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Bei E, Voudris V, Kalogeras K, Oikonomou E, Iakovou I, Kosmas I, Kalantzis C, Vavuranakis MA, Pantelidis P, Lazaros G, Tousoulis D, Tsioufis C, Vavuranakis M. Impact of Evolution of Self-Expandable Aortic Valve Design: Peri-Operative and Short-Term Outcomes. J Clin Med 2023; 12:jcm12051739. [PMID: 36902526 PMCID: PMC10003529 DOI: 10.3390/jcm12051739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
A few data exist on the differences of implantable aortic valve bio-prostheses. We investigate three generations of self-expandable aortic valves in terms of the outcomes. Patients undergoing transcatheter aortic valve implantation (TAVI) were allocated into three groups according to the valve type: group A (CoreValveTM), group B (EvolutTMR) and group C (EvolutTMPRO). The implantation depth, device success, electrocardiographic parameters, need for permanent pacemaker (PPM), and paravalvular leak (PVL) were assessed. In the study, 129 patients were included. The final implantation depth did not differ among the groups (p = 0.07). CoreValveTM presented greater upward jump of the valve at release (2.88 ± 2.33 mm vs. 1.48 ± 1.09 mm and 1.71 ± 1.35 mm, for groups A, B, and C, respectively, p = 0.011). The device success (at least 98% for all groups, p = 1.00) and PVL rates (67% vs. 58%, vs. 60% for groups A, B, and C, respectively, p = 0.64) did not differ. PPM implantation within 24 h (33% vs. 19% vs. 7% for groups A, B, and C, respectively, p = 0.006) and until discharge (group A: 38% vs. group B: 19% and group C: 9%, p = 0.005) was lower in the newer generation valves. Newer generation valves present better device positioning, more predictable deployment, and fewer rates of PPM implantation. No significant difference in PVL was observed.
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Affiliation(s)
- Evangelia Bei
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Vasileios Voudris
- Interventional Department of Cardiology, Onassis Cardiac Surgery Center, 17674 Athens, Greece
| | - Konstantinos Kalogeras
- Third Department of Cardiology, Sotiria General Hospital for Chest Diseases, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelos Oikonomou
- Third Department of Cardiology, Sotiria General Hospital for Chest Diseases, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-210-776-3492
| | - Ioannis Iakovou
- Interventional Department of Cardiology, Onassis Cardiac Surgery Center, 17674 Athens, Greece
| | - Ilias Kosmas
- Interventional Department of Cardiology, Onassis Cardiac Surgery Center, 17674 Athens, Greece
| | - Charalampos Kalantzis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Michael-Andrew Vavuranakis
- Third Department of Cardiology, Sotiria General Hospital for Chest Diseases, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panteleimon Pantelidis
- Third Department of Cardiology, Sotiria General Hospital for Chest Diseases, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - George Lazaros
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Constantinos Tsioufis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Manolis Vavuranakis
- Third Department of Cardiology, Sotiria General Hospital for Chest Diseases, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Baldini GM, Malvasi A, Hatirnaz S, Kosmas I, Tinelli A, Baldini D. In patients with isthmocele undergoing IVF, the risk of ectopic pregnancy on the cesarean scar is reduced only if the ultrasound-guided transfer is performed on day 5 - A retrospective case-control study. Eur Rev Med Pharmacol Sci 2022; 26:5520-5528. [PMID: 35993649 DOI: 10.26355/eurrev_202208_29423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The study aimed to demonstrate that the risk of Cesarean Scar Pregnancy (CSP) for patients with isthmocele decreases when the embryo transfer is performed on day 5 at the blastocyst stage. PATIENTS AND METHODS From January 2014 to December 2021, 167 patients who previously had an IVF treatment and delivered by cesarean section, were selected. The isthmocele was found in 98 of them. Firstly, we evaluated whether the isthmocele increases the risk of CSP. Subsequently, we investigated the possible correlation between the risk of the CSP with the day of the embryo transfer. Hence, the selected patients were divided into two groups: Group A where the embryo transfer was performed at the cleavage stage on day 3 and Group B where the embryo was transferred at the blastocyst stage on day 5. RESULTS The outcomes show that the isthmocele does not seem to increase the risk of CSP, while the embryo transfer on day 3 increases its rate. CONCLUSIONS When the isthmocele is diagnosed, according to our results, an embryo transfer on day 5 at the blastocyst stage seems to minimize the risk of the CSP.
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Stathogiannis K, Synetos A, Latsios G, Karanasos A, Trantalis G, Toskas P, Drakopoulou M, Xanthopoulou M, Karmpalioti M, Simopoulou C, Soulaidopoulos S, Oikonomou G, Benetos G, Tsalamandris S, Kosmas I, Voudris V, Mastrokostopoulos A, Katsimagklis G, Halvatsiotis P, Deftereos S, Tsioufis C, Toutouzas K. Long-Term Outcomes and Valve Performance in Patients Undergoing Transcatheter Aortic Valve Implantation. Am J Cardiol 2021; 147:80-87. [PMID: 33621524 DOI: 10.1016/j.amjcard.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/26/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) is an established method for treating patients with aortic valve stenosis. We sought to determine the long-term clinical outcomes and performance of a self-expanding bioprosthesis beyond 5 years. Consecutive patients scheduled for TAVI were included in the analysis. Primary end points were all-cause and cardiovascular mortality, structural valve deterioration (SVD) and bioprosthetic valve failure (BVF), based on the VARC-2 criteria and consensus statement by ESC/EAPCI. The study prospectively evaluated 273 patients (80.61 ± 7.00 years old, 47% females) who underwent TAVI with CoreValve/Evolut-R (Medtronic Inc.). The median follow-up duration was 5 years (interquartile range: 2.9 to 6; longest: 8 years). At 1, 5, and 8 years, estimated survival rates were 89.0%, 61.1%, and 56.0%, respectively, while cardiovascular mortality was 8% at the end of follow-up. Regarding valve performance, 5% of patients had early BVF and 1% had late BVF. Concerning SVD, 16 patients (6% of the total population) had moderate SVD (91% had an increase in mean gradient), with no severe SVD cases. Five patients with SVD died during follow-up. Actual analysis of the 8-year cumulative incidence of function of moderate SVD was 5.9% (2.5% to 16.2%). At multivariate analysis, the factor that emerged as an independent predictor for future SVD, was smaller bioprosthetic valve size (HR 0.58, 95% CI 0.41 to 0.82, p = 0.002). Long-term evaluation beyond 5 years after TAVI with a self-expanding bioprosthesis demonstrated low rates of cardiovascular mortality and structural valve deterioration. Valve size was an independent predictor for SVD.
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Voudris V, Iakovou I, Kosmas I, Sbarouni E. Repeated transcatheter aortic valve implantation for the treatment of a degenerated transcatheter aortic valve implantation valve (valve-in-valve technique): a case report. Eur Heart J Case Rep 2020; 4:1-6. [PMID: 34109287 PMCID: PMC8183662 DOI: 10.1093/ehjcr/ytaa256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/25/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022]
Abstract
Background Valve-in-valve transcatheter aortic valve implantation (TAVI) has emerged as a competent alternative for the treatment of degenerated bioprosthetic valves after surgical aortic valve replacement, or during TAVI procedure as a bailout option. Herein, we report a rare case of a self-expandable Medtronic Evolut R valve into a failing Medtronic CoreValve, with the use of modern pre-TAVI imaging screening, suggesting the proper procedural design steps for so complicated implantations. Case summary A frail 78-year-old woman with a degenerated Medtronic Core Valve 26 mm bioprosthesis, implanted in 2011 due to severe aortic stenosis, was referred to our hospital due to worsening dyspnoea New York Heart Association III. The screening echocardiography documented severe aortic stenosis, while the classical risk scores were in favour of repeated TAVI (EuroSCORE II 5.67%). Computed tomography measurements and three-dimensional (3D) printing model were of great help for the proper valve selection (Medtronic Evolut R 26 mm), while the use of cerebral protection device (Claret Sentinel) was considered as a necessary part of the procedure. The simultaneous use of fluoroscopy and transoesophageal echocardiogram led to optimal haemodynamic result, confirmed by the discharge echocardiogram, with a significant clinical improvement during the first month follow-up. Discussion The main periprocedural concerns remain valve malpositioning, coronary artery obstruction, and high remaining transvalvular gradients. The multimodality pre-TAVI imaging screening may be helpful for precise procedural design. Despite the limited use of 3D models, it is necessary to adopt such tissue-mimicking phantoms to increase the possibility of optimal procedural result.
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Affiliation(s)
- Vassileios Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece
| | - Ioannis Iakovou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece
| | - Ilias Kosmas
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece
| | - Eftychia Sbarouni
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece
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Papadopoulou V, Karyofyllis P, Tsiapras D, Demerouti E, Kosmas I, Voudris V. Systematic Review: Does Balloon Pulmonary Angioplasty (BPA) Improve Right Ventricular Function in CTEPH Patients? Evaluation Based on Imaging Findings. Curr Treat Options Cardio Med 2020. [DOI: 10.1007/s11936-020-00839-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kosmas I, Iakovou I, Gkonteva M, Aravanis N, Sbarouni E, Leontiadis E, Voudris V. TCT CONNECT-475 In TAVI, the Less Antibiotics, the Better! J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Benetos G, Drakopoulou M, Karmpalioti M, Stathogiannis K, Xanthopoulou M, Latsios G, Synetos A, Kosmas I, Katsimagklis G, Mastrokostopoulos A, Danenberg H, Tousoulis D, Toutouzas K. TCT CONNECT-140 Direct Implantation of a Supra-Annular Self-Expanding Bioprostheses Has No Impact on 1-Year Clinical Outcomes. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kosmas I, Aravanis N, Iakovou I, Leontiadis E, Sbarouni E, Mpalanika M, Voudris V. Transcatheter management of valvular regurgitation beyond the aortic valve (mitral - tricuspid valve): Literature overview and future perspectives. Hellenic J Cardiol 2020; 61:299-305. [PMID: 32387589 DOI: 10.1016/j.hjc.2020.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/31/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022] Open
Abstract
The growth of the available transcatheter treatment approaches for the mitral and tricuspid position was accompanied by important clinical trials and studies through the last years. The selection of appropriate candidates for transcatheter techniques requires significant insight into anatomical limitations of each patient undergoing clinical evaluation. Furthermore, technological characteristics of the available devices, and risks and benefits of each potential therapy, play the most important role in a physician's decision. This knowledge should be valuable to both interventional cardiologists and researchers. This paper aims to offer a concise overview of the technological advances in this field of Interventional Cardiology. Trials and studies announced at the major interventional cardiology congresses during 2018 and 2019 were systematically reviewed. Moreover, a literature search in PubMed for the same period identified an amount of publications eligible for inclusion, based on their relevance to the subject, and their potential impact on current guidelines of good clinical practice.
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Affiliation(s)
- I Kosmas
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece.
| | - N Aravanis
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - I Iakovou
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Leontiadis
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Sbarouni
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Mpalanika
- Department of Anaesthesiology, Onassis Cardiac Surgery Center, Greece
| | - V Voudris
- Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
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Kosmas I, Iakovou I, Leontiadis E, Sbarouni E, Georgiadou P, Bousoula E, Aravanis N, Stratinaki M, Voudris V, Mpalanika M. The first transcatheter valve-in-valve implantation of a self-expandable valve for the treatment of a degenerated sutureless aortic bioprosthesis. Hellenic J Cardiol 2019; 61:49-50. [PMID: 31039413 DOI: 10.1016/j.hjc.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/05/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- I Kosmas
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece.
| | - I Iakovou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Leontiadis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Sbarouni
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - P Georgiadou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Bousoula
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - N Aravanis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Stratinaki
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - V Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Mpalanika
- Department of Anaesthesiology, Onassis Cardiac Surgery Center, Greece
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Malvasi A, Kosmas I, Mynbaev OA, Sparic R, Gustapane S, Guido M, Tinelli A. Can trans resveratrol plus d-chiro-inositol and myo-inositol improve maternal metabolic profile in overweight pregnant patients? Clin Ter 2017; 168:e240-e247. [PMID: 28703838 DOI: 10.7417/t.2017.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effect of trans-resveratrol from Polygonum cuspidatum/magnesium hydroxide complex, trademark Revifast®, plus D-chiro-inositol (DCI) and Myo-inositol (MI) during spontaneous pregnancies in overweight patients in a pilot study. STUDY DESIGN A one-year, prospective, randomized, double-blinded, placebo-controlled single center clinical study was carried out on overweight pregnant women. 110 patients were randomized in 3 groups to receive: Revifast® with DCI/MI (group I), DCI/MI alone (group II) or control group (group III) for 30 and 60 days. The main outcomes were to explore the lipid profile (total cholesterol, LDL, HDL, TG) and glucose levels, after 30 and 60 days of therapy. RESULTS No difference in systolic and diastolic parameters among 3 groups during study. All blood chemistry parameters improved compared to placebo at 30 days already, but significantly to 60 days, respect placebo. By comparing the two treatment groups, group I demonstrates significantly improved lipid and glucose parameters than group II, which are at 30 to 60 days of treatment. CONCLUSIONS The supplementation of Trans-resveratrol, Revifast® in addition to DCI/MI in overweight pregnant woman with an elevated fasting glucose improves glucose levels, Total Cholesterol, LDL and TG.
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Affiliation(s)
- A Malvasi
- Department of Obstetric & Gynecology, Santa Maria Hospital, GVM Care & Research, Bari, Italy; Laboratory of Human Anatomy, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Moscow Region, Russia
| | - I Kosmas
- Department of Obstetrics and Gynecology, University of Ioannina, Medical School, Greece; Laboratory of Human Anatomy, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Moscow Region, Russia
| | - O A Mynbaev
- Laboratory of Human Anatomy, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; Peoples' Friendship University of Russia, Moscow, Russia; Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - R Sparic
- School of Medicine, University of Belgrade, Belgrade, Serbia, Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
| | - S Gustapane
- Department of Obstetric and Gynecology, Salus Hospital, Brindisi, Italy
| | - M Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - A Tinelli
- Department of Obstetrics and Gynecology, Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy; Laboratory of Human Anatomy, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Moscow Region, Russia; Department of Obstetrics and Gynecology. Vito Fazzi Hospital, Lecce, Italy
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Gialafos E, Triposkiadis F, Kouranos V, Rapti A, Kosmas I, Manali E, Giamouzis G, Elezoglou A, Peros I, Anagnostopoulou O, Koulouris N, Gazouli M. Relationship between tumor necrosis factor-α (TNFA) gene polymorphisms and cardiac sarcoidosis. In Vivo 2014; 28:1125-1129. [PMID: 25398810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Identification of genetic predisposition to cardiac sarcoidosis could play a critical role in the detection of sub-clinical forms of the disease. The aim of this study was to investigate the possible correlations between the emergence of cardiac sarcoidosis and the -1.031T/C, -857C/T, -308G/A, and -238G/A Tumor Necrosis Factor-α (TNFA) polymorphisms in a well-defined Greek cohort. One-hundred and seventy-three patients of Greek origin with sarcoidosis were recruited in the present study. Cardiac sarcoidosis was determined according to established criteria. Blood samples were collected and the TNFA polymorphisms were genotyped. No significant difference was noted between the patients with cardiac involvement and those without, concerning the -1.031T/C and -238G/A TNFA polymorphisms. Regarding the -857C/T polymorphism, the TT genotype and the T allele were found to be over-represented in patients with cardiac involvement (p=0.02 and 0.012, respectively). AA genotype of the -308G/A as well as the A allele were also found significantly more frequently in patients with cardiac sarcoidosis (p=0.014 and 0.012 respectively). From the investigated TNFA promoter polymorphisms, we were able to deduce nine main haplotypes. Haplotypes 3 and 5, including A nucleotide at position -308, and T nucleotide at position -857 respectively, were significantly over-represented in the group with cardiac involvement. We detected an increased presence of genetic polymorphisms in the TNFA gene of patients with cardiac involvement. However, the role and the clinical application of these findings need further exploration.
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Affiliation(s)
- Elias Gialafos
- Cardiology Department, University of Thessaly, Thessaly, Greece First Department of Pulmonology, University of Athens, Athens, Greece
| | | | - Vassilios Kouranos
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Aggeliki Rapti
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Ilias Kosmas
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Efrosini Manali
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | | | - Antonia Elezoglou
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Ilias Peros
- Outpatient Sarcoidosis Clinic, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | | | | | - Maria Gazouli
- Biology Laboratory, Department of Basic Medical Science, School of Medicine, University of Athens, Athens, Greece
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Malvasi A, Casciaro F, Minervini MM, Kosmas I, Mynbaev OA, Pacella E, Monti Condesnitt V, Creanza A, Di Renzo GC, Tinelli A. Myo-inositol, D-chiro-inositol, folic acid and manganese in second trimester of pregnancy: a preliminary investigation. Eur Rev Med Pharmacol Sci 2014; 18:270-274. [PMID: 24488919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
DESIGN AND PURPOSE The supplemental administration of myo-inositol, D-chiro-inositol, folic acid and manganese (MDFM) was tested in a prospective, randomized, double-blind, placebo controlled clinical trial, pilot study, to test the hypothesis that its supplemental administration in the second trimester of pregnancy would improve glucose and glycemic parameters and blood pressure. SUBJECTS AND METHODS Non-obese uniparous healthy pregnant women between 13th and 24th week of pregnancy were divided into two groups: group I, control group with placebo, and the group II, women in treatment with myo-inositol, D-chiro-inositol, folic acid and manganese. The main outcome measures were the comparative analysis of the parameters analyzed at time 0, after 30 days and 60 days; secondary outcome measure was the overall analysis of investigated parameters. RESULTS 24 women were allocated to receive MDFM and 24 the placebo. The two groups did not significantly differ for demographic, lipidic and glycemic parameter and blood pressure. After 30 days, significantly lower cholesterol (p = 0.0001), significantly lower LDL (p = 0.0013), lower TG (p < 0.0001) and lower glycemia (p = 0.0021) were observed all favoring group II. No significant difference was observed for HDL, diastolic and systolic blood pressure. After 60 days, significant difference was observed for cholesterol (p = 0.0001), LDL (p = 0.0001), HDL (p = 0.0001), TG (p = 0.0001), glycemia (p = 0.0064), all favoring the group treated with MDFM. No significant differences were observed for systolic (p = 0.12) and diastolic blood pressure (p = 0.42). When examining for overall differences between the two groups, a significant difference was observed for examined parameters at time 0 and at time 60; cholesterol (p = 0.0001), LDL (p = 0.0001), HDL (p = 0.047), TG (p = 0.0001) and glycemia (p = 0.019) were reduced in the MDFM group. A significant reduction was also observed in group II for systolic blood pressure after 60 days of intervention (p = 0.0092), but not for diastolic blood pressure (p = 0.29). CONCLUSIONS MDFM administration after 30 days in pregnancy improved glycemic and lipidic parameters, with significant gain after 60 days, without affecting diastolic blood pressure levels.
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Affiliation(s)
- A Malvasi
- Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy.
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Lazaros L, Xita N, Takenaka A, Sofikitis N, Makrydimas G, Stefos T, Kosmas I, Zikopoulos K, Hatzi E, Georgiou I. Synergistic effect of follicle-stimulating hormone receptor and androgen receptor gene variants on semen quality. Andrologia 2012; 45:339-44. [DOI: 10.1111/and.12021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2012] [Indexed: 02/03/2023] Open
Affiliation(s)
- L. Lazaros
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
| | - N. Xita
- Department of Endocrinology; Ioannina University Medical School; Ioannina; Greece
| | - A. Takenaka
- Department of Urology; Tottori University Faculty of Medicine; Tottori; Japan
| | - N. Sofikitis
- Department of Urology; Ioannina University Medical School; Ioannina; Greece
| | - G. Makrydimas
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
| | - T. Stefos
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
| | - I. Kosmas
- Department of Obstetrics and Gynecology; ‘Hatzikosta’ Hospital; Ioannina; Greece
| | - K. Zikopoulos
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
| | - E. Hatzi
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
| | - I. Georgiou
- Genetics and IVF Unit; Department of Obstetrics and Gynecology; Ioannina University Medical School; Ioannina; Greece
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Lazaros L, Xita N, Takenaka A, Sofikitis N, Makrydimas G, Stefos T, Kosmas I, Zikopoulos K, Hatzi E, Georgiou I. Semen quality is influenced by androgen receptor and aromatase gene synergism. Hum Reprod 2012; 27:3385-92. [PMID: 23001776 DOI: 10.1093/humrep/des334] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Does synergism between AR(CAG)(n) and CYP19(TTTA)(n) polymorphisms influence the quality of sperm? SUMMARY ANSWER AR(CAG)(n) and CYP19(TTTA)(n) polymorphisms had a synergistic effect on sperm concentration and motility. WHAT IS KNOWN ALREADY Androgens exert their action in the testicular tissue by binding to androgen receptor (AR), while their action is mediated by the aromatase P450 enzyme (CYP19). AR(CAG)(n) alleles are associated with sperm motility and CYP19(TTTA)(n) allelic variants have implications for sperm concentration and motility. STUDY DESIGN, SIZE, DURATION Two hundred oligozoospermic and 250 normozoospermic men who presented for infertility investigation were examined during a period of 2 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Conventional semen analysis was performed. DNA was extracted from spermatozoa and both polymorphisms were genotyped by polymerase chain reaction. Serum hormone levels were determined. MAIN RESULTS AND THE ROLE OF CHANCE Six combined genotypes were identified between the 18 AR(CAG)(n) alleles with 12-32 repeats and the 6 CYP19(TTTA)(n) alleles with 7-12 repeats. A gradual reduction in the sperm concentration (10(6)/ml) and motility (%) from long AR allele-non-CYP19(TTTA)(7) allele carriers to long AR allele-CYP19(TTTA)(7) homozygotes and from short AR allele-non-CYP19(TTTA)(7) carriers to short AR allele-CYP19(TTTA)(7) homozygotes was observed in normozoospermic men (means ± SD; concentration: 93 ± 53.1 versus 65 ± 48.6 and 85 ± 60.1 versus 37 ± 17.2l, P < 0.002; motility: 63 ± 10.3 versus 55 ± 14.5 and 52 ± 19.6 versus 41 ± 13.7, P < 0.001, respectively). Similar associations were observed in oligozoospermic men (concentration: 10 ± 4.2 versus 9 ± 5.9 and 10 ± 6.3 versus 6 ± 3.1, P < 0.03; motility: 47 ± 17.1 versus 39 ± 6.2 and 39 ± 22 versus 27 ± 18.3, P < 0.003, respectively). The above associations of the combined genotypes with sperm concentration and motility were confirmed in the total study population (P < 0.006 and P < 0.001, respectively). LIMITATIONS, REASONS FOR CAUTION Our study population was limited to Greek Caucasian adult males, residents of Northwest Greece. WIDER IMPLICATIONS OF THE FINDINGS The confirmation of our findings in other populations would verify the significance of AR and CYP19 genes for spermatogenesis. STUDY FUNDING/COMPETING INTERESTS This study did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. The authors declare no conflicts of interest.
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Affiliation(s)
- L Lazaros
- Genetics and IVF Unit, Department of Obstetrics and Gynecology, Medical School, Ioannina University, Ioannina, Greece
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Budak E, Karatekelioglu E, Gulebenzer G, Soydan E, Pehlivan Budak T, Mannaerts B, Van Kuijk J, Griesinger G, Braam SC, Consten D, Smeenk JMJ, Cohlen BJ, Curfs MHJM, Hamilton CJCM, Repping S, Mol BWJ, de Bruin JP, Fabregues F, Iraola A, Casals G, Peralta S, Creus M, Balasch J, Kosmas I, Kitsou X, Euaggelou A, Peschos D, Eliseeva M, Mynbaev O, Lazaros L, Stefos T, Fatemi H, Tournaye H, Prapa S, Prapas N, Prapas Y, Zikopoulos K, Georgiou I. SESSION 18: OHSS. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rosenbluth EM, Wells LM, Sparks AE, Van Voorhis BJ, Reyes-Palomares A, Palomares AR, Medina MA, Ruiz Galdon M, Reyes Engel A, Stanghellini I, Luiselli D, Magli MC, Lang M, Romeo G, Ferraretti AP, Gianaroli L, Gun Eryilmaz O, Sarikaya E, Yilmaz S, Avci A, Ozogul C, Barun S, Genc M, Kitsou C, Kosmas I, Peschos D, Euaggelou A, Lazaros L, Stefos T, Tournaye H, Prapa S, Prapas N, Prapas Y, Zikopoulos K, Georgiou I, Loewke K, Moussavi F, Maddah M, Conaghan J, Ivani K, Suraj V, Chen A, Shen S, Dittrich R, Hoffmann I, Kunzel J, Lotz L, Mueller A, Reissmann C, Hildebrandt T, Hakl J, Unluhan N, Oppelt PG, Beckmann MW, Huszar G, Geerts N, McGrath J, Vanderlick K, Pohl O, Gotteland JP, Bestel E, Sinai Talaulikar V, Manyonda I. TRANSLATIONAL RESEARCH. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sharma M, Taylor A, di Spiezio Sardo A, Buck L, Mastrogamvrakis G, Kosmas I, Tsirkas P, Magos A. Outpatient hysteroscopy: traditional versus the 'no-touch' technique. BJOG 2005; 112:963-7. [PMID: 15958000 DOI: 10.1111/j.1471-0528.2005.00425.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess whether outpatient hysteroscopy using the 'no-touch' technique confers any advantages in terms of patient discomfort over the traditional technique. DESIGN Prospective randomised controlled study. SETTING Outpatient hysteroscopy clinic in a large university undergraduate teaching hospital. POPULATION All women referred for outpatient hysteroscopy in a 12-month period. INTERVENTIONS Women were randomised to undergo either traditional saline hysteroscopy requiring the use of a speculum and tenaculum, or a 'no-touch' vaginoscopic hysteroscopy which does not require a speculum or tenaculum. Each group was further subdivided to have hysteroscopy with either a 2.9-mm or 4-mm hysteroscope. Patients were asked to complete pre- and postprocedure questionnaires ranking pain scores. MAIN OUTCOME MEASURES The relative success of each of these techniques, requirement for local anaesthetic and pain scores at different times during the hysteroscopy were recorded at the end of the procedure. The time taken to carry out each procedure was also measured. RESULTS One hundred and twenty women were recruited in this study: 60 were randomised to traditional hysteroscopy and 60 to 'no-touch' hysteroscopy. The overall success rate for hysteroscopy was 99%. There was no significant difference in the requirement for local anaesthetic between the two groups, but those who underwent 'no-touch' hysteroscopy with a 2.9-mm hysteroscope had the lowest requirement of local anaesthetic (10% compared with 27% in the no-touch hysteroscopy with a 4-mm hysteroscope group). The time taken to perform hysteroscopy and biopsy was significantly shorter with 'no-touch' hysteroscopy (5.9 vs 7.8 min; difference 1.9, 95% CI 0.7-3.1). There were no differences in pain scores between the groups at different times during hysteroscopy. CONCLUSIONS 'No-touch' or vaginoscopic hysteroscopy is significantly faster to perform than the traditional technique. Although there was no difference in pain scores between the two techniques, local anaesthetic requirements were least in those who underwent 'no-touch' hysteroscopy with a narrow bore hysteroscope.
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Affiliation(s)
- M Sharma
- Minimally Invasive Therapy Unit and Endoscopy Training Centre, University Department of Obstetrics and Gynaecology, Royal Free Hospital, Hampstead, London, UK
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