitoring samples. Methods: A systematic review was performed on databases such as PubMed and TOXLINE. This review was restricted to articles published from January 1988 to January 2018. Priority was given to original research and randomized controlled trials. Results: Recent epidemiological studies have shown that mercury concentration in Cyprus was found to be higher than the average concentration-although within the normal range [2]. Studies, performed during non-fasting periods, suggested no correlation between mercury concentration and dietary fish consumption [3]. Our review suggests that the reason for this statement is not only because the traditional regional diet is rich in fish, but also because seawaters surrounding Cyprus lack nutrients and plankton vital for the growth of large marine fish populations. Alternatively, power plants, cement and limestone quarries, and landfills are significant potential anthropogenic sources. Additionally, Cyprus holds a high car ownership rate in the world with 742 cars per 1000 people, so emissions from vehicles could be a major contributor to mercury levels in Cyprus. The wind in Cyprus blows in the southwest direction; mercury from the sources above may land by precipitation and vapor, contaminating soil, air, and water; hence food-chain. Air-transfer of mercury could also explain the elevated mercury levels suggested by the latest regional human biomonitoring study, as the sampling areas correspond with locations
Diabetologie Und Stoffwechsel, May 1, 2011
European journal of public health, Nov 1, 2019
expression of ''compunetics'' (Information and Communication Technologies & ethics), intervention... more expression of ''compunetics'' (Information and Communication Technologies & ethics), interventions that truly consider the unintended consequences of eHealth on social and geographic health inequalities are absolutely necessary. The conceptual model analysing the whole literature on this interaction makes it easy to understand the types of interventions that are or could be carried out to tackle equity issues in digital health interventions. Its recommendations become easy to implement in the field and can be extremely helpful for decision-making. Key messages: Strategies that take into account equity in eHealth for healthcare system users and patients can be presented in light of the five key action areas of the Ottawa Charter for Health Promotion. The conceptual model we elaborated makes it easy to understand the types of interventions that could be carried out to tackle equity issues in digital health interventions.
European journal of public health, Nov 1, 2016
Journal of epidemiological research, Aug 1, 2017
S. pneumoniae may cause serious invasive infections mainly in children and elderly adults leading... more S. pneumoniae may cause serious invasive infections mainly in children and elderly adults leading to significant morbidity and mortality. This report describes the circulating serotypes and antimicrobial resistance of S. pneumoniae colonizing the nasopharynx of Cypriot children in 2007-2008 when the immunization coverage of children was still relatively low. The study focused on children between 6 months to 5 years of age in the Nicosia district. A nasopharyngeal specimen was obtained from 402 children who visited public immunization centers, public outpatient departments and the offices of private sector practicing pediatricians. The percentage of carriage was 35.3%. Intermediate and full resistance to penicillin was estimated at 39.4% and 1.4%, respectively. Intermediate and full resistance to erythromycin was estimated at 1.4% and 39.6%, respectively. Resistance to clindamycin was found to be 30.8%. MLSb was the dominant phenotype of resistance (77.2%). Multi-resistance was found amongst 24.1% of strains. Most frequent colonizing serotypes were 15B, 6B, 23A, 23B, 19F. The two vaccine serotypes 6B and 19F were highly resistant to both penicillin and erythromycin and were also multi-resistant at 27% and 50%, respectively. The percentages of fully immunized, partially immunized and non immunized children with the PCV7 were 24.6%, 14.3%, and 61.1%, respectively. Fully immunized children carried fewer vaccine serotypes in comparison with the non immunized children (p = .05). Some vaccine serotypes were among those more frequently colonizing children and exhibit significant resistance. An increase in vaccination coverage and prudent use of antimicrobials could have a significant impact on resistance.
European journal of public health, Oct 20, 2017
European journal of public health, Nov 1, 2019
successful disease management. Most evidence for multimorbidity at different ages comes from cros... more successful disease management. Most evidence for multimorbidity at different ages comes from cross-sectional data, hindering understanding the extent and types of multimorbidity across the lifecourse, how they develop and associated risk factors. The aim of this study is to investigate the clustering and patterning of multimorbidity over the lifecourse using one of the longest running national birth cohort studies. Methods: This ongoing study is based on the National Survey of Health & Development (NSHD), a birth cohort study following 5,362 individuals born in 1946 with detailed sociodemographic and clinical data collected from 22 waves across the lifecourse till date. This study will investigate the trajectories and clustering of 24 diseases (physical and mental health) and potential differences by sex and socioeconomic status using mixedeffects linear spline modelling. Results: Preliminary analyses indicate that as expected, the rates of many conditions increase with age (e.g. 13% obese at age 43 to 31% at age 69), increasing the likelihood of individuals suffering from multiple conditions with age. At age 63, 73% with diabetes had hypertension, increasing to 85% with hypertension at age 69. We will estimate longitudinal trajectories of multimorbidity for individuals and whether the age of onset and rate of accumulation vary by sex, lifeperiod and SES. Given the longitudinal nature of the data, we will investigate the extent to which multimorbidity earlier in the lifecourse predicts the rate of further multimorbidity later in the lifecourse. Conclusions: Understanding patterning and trajectories of multimorbidity over the lifecourse and associated inequalities will better inform health care provision planning including appropriate window periods for intervention, specifically for the disadvantaged at higher risk of high multimorbidity. Key messages: This is the first study to investigate trajectories of multimorbidity with data from birth to old age. Understanding how early life factors predict later life multimorbidity will better inform healthcare planning.
European journal of public health, Nov 1, 2018
Clinical nutrition ESPEN, Jun 1, 2016
Materials and methods: In 699 healthy adults (436 women, 273 men) of 18 to 75 years old weight, h... more Materials and methods: In 699 healthy adults (436 women, 273 men) of 18 to 75 years old weight, height, body circumferences and body skinfolds measurements were obtained. Five simple noninvasive models estimating %TBF were examined, based on the mentioned measurements. Dual Xenergy Absorptiometry (DXA) was the reference method. The validity and reliability of each method was determined with Bland Altman Test and Intraclass Correlation Coefficient. Results: Mean %BF DXA was 35.2% and 22.9% for women and men respectively. Waist circumference was found to correlate with %BF DXA more than any other anthropometric measurement, both for women (r¼0.794, p<0.01) and men (r¼0.826, p<0.01). Regarding the evaluated models, % BF DEURENBERG was found to have a relative low bias (0.04%, p¼0.831 and limits of agreement¼± 10.78) and high reliability (ІCC¼0.919). Conclusions: Among the five simple noninvasive models, only the one of Deurenberg et al, was found to be valid and reliable in estimating %BF. Development of noninvasive and low cost models estimating body composition customized for Greek population is considered to be necessary. Furthermore, the results of this study suggest the use of waist circumference in such models.
European journal of public health, Oct 20, 2017
Background The role of nurses has expended from provider of care and comfort to a professional wh... more Background The role of nurses has expended from provider of care and comfort to a professional who has a direct role in patient treatment and health promotion. Despite these developments, in some countries, nurses' role still remains minimal, nurses are not independent and have a distorted understanding of the profession. The current study aimed to investigate nurses' perceptions regarding their profession and explore how nurses describe the best and worst aspects of their profession in Armenia. Methods We conducted a qualitative cross-sectional study using indepth interviews and focus group discussions. Through the purposive and convenient sampling techniques, we recruited 86 practicing nurses with diverse experiences from different health care facilities located in the capital city, regions, and rural areas of Armenia. The conventional content analysis was used to inductively create categories using NVivo10 statistical software. Results Throughout the study, nurses demonstrated a low self-esteem making regular comparisons between themselves and physicians. They described the nursing profession as ''physician's doer'' and missed the concept of nursing as an independent health care professional. The main reasons that contributed nurses' low-self esteem were their low level of education, distrust to their own knowledge and skills, limited career opportunities and very hierarchical relationship at work environment. However, almost all nurses were proud for being a nurse as they were helping people, providing care in emergency situations, and being appreciated by patients. Conclusions Our study found that nurses in Armenia have a low selfesteem. To strengthen nurses' contribution in health care service it is important to provide better education in nursing and develop an expanded national definition of nursing.
Osteoporosis International, Jan 9, 2021
Thalassemia is a chronic congenital disease characterized by a combination of endocrine and metab... more Thalassemia is a chronic congenital disease characterized by a combination of endocrine and metabolic disorders. Bone disease is a very common complication related to the poor absorption of calcium, the secondary chronic renal disease with low vitamin D, as well as multiple endocrine risk factors. The aim of this systematic review was to estimate the prevalence of vitamin D deficiency in thalassemia, as well as its association with osteoporosis/low bone mass. A systematic review was carried out using PubMed/Medline, Cochrane, and EBSCO databases. The methodological quality of the included studies was assessed with the validated Newcastle–Ottawa Quality Assessment Scale adapted for cross-sectional studies and cohort studies respectfully and the Cochrane Collaboration for clinical trials. After application of predetermined exclusion criteria compatible with the PICOS process, a total of 12 suitable articles were identified. The prevalence of vitamin D deficiency varied considerably. Only five of the reviewed studies examined the correlation between vitamin D levels and BMD of which just three showed a statistically significant positive association of mild/moderate grade. Vitamin D deficiency is a common comorbidity in patients with thalassemia. However, both its prevalence and its severity vary considerably in different populations, and existing evidence is insufficient to conclude whether vitamin D supplementation is also associated with BMD improvement in this special population group.
AIDS Research and Human Retroviruses, 2021
Drug use involves social interactions. Therefore, norms in the proximal environment of people who... more Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may in turn result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of severe economic recession and political activism that followed the fiscal crisis and soon after a recent HIV outbreak had leveled off. The Transmission Reduction Intervention Project (TRIP) was a social network-based approach (June 2013 - July 2015) that involved two groups of PWID seeds - one with recent HIV infection and one with long-term HIV infection - and one control group of HIV-negative PWID. Network contacts of seeds were also enrolled. TRIP participants answered a structured questionnaire that included items on injection-related norms and behaviors. TRIP recruited 320 PWID (HIV positive, 44.4%). TRIP participants, especially those without HIV, often recalled or perceived as normative among their partners and in their networks some behaviors that can lead to HIV transmission. TRIP participants who recalled that they were encouraged by their regular drug partners to use an unclean syringe were almost twice as likely to report that they share syringes [Odds ratio (OR): 2.03 (95% Confidence Interval: 1.86, 2.21), or give syringes to someone else (OR: 1.70; 95% CI: 1.42, 2.04) as those who did not recall such an encouragement. Associations were modified by HIV-status. Further research is needed on the multiple determinants (social, economic, political) of norms in the social environments of PWID. Since peer norms are associated with risky behaviors, interventions should be developed to encourage norms and peer pressure against the sharing of injection equipment.
European Journal of Public Health, 2018
Journal of Cancer Education, 2020
The purpose of this systematic review was to identify adolescents' awareness on the human papillo... more The purpose of this systematic review was to identify adolescents' awareness on the human papillomavirus (HPV), the HPV vaccine, and the willingness to undergo the vaccination. A systematic review of studies concerning the adolescent's knowledge and education on the admission of the HPV vaccine was carried out, through the Medline/PubMed and the Google Scholar databases, covering information on adolescent attitudes towards HPV vaccination, as well as their perceptions regarding the vaccination and the need for more training, towards the public information about the HPV and the HPV vaccine. This study concludes that adolescents are poorly informed about the HPV and the preventive vaccination issues, underestimating the likelihood of the infection by the virus. The way to improve their knowledge about the HPV and the implications of the HPV infection is to provide information through the framework of compulsory schooling, primary health care, and the development of informative interactive interventions. The awareness for the need of training about the HPV and its implications should be broadened to address the major barrier to vaccination, which is regarded to be the lack of adequate information. The knowledge and the perceptible susceptibility to the HPV infection and HPV-related diseases among adolescents demonstrate the need for a well-designed training program to bridge the gap of information about the HPV virus and to accept the HPV vaccine.
European Journal of Public Health, 2018
Uploads
Papers by Giagkos Lavranos