OBJECTIVES: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. METHODS: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. RESULTS: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). CONCLUSIONS: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
Adult* ; Depression ; Food Habits ; Humans ; Life Style* ; Mediterranean Islands ; Mediterranean Region* ; Methods ; Motor Activity ; Public Health ; Smoke ; Smoking ; Social Class ; Social Isolation ; Uncertainty

BACKGROUND/OBJECTIVES: To compare five indices of adherence to the Mediterranean Diet (MD) among adults living in the Mediterranean region. SUBJECTS/METHODS: A total of 100 healthy Lebanese adults aged between 18 and 65 years. Face-to-face interviews to collect sociodemographic and medical information, to take anthropometric measurements, and to fill a validated, culturally adapted, food frequency questionnaire (FFQ). The score for each item was calculated following the recommendations for each corresponding index. The five MD indices were Mediterranean Diet Scale (MDScale), Mediterranean Food Pattern (MFP), MD Score (MDS), Short Mediterranean Diet Questionnaire (SMDQ), and the MedDiet score. RESULTS: Significant correlations were detected between items with P-values < 0.001. Minimal agreement was seen between MDScale and MedDiet score and maximal agreement between MDS and MedDiet score. Univariate and multivariate analyses showed that MDS and MedDiet scores had significant correlations with fiber and olive oil intake, main components of the MD. MDScale showed a significant correlation with waist-to-hip ratio and with total energy intake but none of the five indices was correlated to body mass index (BMI). CONCLUSIONS: The indices that showed the highest correlation with variables related to the MD are the MDScale and the MedDiet score; therefore, they can be used to assess our future study populations. Based on the current results, more than half of the study population was non-adherent to the MD and adherence to this diet did not appear to protect against being overweight (BMI ≥ 30).
Adult ; Body Mass Index ; Diet ; Diet, Mediterranean ; Energy Intake ; Humans ; Mediterranean Region ; Multivariate Analysis ; Olive Oil ; Overweight ; Waist-Hip Ratio

Brucellosis is a systemic, infectious disease caused by the bacterial genus Brucella and a common zoonosis that still remains a major health problem in certain parts of the world such as the Mediterranean region, the Middle East, and Latin America. It may involve multiple organs and tissues. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylitis is often difficult since the clinical presentation may be obscured by many other conditions. There are only a few reports on brucellar spondylitis in Korea. Here, we report a case of spondylitis due to brucella in an elderly male.
Aged ; Back Pain ; Brucella ; Brucellosis ; Communicable Diseases ; Humans ; Korea ; Latin America ; Lumbosacral Region ; Male ; Mediterranean Region ; Middle East ; Spondylitis

Thalassemias are a diverse group of inherited anemias that are characterized by defective synthesis of one or more globin chains. The thalassemias are classified according to the globin chain or chains the synthesis of which is deficient : alpha-, beta-, delta beta-, delta-, and gamma delta beta- Thalassemia. They are common in the Mediterranean region, The Middle East, India, Burma, and Southeast Asia. Beta-thalassemia minor, the heterozygous state, is most frequently characterized by hypochrmia, microcytosis and an elevated percentage of hemoglobin A2. We experienced a case of a familial beta-thalassemia minor in pneumonia patient and his family.
Anemia ; Asia, Southeastern ; beta-Thalassemia* ; Globins ; Hemoglobin A2 ; Humans ; India ; Mediterranean Region ; Middle East ; Myanmar ; Pneumonia ; Thalassemia

Hydatid disease is caused by the larval stage of taenia Echinococcus, which endemic in the Mediterranean region. Recently, the prevalence of the disease has increased worldwide due to an increase in the frequency of travel and immigration. As the infested larvae migrate through the bloodstream, the final destination is most commonly the liver or lungs; direct pleural invasion is very rare. A 50-year-old diabetic Korean man presented with an incidentally noted 2 cm right pleural nodule. On follow up imaging after three months, its size had increased. To confirm the diagnosis of the lesion, surgical excision was performed. Histopathological examination showed the diagnosis of a hydatid cyst. The patient had no history of overseas travel, but lives in an urban area where many foreign workers from endemic countries reside. This is the first reported case of primary pleural hydatid disease in a non-endemic country.
Echinococcosis ; Echinococcus ; Emigration and Immigration ; Follow-Up Studies ; Humans ; Larva ; Liver ; Mediterranean Region ; Middle Aged ; Pleura ; Prevalence ; Taenia

Multiple symmetric lipomatosis (Madelung's disease) is an infrequent disease of unknown etiology. The typical characteristic of the disease is bulging, symmetric masses of fat tissue on the neck, upper extremities, and upper parts of the trunk. The disease strongly affects middle-aged men, people from Mediterranean regions and with alcohol abuse history. We report three cases of middle to old age males with long-standing multi-lobulated bulging of the neck, which gradually enlarged over many years. Of peculiar interest is one patient who presented with snoring and apnea together with typical findings of Madelung's disease. The case had involvement of the hypopharynx, which was successfully managed with microscopic laryngeal surgery with CO2 laser. The authors elucidate three cases of Madelung's disease found in the pharynx and neck, and report a review of the literature.
Alcoholism ; Apnea ; Humans ; Hypopharynx ; Lasers, Gas ; Lipomatosis, Multiple Symmetrical* ; Male ; Mediterranean Region ; Neck* ; Pharynx* ; Snoring ; Upper Extremity

Brucellosis is an endemic zoonotic disease, particularly in the Middle East and Mediterranean regions, and can involve many organs and tissues. Recently, the incidence of human brucellosis has increased rapidly in Korea. Brucellosis may often appear as other infections and asymptomatic conditions because of its range of clinical manifestations. Therefore, its diagnosis is frequently missed or delayed. Early diagnosis of brucellar spondylitis is important for reducing the number and intensity of complications. Therefore, it should be included in a differential diagnosis of back pain with an unknown origin. Brucellosis is normally transmitted to humans by direct contact with infected animals or by the ingestion of unpasteurized dairy products. We report an unusual case of brucellar spondylitis complicated by acupuncture.
Acupuncture ; Animals ; Asymptomatic Diseases ; Back Pain ; Brucellosis ; Dairy Products ; Diagnosis, Differential ; Early Diagnosis ; Eating ; Humans ; Incidence ; Korea ; Mediterranean Region ; Middle East ; Spondylitis

Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.
Adolescent ; Atrioventricular Block ; Cardiac Glycosides ; Charcoal ; Digitalis ; Digoxin ; Dizziness ; Eating ; Electrocardiography ; Emergencies ; Hematologic Tests ; Humans ; Intensive Care Units ; Korea ; Mediterranean Region ; Nausea ; Nerium ; Vital Signs ; Vomiting

Alpha-thalassemia (alpha-thalassemia), which is prevalent in the Mediterranean region, is caused by deficient synthesis of the alpha-globin chains. It is commonly caused by HBA1 and/or HBA2 gene deletion and is diagnosed by DNA sequence analysis. The proband was a 38-year-old woman who was found to have microcytic and hypochromic anemia on a routine health checkup. Results of the Hb electrophoresis (EP) and direct sequencing of the HBA1 and HBA2 genes were found to be normal. As multiplex ligation-dependent probe amplification (MLPA) for the HBA1 and HBA2 genes revealed heterozygous deletion, she was diagnosed with heterozygous alpha+-thalassemia. Although routine laboratory tests revealed similar findings in the proband's father, brother and niece, MLPA revealed heterozygous deletions of the HBA1 or HBA2 gene in her brother and niece. In summary, we report a case of heterozygous alpha+-thalassemia in a Korean family that was detected by MLPA. We recommend that patients with suspected hemoglobinopathies should be followed-up further with MLPA, especially when Hb EP shows a normal pattern.
alpha-Globins ; alpha-Thalassemia ; Anemia, Hypochromic ; Electrophoresis ; Fathers ; Female ; Gene Deletion ; Hemoglobin A, Glycosylated ; Hemoglobinopathies ; Humans ; Mediterranean Region ; Multiplex Polymerase Chain Reaction ; Sequence Analysis, DNA ; Siblings

PURPOSE: Vitis vinifera is a species of Vitis that is native to the Mediterranean region, central Europe, and southwestern Asia, and has been used as a drug in traditional medicine. Traditional medicinal plants have been used for medical purposes with increasing effectiveness. It is important to identify drugs that inhibit spermatogenesis. Therefore, the present study aimed to investigate the effect of grape juice (GJ) on serum levels of inhibin B and sperm count in normal male rats. MATERIALS AND METHODS: Thirty-five adult male rats were randomly divided into five groups, each containing seven rats. Rats in the control group received 1 mL of normal saline over the course of the study. The experimental groups received GJ (100, 200, 400, and 1,600 mg/kg, orally, for 35 days consecutively). At the end of the treatment period, fertility indices were measured, including body weight difference, sex organ weight, sperm motility and count, epididymal sperm reserve, daily sperm production (DSP), and serum inhibin B levels. RESULTS: We found that GJ reduces body weight difference, was associated with decreased sperm motility and count in all treatment groups (p< or =0.05 and p< or =0.001, respectively). Moreover, DSP was significantly decreased in all treatment groups compared to the control group (p< or =0.05), except in the group receiving 100 mg/kg of GJ. Inhibin B levels were significantly decreased in all treatment groups (p< or =0.05). CONCLUSIONS: The results of our study suggest that GJ in all doses, but especially in higher doses, may decrease fertility in male rats.
Adult* ; Animals ; Asia ; Body Weight ; Europe ; Fertility ; Humans ; Inhibins* ; Male* ; Medicine, Traditional ; Mediterranean Region ; Organ Size ; Plants, Medicinal ; Rats* ; Sex Characteristics ; Sperm Count* ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Vitis*