Design and Development of a Viral Hepatitis and HIV Infection Screening Program (Hprolipsis) for the General, Greek Roma, and Migrant Populations of Greece: Protocol for Three Cross-Sectional Health Examination Surveys.

BACKGROUND: Although infectious diseases are globally on the decline, they remain a major global public health problem. Among them, the hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV infection are of primary interest. Valid prevalence data on these infections are sparse in Greece, especially for vulnerable populations. OBJECTIVE: This study aimed to present the design and methods of Hprolipsis, an integrated viral hepatitis and HIV screening program administered to adults (≥18 years) from the general, Greek Roma, and migrant populations. Its aims were to estimate the prevalence of HBV, HCV, and HIV; assess infectious disease knowledge level; design, implement, and assess population-specific awareness actions; and offer individual counseling and referral when indicated and HBV vaccination to susceptible Roma and migrants. METHODS: Multistage, stratified, random sampling based on the 2011 Census was applied to select the general population sample, and nonprobability multistage quota sampling was used for Roma and migrant sample selection. Trained personnel made home (general population) or community (Roma and migrants) visits. Collected blood samples were tested for Hepatitis B surface Antigen, Hepatitis B core Antibody, Hepatitis B surface Antibody, Hepatitis C Antibody, and HIV 1,2 Antibody. The surveys were conducted during May 2013 and June 2016. To estimate an HCV prevalence of 1.5% with 0.3 precision, the required general population sample size was estimated to be 6000. As migrants constitute 10% of the whole Greek population, the migrant sample size was set to 600. A feasible sample size of 500 Greek Roma was set. RESULTS: In total, 6006 individuals from the general population (response rate 72%), 534 Greek Roma, and 612 migrants were recruited. Blood test results are available for 4245 individuals from the general population, 523 Roma, and 537 migrants. CONCLUSIONS: Hprolipsis is the first nationwide survey on HBV, HCV, and HIV. Its results will enhance our understanding of the health needs and disease burden of these diseases in the 3 studied populations. Its implementation provided useful recommendations for future studies, particularly in vulnerable populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13578.

Lower Levels of Vitamin D Among Bangladeshi Immigrants with Diabetes in Greece Compared to Indigenous Greek Patients with Diabetes.

AIM: Vitamin D deficiency is thought to impair insulin action and glucose metabolism; however, previous studies have not examined ethnic differences. We investigated a cohort of predominantly white Greek Caucasian and Bangladeshi immigrant patients with diabetes mellitus in order assess the association between diabetes mellitus and 25-hydroxyvitamin D [25(OH)VitD]. MATERIALS AND METHODS: A total of 165 patients from Bangladesh and 118 patients from Greece with diabetes were assessed for diabetes and 25(OH)VitD status. RESULTS: The 25(OH)VitD levels of Bangladeshi patients were significantly lower compared to Greek patients (12.42±5.86 ng/ml vs. 23.06±12.36 ng/ml, p<0.001). Only 1.2% of Bangladeshi patients vs. 24.57% of Greek patients had sufficient levels of 25(OH)VitD (≥30 ng/ml) CONCLUSION: The prevalence of vitamin D deficiency is very high amongst patients with diabetes but immigrants are at greater risk. Vitamin D supplementation could be valuable in the prevention or treatment of diabetes.

Epidemiological and clinical study of diabetes in immigrants from Bangladesh in Athens versus Greek patients.

BACKGROUND/AIM: Greece has experienced a large wave of immigration from Bangladesh. The purpose of this study was to determine whether Bangladeshi immigrants with diabetes have poorer preventive follow-up and diabetes self-care compared to Greek patients. PATIENTS AND METHODS: A total of 166 patients from Bangladesh and 123 patients from Greece were recruited. Interviews were conducted, a physical examination followed and blood and urine samples were collected. RESULTS: Patients from Bangladesh had worse glycemic control (A1C=7.74±1.6 vs. 7.55±1.7%; p=0.3), and lower high-density lipoprotein levels (33.99±9.4 vs. 44.05±10.43 mg/dl; p=0.037). They were less likely to regularly take their medication for diabetes mellitus, or to follow dietary recommendations. However, fewer of them smoked, and had a significantly lower body mass index than Greek patients. CONCLUSION: Bangladeshi immigrants are less likely to engage self-care behaviors and have worse glycemic control and less access to medication, laboratory test and healthcare Units.

Bile duct injuries associated with laparoscopic and open cholecystectomy: an 11-year experience in one institute.

PURPOSE: Bile duct injury (BDI) represents the most serious complication of laparoscopic cholecystectomy (LC). The aim of this retrospective single-institution study was to evaluate the real incidence of BDI during laparoscopic and open cholecystectomy (OC) in a tertiary academic center in Athens, Greece. METHODS: Between January 1991 and December 2001, 3637 patients underwent cholecystectomy in our department; as LC in 2079 patients (LC group) and as OC in 1558 patients (OC group). All the LCs were performed or supervised by five staff surgeons and all the OCs were performed or supervised by another five staff surgeons. RESULTS: There were 13 BDIs associated with LC (0.62%) and 6 associated with OC (0.38%) (P = 0.317). There was one death associated with BDI after LC. Only two (15.4%) of the BDIs associated with LC occurred within the proposed learning curve limit of 50 LCs per individual surgeon. CONCLUSION: Laparoscopic cholecystectomy is safe and is not associated with a higher incidence of BDI than OC. Moreover, we did not find that the learning curve for LC affected BDI occurrence.