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Sileo FG, Accurti V, Baschat A, Binder J, Carreras E, Chianchiano N, Cruz-Martinez R, D'Antonio F, Gielchinsky Y, Hecher K, Johnson A, Lopriore E, Massoud M, Nørgaard LN, Papaioannou G, Prefumo F, Salsi G, Simões T, Umstad M, Vavilala S, Yinon Y, Khalil A. Perinatal outcome of monochorionic triamniotic triplet pregnancy: multicenter cohort study. Ultrasound Obstet Gynecol 2023; 62:540-551. [PMID: 37204929 DOI: 10.1002/uog.26256] [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] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Monochorionic (MC) triplet pregnancies are extremely rare and information on these pregnancies and their complications is limited. We aimed to investigate the risk of early and late pregnancy complications, perinatal outcome and the timing and methods of fetal intervention in these pregnancies. METHODS This was a multicenter retrospective cohort study of MC triamniotic (TA) triplet pregnancies managed in 21 participating centers around the world from 2007 onwards. Data on maternal age, mode of conception, diagnosis of major fetal structural anomalies or aneuploidy, gestational age (GA) at diagnosis of anomalies, twin-to-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), twin reversed arterial perfusion (TRAP) sequence and or selective fetal growth restriction (sFGR) were retrieved from patient records. Data on antenatal interventions were collected, including data on selective fetal reduction (three to two or three to one), laser surgery and any other active fetal intervention (including amniodrainage). Data on perinatal outcome were collected, including numbers of live birth, intrauterine demise, neonatal death, perinatal death and termination of fetus or pregnancy (TOP). Neonatal data such as GA at birth, birth weight, admission to neonatal intensive care unit and neonatal morbidity were also collected. Perinatal outcomes were assessed according to whether the pregnancy was managed expectantly or underwent fetal intervention. RESULTS Of an initial cohort of 174 MCTA triplet pregnancies, 11 underwent early TOP, three had an early miscarriage, six were lost to follow-up and one was ongoing at the time of writing. Thus, the study cohort included 153 pregnancies, of which the majority (92.8%) were managed expectantly. The incidence of pregnancy affected by one or more fetal structural abnormality was 13.7% (21/153) and that of TRAP sequence was 5.2% (8/153). The most common antenatal complication related to chorionicity was TTTS, which affected just over one quarter (27.6%; 42/152, after removing a pregnancy with TOP < 24 weeks for fetal anomalies) of the pregnancies, followed by sFGR (16.4%; 25/152), while TAPS (spontaneous or post TTTS with or without laser treatment) occurred in only 4.6% (7/152) of pregnancies. No monochorionicity-related antenatal complication was recorded in 49.3% (75/152) of pregnancies. Survival was apparently associated largely with the development of these complications: there was at least one survivor beyond the neonatal period in 85.1% (57/67) of pregnancies without antenatal complications, in 100% (25/25) of those complicated by sFGR and in 47.6% (20/42) of those complicated by TTTS. The overall rate of preterm birth prior to 28 weeks was 14.5% (18/124) and that prior to 32 weeks' gestation was 49.2% (61/124). CONCLUSION Monochorionicity-related complications, which can impact adversely perinatal outcome, occur in almost half of MCTA triplet pregnancies, creating a challenge with regard to counseling, surveillance and management. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F G Sileo
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - V Accurti
- Fetal Medicine and Surgery Service, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Baschat
- Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - J Binder
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - E Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Reproductive Medicine, Grup de Recerca en Medicina Materna I Fetal, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - N Chianchiano
- Fetal Medicine Unit, Bucchieri La Ferla-Fatebenefratelli Hospital, Palermo, Italy
| | - R Cruz-Martinez
- Fetal Surgery Center, Instituto Medicina Fetal México, Queretaro/Guadalajara, Jalisco, Mexico
| | - F D'Antonio
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University 'G. d'Annunzio' of Chieti-Pescara, Chieti, Italy
| | - Y Gielchinsky
- Fetal Medicine Center, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikvah, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Johnson
- Department of Obstetrics and Gynecology, The Fetal Center at Children's Memorial Hermann Hospital, University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA
| | - E Lopriore
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Massoud
- Department of Obstetrics and Fetal Medicine, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - L N Nørgaard
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - G Papaioannou
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece
| | - F Prefumo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - G Salsi
- Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - T Simões
- Department of Maternal-Fetal Medicine and Maternity Dr. Alfredo da Costa, Nova Medica School, Lisbon, Portugal
| | - M Umstad
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - S Vavilala
- Department of Fetal Medicine, Fernandez Hospital, Hyderabad, Telangana, India
| | - Y Yinon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Mammas IN, Drysdale SB, Charalampous C, Koletsi P, Papatheodoropoulou A, Koutsaftiki C, Sergentanis T, Merakou K, Kornarou H, Papaioannou G, Kramvis A, Greenough A, Theodoridou M, Spandidos DA. Navigating paediatric virology through the COVID‑19 era (Review). Int J Mol Med 2023; 52:83. [PMID: 37503745 PMCID: PMC10555476 DOI: 10.3892/ijmm.2023.5286] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
The present review article presents the key messages of the 8th Workshop on Paediatric Virology organised virtually by the Institute of Paediatric Virology based on the island of Euboea in Greece. The major topics covered during the workshop were the following: i) New advances in antiviral agents and vaccines against cytomegalovirus; ii) hantavirus nephropathy in children; iii) human rhinovirus infections in children requiring paediatric intensive care; iv) complications and management of human adenovirus infections; v) challenges of post‑coronavirus disease 2019 (COVID‑19) syndrome in children and adolescents; and vi) foetal magnetic resonance imaging in viral infections involving the central nervous system. The COVID‑19 era requires a more intensive, strategic, global scientific effort in the clinic and in the laboratory, focusing on the diagnosis, management and prevention of viral infections in neonates and children.
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Affiliation(s)
- Ioannis N. Mammas
- Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion
- First Department of Paediatrics, School of Medicine, University of Athens, 11527 Athens
- Paediatric Clinic, Aliveri, 34500 Island of Euboea, Greece
| | - Simon B. Drysdale
- Centre for Neonatal and Paediatric Infection, St. George's, University of London, London SW17 0RE
- Department of Paediatrics, St. George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK
| | | | - Patra Koletsi
- Department of Paediatrics, 'Penteli' Children's Hospital, 15236 Palaia Penteli
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, 15236 Palaia Penteli
| | | | - Chryssie Koutsaftiki
- COVID-19 Reference Centre, 'Rafina' Health Care Centre, 19009 Rafina
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens
| | - Theodoros Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens
| | - Kyriakoula Merakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens
| | - Helen Kornarou
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens
| | - Georgia Papaioannou
- Department of Paediatric Radiology, 'Mitera' Children's Hospital, 15123 Athens, Greece
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, 2193 Johannesburg, South Africa
| | - Anne Greenough
- Division of Asthma, Allergy and Lung Biology, King's College London, London SE5 9RS, UK
| | - Maria Theodoridou
- First Department of Paediatrics, School of Medicine, University of Athens, 11527 Athens
| | - Demetrios A. Spandidos
- Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion
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Papaioannou G, Garel C. The fetal brain: migration and gyration anomalies - pre- and postnatal correlations. Pediatr Radiol 2023; 53:589-601. [PMID: 35913508 DOI: 10.1007/s00247-022-05458-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/16/2022] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
The cerebral cortex represents a laminar structure of precisely spatially organized neurons in horizontal layers and vertical columns. Neurogenesis, neuronal migration and neuronal wiring are tightly regulated and coordinated procedures that result in the accurate formation of the human cerebral cortex. Abnormal fetal corticogenesis results in several types of migration and gyration anomalies, known as malformations of cortical development, which have long been a topic of investigation. According to the stage of cortical development that is affected, with diverse genetic and non-genetic etiologies, these malformations can cause abnormal head size, abnormal brain surface and abnormal cortical layering with various degrees of neurodevelopmental delay and epilepsy. The pathogenesis of these malformations is multifactorial and includes genetic mutations or environmental insults, acquired either in utero at varying stages of brain development or during the perinatal period after corticogenesis. In this article, we focus on cortical malformations detected on fetal MRI. We present the main antenatal findings that should raise suspicion for malformations of cortical development, together with findings that might be missed on prenatal imaging and describe the correlations between fetal and postnatal MRI.
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Affiliation(s)
- Georgia Papaioannou
- Department of Pediatric Radiology, Mitera Maternity and Children's Hospital, 6 Erythrou Stavrou str, 15123, Maroussi, Athens, Greece.
| | - Catherine Garel
- Service de Radiologie, Hôpital d'Enfants Armand-Trousseau APHP, Sorbonne Université, Paris, France
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4
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Papaioannou G, Caro-Domínguez P, Klein WM, Garel C, Cassart M. Indications for magnetic resonance imaging of the fetal body (extra-central nervous system): recommendations from the European Society of Paediatric Radiology Fetal Task Force. Pediatr Radiol 2023; 53:297-312. [PMID: 36161506 DOI: 10.1007/s00247-022-05495-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 02/04/2023]
Abstract
The indications for fetal body MRI are amplifying because of the expanding possibilities of fetal and perinatal therapy. However, huge heterogeneity regarding the indications for fetal body MRI is seen among different European countries that is mostly related to local use of US, but also to local fetal MRI expertise and legislation on pregnancy termination. The purpose of this article is to summarize the precise indications for fetal MRI, excluding the central nervous system. MRI indications arise from the sonographic findings, based on the operator's experience and the various practices in the countries and institutions represented on the European Society of Paediatric Radiology Fetal Task Force. We also highlight the strengths and weaknesses of fetal US and MRI of the fetal body.
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Affiliation(s)
- Georgia Papaioannou
- Department of Pediatric Radiology, Mitera Maternity and Children's Hospital, 6 Erythrou Stavrou str, Maroussi 15123, Athens, Greece.
| | - Pablo Caro-Domínguez
- Pediatric Imaging Unit, Department of Radiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Willemijn M Klein
- Department of Medical Imaging, Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catherine Garel
- Department of Radiology, Armand-Trousseau Hospital, Paris, France
| | - Marie Cassart
- Department of Radiology and Fetal Medicine, Iris South Hospitals, Brussels, Belgium
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Papaioannou G, Kosma I, Badeka AV, Kontominas MG. Profile of Volatile Compounds in Dessert Yogurts Prepared from Cow and Goat Milk, Using Different Starter Cultures and Probiotics. Foods 2021; 10:foods10123153. [PMID: 34945703 PMCID: PMC8701116 DOI: 10.3390/foods10123153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to determine the profile of volatile compounds (aroma) and overall flavor in dessert yogurts prepared from cow and goat milk, using three different, commercially available starter cultures, in the presence or absence of probiotic bacteria and to correlate this to organoleptic evaluation results obtained using a consumer acceptability method. The extraction of volatile compounds was carried out by solid phase micro-extraction; separation and analysis by gas chromatography-mass spectrometry. Variations among the different classes of compounds (i.e., aldehydes, alcohols, ketones, volatile acids, hydrocarbons, and terpenes) were recorded for different treatments. The results showed that the main volatiles in the cow milk dessert yogurts without Bifidobacterium BB-12 were: acetaldehyde, 2,3-butanedione, 2,3-pentanedione, 3-OH-2-butanone, 2-propanone, hexanoic acid and limonene). Respective volatiles in cow milk dessert yogurts with Bifidobacterium BB-12 were: acetaldehyde, pentanal, hexanal, the same ketones, acetic acid and limonene). The volatiles in goat milk dessert yogurts without Lactobacillus acidophilus LA-5 were: acetaldehyde, the same ketones, no carboxylic acids, limonene, camphene, α- and β-pinene. Respective volatiles in goat milk dessert yogurts with Lactobacillus acidophilus LA-5 were: aldehydes acetaldehyde, the same ketones, butanoic acid, α-pinene and camphene varying in concentration in different samples. Based on the results of volatiles and organoleptic evaluation, it can be concluded that dessert yogurts from cow milk without probiotic bacterial strains using the mild and classic starter cultures, and dessert yogurts from goat milk with probiotic bacterial strains using the classic and acidic starter cultures are found to be more organoleptically acceptable by consumers. In most cases, a positive correlation was found between dessert yogurt organoleptically determined flavor and volatiles (aldehydes, ketones and carboxylic acids).
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6
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Papaioannou G, Klein W, Cassart M, Garel C. Indications for magnetic resonance imaging of the fetal central nervous system: recommendations from the European Society of Paediatric Radiology Fetal Task Force. Pediatr Radiol 2021; 51:2105-2114. [PMID: 34137935 DOI: 10.1007/s00247-021-05104-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/25/2021] [Accepted: 05/02/2021] [Indexed: 11/30/2022]
Abstract
Fetal central nervous system MRI is a well-established method to complement a high-quality fetal ultrasound and to clarify sonographically detected abnormalities in complex pregnancies. However, there is still worldwide heterogeneity and confusion regarding the indications of fetal central nervous system MRI, which has roots in differences among countries regarding the performance of ultrasound examinations and legislation on pregnancy termination. The purpose of this article is to clarify the indications for fetal central nervous system MRI by focusing on the ultrasound findings that guide further investigation with MRI and highlight the strengths and the weaknesses of each modality on imaging the fetal central nervous system.
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Affiliation(s)
- Georgia Papaioannou
- Department of Pediatric Radiology, Mitera Maternity and Children's Hospital, 6 Erythrou Stavrou str, Maroussi, 15123, Athens, Greece.
| | - Willemijn Klein
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud Medical Center, Nijmegen, Netherlands
| | - Marie Cassart
- Department of Radiology and Fetal Medicine, Iris South Hospitals, Brussels, Belgium
| | - Catherine Garel
- Department of Radiology, Armand-Trousseau Hospital, Paris, France
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7
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Vasilakis AA, Papaioannou G, Vitsas N, Gkaravelis A, Sousa Santos B, Alford G. Remote Teaching Advanced Rendering Topics Using the Rayground Platform. IEEE Comput Graph Appl 2021; 41:99-103. [PMID: 34506271 DOI: 10.1109/mcg.2021.3093734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Rayground is a novel online framework for fast prototyping and interactive demonstration of ray tracing algorithms. It aims to set the ground for the online development of ray-traced visualization algorithms in an accessible manner for everyone, stripping off the mechanics that get in the way of creativity and the understanding of the core concepts. Due to the COVID-19 pandemic, remote teaching and online coursework have taken center stage. In this work, we demonstrate how Rayground can incorporate advanced instructive rendering media during online lectures as well as offer attractive student assignments in an engaging, hands-on manner. We cover things to consider when building or porting methods to this new development platform, best practices in remote teaching and learning activities, and time-tested assessment and grading strategies suitable for fully online university courses.
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Petridou M, Matopoulou E, Kanellos I, Daios S, Patrikios I, Charalampous K, Lampropoulos K, Stefanou A, Skantzis P, Arkouli V, Papaioannou N, Papaioannou G, Kaiafa G, Savopoulos C, Papaioannou S. Routine podiatry assessment as a potential preventive tool for atrial fibrillation screening in diabetics. Europace 2021. [DOI: 10.1093/europace/euab116.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Atrial fibrillation (AF) is a common heart arrhythmia predominantly in advanced age patients and in diabetic’s type II (DMPII). Even if the risk of stroke in AF in DMPII is relative high, 25% of AF patients remains undiagnosed and also cryptogenic AF is very common in the diabetic population. During a 12-month study project, podiatrists and podologists performed foot pulse-checks in their routine podiatry assessment, when encountering visual symptoms that suggest an underlying circulatory disorder in diabetics. This simple non-invasive method aims to increase screening and diagnosis of AF from allied health professionals, in order to reveal patients with previously undiagnosed AF and patients with cryptogenic Af, challenging the potential reduction of AF complications and mainly of stroke.
Purpose
Early detection of AF in diabetics from allied health professionals during routine podiatry assessment. Revealing of previously undiagnosed AF contributes to stroke and other AF complications incidence reduction in the diabetics population.
Methods
During a 12-month study, 2 podiatrists and 6 podologists performed foot pulse-checks on diabetics, during their annual foot screening appointments, since they have been trained from medical doctors to spot rhythm abnormalities during pulse palpation of the foot arteries. They have been also trained to confirm their pulse palpation evidence thought Doppler ultrasound wave assessments during evaluation of arterial blood supply (anterior-posterior tibial arteries and ramifications) of the diabetic foot. During the study 300 diabetics (mean age 60 years old, 180 males, 120 females) had their feet pulse-tested. Spss statistical software had been used.
Results
17% of diabetics during foot pulse-checks presents undiagnosed AF. There was no statistically significant difference (p < 0.05) between sex (males and females AF screening percents were similar).
Conclusion(s)
Early detection and properly managed during AF screening reduces AF complications and specifically stroke incidence. Opportunistic podiatric detection of previously undiagnosed and cryptogenic AF from allied professionals is a non invasive, safe, fast and economic method with potential contributions in this direction. More studies must be designed in order to support the routine podiatry assessment, as a useful Screening diagnostic tool of AF for reducing cardiovascular complications incidence in diabetics but also in the general population.
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Affiliation(s)
- M Petridou
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - E Matopoulou
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - I Kanellos
- European University of Cyprus, Medical School, Nicosia, Cyprus
| | - S Daios
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - I Patrikios
- European University of Cyprus, Medical School, Nicosia, Cyprus
| | - K Charalampous
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - K Lampropoulos
- European University of Cyprus, Medical School, Nicosia, Cyprus
| | - A Stefanou
- European University of Cyprus, Medical School, Nicosia, Cyprus
| | - P Skantzis
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - V Arkouli
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - N Papaioannou
- Naval Hospital of Athens, Cardiology, Athens, Greece
| | - G Papaioannou
- European University of Cyprus, Medical School, Nicosia, Cyprus
| | - G Kaiafa
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - C Savopoulos
- Ahepa General Hospital of Aristotle University, Thessaloniki, Greece
| | - S Papaioannou
- Naval Hospital of Athens, Cardiology, Athens, Greece
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Pavlidis G, Hatzifilalithis S, Marwan Zawaher N, Papaioannou G, Giagkousiklidou E, Vivas AB. The Cultural Adaptation of the Everyday Problems Test-Greek Version: An Instrument to Examine Everyday Functioning. Gerontol Geriatr Med 2021; 7:23337214211027683. [PMID: 34286049 PMCID: PMC8261850 DOI: 10.1177/23337214211027683] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/28/2021] [Accepted: 06/06/2021] [Indexed: 11/28/2022] Open
Abstract
Assessing cognitive decline and everyday functioning (EvF) in older age is valuable in detecting age-related neurological disorders. In Greece, there is a lack of sensitive instruments that capture fluctuations in EvF among older persons who are cognitively healthy or have subtle cognitive impairments. The EPT 28-items test, a widely used paper-and-pencil EvF measure, was translated in Greek and adapted to the Greek culture in this study. A multi-step methodology using a sample of 139 older Greek persons was employed. The results indicate that the Greek version of the EPT 28-items (i.e., the EPT-G) was well adapted, representing everyday tasks in Greece within a good range of task difficulty. The psychometric properties of the EPT-G replicate those of the original instrument, capturing EvF fluctuations among older persons with mild cognitive impairments. It was concluded that the EPT-G is a useful measure of EvF among Greek older persons.
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Affiliation(s)
| | | | | | | | | | - Ana B. Vivas
- The University of Sheffield,
International Faculty, Thessaloniki, Greece
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10
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Koutsaftiki C, Papatheodoropoulou A, Papaioannou G, Korovessi P, Mammas IN, Theodoridou M, Spandidos DA. COVID-19 threat and frontline paediatric care professionals. Exp Ther Med 2020; 20:291. [PMID: 33209135 PMCID: PMC7668128 DOI: 10.3892/etm.2020.9421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/24/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Chryssie Koutsaftiki
- COVID-19 Reference Centre, ‘Rafina’ Health Care Centre, 19009 Rafina, Greece
- Paediatric Intensive Care Unit (PICU), ‘Penteli’ Children's Hospital, 15236 Palaia Penteli, Greece
| | | | - Georgia Papaioannou
- Department of Paediatric Radiology, ‘Mitera’ Children's Hospital, 15123 Athens, Greece
| | - Paraskevi Korovessi
- Department of Paediatrics, ‘Penteli’ Children's Hospital, 15236 Palaia Penteli, Greece
| | - Ioannis N. Mammas
- Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece
- Paediatric Clinic, Aliveri, 34500 Island of Euboea, Greece
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Maria Theodoridou
- Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Demetrios A. Spandidos
- Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
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Vamvuka D, Papaioannou G, Alexandrakis S, Stratakis A. Control of the mobility of heavy metals in soil from disposal of bio-solid and olive by-product ashes using waste additives. Environ Pollut 2020; 266:115136. [PMID: 32650203 DOI: 10.1016/j.envpol.2020.115136] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/10/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
In compliance to European Union directives to reuse urban wastes as secondary fuels, the aim of present work was to investigate and control the environmental impact from disposal of ashes generated by combustion of a bio-solid, an olive by-product and their blend. Two waste materials were admixed with the ash and their performance as potential stabilizers was assessed. Metals and ions leached through a soil were measured. The results showed that dissolution of some alkaline substances raised the pH of water effluents, decreasing the extractability of heavy metals from the ashes. In some cases Cr and As leached reached hazardous levels. Upon addition of waste materials to ash, the concentration of Cr in liquid extracts was reduced by 35-97%, while that of Cu and As by 100%. All heavy metal values measured in the leachates were decreased to values below legislation limits. The mineralogy, the chemistry and the pH of solids involved were key factors for the retention of elements.
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Affiliation(s)
- D Vamvuka
- School of Mineral Resources Engineering, Technical University of Crete, University Campus, Hania, 73100, Greece.
| | - G Papaioannou
- School of Mineral Resources Engineering, Technical University of Crete, University Campus, Hania, 73100, Greece
| | - S Alexandrakis
- School of Mineral Resources Engineering, Technical University of Crete, University Campus, Hania, 73100, Greece
| | - A Stratakis
- School of Mineral Resources Engineering, Technical University of Crete, University Campus, Hania, 73100, Greece
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12
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Karamanidi M, Chrysikos D, Samolis A, Protogerou V, Fourla N, Michalis I, Papaioannou G, Troupis T. Agenesis of the coeliac trunk: a case report and review of the literature. Folia Morphol (Warsz) 2020; 80:718-721. [PMID: 32827311 DOI: 10.5603/fm.a2020.0093] [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: 06/09/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 11/25/2022]
Abstract
Vascular anatomical variations of the abdomen are very common. Awareness of these variations is of paramount importance in clinical practice mainly in achieving best results in minimal invasive or surgical vascular procedures. From surgical point of view, the preoperative knowledge of vascular anatomy and the relations to the surrounding structures and tissues aims to minimise inadvertent complications. Agenesis of the coeliac trunk is one of the rare anatomical variations of the abdominal aorta. Limited number of cases have been reported in the medical literature, most of which are based on angiographic and cadaveric studies of adult humans. In this paper, we report a case of absence of the coeliac trunk that has been detected as an incidental radiological finding in a female patient who was admitted with abdominal pain.
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Affiliation(s)
- M Karamanidi
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - D Chrysikos
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - A Samolis
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - V Protogerou
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - N Fourla
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - I Michalis
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece
| | - G Papaioannou
- Department of Surgery, "Thriasio" General Hospital, Athens, Greece
| | - T Troupis
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Greece.
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13
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Mammas IN, Drysdale SB, Rath B, Theodoridou M, Papaioannou G, Papatheodoropoulou A, Koutsounaki E, Koutsaftiki C, Kozanidou E, Achtsidis V, Korovessi P, Chrousos GP, Spandidos DA. Update on current views and advances on RSV infection (Review). Int J Mol Med 2020; 46:509-520. [PMID: 32626981 PMCID: PMC7307844 DOI: 10.3892/ijmm.2020.4641] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022] Open
Abstract
Respiratory syncytial virus (RSV) infection represents an excellent paradigm of precision medicine in modern paediatrics and several clinical trials are currently performed in the prevention and management of RSV infection. A new taxonomic terminology for RSV was recently adopted, while the diagnostic and omics techniques have revealed new modalities in the early identification of RSV infections and for better understanding of the disease pathogenesis. Coordinated clinical and research efforts constitute an important step in limiting RSV global predominance, improving epidemiological surveillance, and advancing neonatal and paediatric care. This review article presents the key messages of the plenary lectures, oral presentations and posters of the '5th workshop on paediatric virology' (Sparta, Greece, 12th October 2019) organized by the Paediatric Virology Study Group, focusing on recent advances in the epidemiology, pathogenesis, diagnosis, prognosis, clinical management and prevention of RSV infection in childhood.
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Affiliation(s)
- Ioannis N Mammas
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | | | - Barbara Rath
- Vienna Vaccine Safety Initiative, D‑10437 Berlin, Germany
| | - Maria Theodoridou
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Georgia Papaioannou
- Department of Paediatric Radiology, 'Mitera' Children's Hospital, 15123 Athens, Greece
| | | | - Eirini Koutsounaki
- Neonatal Department, 'Alexandra' Maternity Hospital, 15123 Athens, Greece
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, 15236 Penteli, Greece
| | - Eleftheria Kozanidou
- 2nd Department of Internal Medicine, 'St Panteleimon' General Hospital of Nikaia, 18454 Piraeus, Greece
| | - Vassilis Achtsidis
- Department of Ophthalmology, Royal Cornwall Hospitals, Cornwall TR1 3LQ, UK
| | - Paraskevi Korovessi
- Department of Paediatrics, 'Penteli' Children's Hospital, 15236 Penteli, Greece
| | - George P Chrousos
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
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14
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Mammas IN, Theodoridou M, Thiagarajan P, Melidou A, Papaioannou G, Korovessi P, Koutsaftiki C, Papatheodoropoulou A, Calachanis M, Dalianis T, Spandidos DA. A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak. Exp Ther Med 2019; 17:4327-4336. [PMID: 31186675 PMCID: PMC6507498 DOI: 10.3892/etm.2019.7515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/16/2019] [Indexed: 12/17/2022] Open
Abstract
This year marks the 100th anniversary of the 1918 Spanish flu outbreak on the Greek Aegean Sea island of Skyros, which devastated its population in less than 30 days. According to Constantinos Faltaits's annals published in 1919, the influenza attack on the island of Skyros commenced acutely ‘like a thunderbolt’ on the 27th of October, 1918 and was exceptionally severe and fatal. At that time, the viral cause of the influenza had not been detected, while the total number of victims of the Spanish flu outbreak has been estimated to have surpassed 50 million, worldwide. Almost one century after this Aegean Sea island's tragedy, the ‘4th Workshop on Paediatric Virology’, organised on the 22nd of September, 2018 in Athens, Greece, was dedicated to the 100 years of the ‘Spanish’ flu pandemic. This review article highlights the plenary and key lectures presented at the workshop on the recent advances on the epidemiology, clinical management and prevention of influenza in childhood.
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Affiliation(s)
- Ioannis N Mammas
- Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Maria Theodoridou
- First Department of Paediatrics, 'Aghia Sophia' Children's Hospital, University of Athens School of Medicine, 115 27 Athens, Greece
| | - Prakash Thiagarajan
- Neonatal Unit, Division for Women's & Children Health, Noble's Hospital, IM4 4RJ Douglas, Isle of Man, British Isles
| | - Angeliki Melidou
- Second Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Georgia Papaioannou
- Department of Paediatric Radiology, 'Mitera' Children's Hospital, 151 23 Athens, Greece
| | - Paraskevi Korovessi
- Department of Paediatrics, 'Penteli' Children's Hospital, 152 36 Penteli, Greece
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, 152 36 Penteli, Greece
| | - Alexia Papatheodoropoulou
- Paediatric Intensive Care Unit (PICU), 'P. and A. Kyriakou' Children's Hospital, 115 27 Athens, Greece
| | - Marcos Calachanis
- Department of Paediatric Cardiology, 'Penteli' Children's Hospital, 152 36 Penteli, Greece
| | - Tina Dalianis
- Karolinska Institutet, Karolinska University Hospital, SE-117 77 Stockholm, Sweden
| | - Demetrios A Spandidos
- Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
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15
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Pastroma A, Papaioannou G, Raissaki M, Alexopoulou E. The Common Among the Rare: A Pictorial Essay of the Most Common Diffuse Lung Diseases in Children. Can Assoc Radiol J 2018; 69:468-478. [PMID: 30390964 DOI: 10.1016/j.carj.2018.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/17/2018] [Accepted: 07/24/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- Angeliki Pastroma
- 2nd Department of Radiology, General University Hospital ATTIKON Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | | | - Maria Raissaki
- Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Efthymia Alexopoulou
- 2nd Department of Radiology, General University Hospital ATTIKON Medical School, National and Kapodistrian University of Athens, Athens, Greece
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16
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Michala L, Vlachopapadopoulou E, Tsimaris P, Papaioannou G, Paisiou A, Peristeri I, Michalacos S, Kitra V. Resolution of Hematocolpos in Adolescents Affected with Graft vs Host Disease. J Pediatr Adolesc Gynecol 2018; 31:536-539. [PMID: 29857111 DOI: 10.1016/j.jpag.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bone marrow transplantation is a lifesaving procedure for a range of serious benign or malignant hematological conditions. A proportion of patients, however, will develop graft vs host disease (GVHD), acute or chronic, with serious long-term sequalae. CASES We present 2 cases of hematocolpos that developed in adolescence because of vaginal synechiae due to GVHD. The condition was initially asymptomatic, resolved spontaneously at first and recurred. In 1 girl blunt lysis of the adhesions was performed with the patient under general anesthesia, followed thereafter by local hydrocortisone and estriol treatment. SUMMARY AND CONCLUSION Genital symptoms might not be readily reported by adolescents after bone marrow transplantation. Physicians should be aware of possible late effects of GVHD on genitalia, inquire about symptoms, and be acquainted with addressing complications, such as vaginal obstruction.
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Affiliation(s)
- Lina Michala
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | | | - Pandelis Tsimaris
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anna Paisiou
- Agia Sophia Children's Hospital, Stem Cell Transplantation Unit, Athens, Greece
| | - Ioulia Peristeri
- Agia Sophia Children's Hospital, Stem Cell Transplantation Unit, Athens, Greece
| | | | - Vassiliki Kitra
- Agia Sophia Children's Hospital, Stem Cell Transplantation Unit, Athens, Greece
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17
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Tan MY, Syngelaki A, Poon LC, Rolnik DL, O'Gorman N, Delgado JL, Akolekar R, Konstantinidou L, Tsavdaridou M, Galeva S, Ajdacka U, Molina FS, Persico N, Jani JC, Plasencia W, Greco E, Papaioannou G, Wright A, Wright D, Nicolaides KH. Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2018; 52:186-195. [PMID: 29896812 DOI: 10.1002/uog.19112] [Citation(s) in RCA: 199] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/04/2018] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the performance of screening for early, preterm and term pre-eclampsia (PE) at 11-13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A). METHODS The data for this study were derived from three previously reported prospective non-intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE. Bayes' theorem was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker multiples of the median (MoM) values to derive patient-specific risks of delivery with PE at < 37 weeks' gestation. The performance of such screening was estimated. RESULTS In pregnancies that developed PE, compared to those without PE, the MoM values of UtA-PI and MAP were increased and those of PAPP-A and PlGF were decreased, and the deviation from normal was greater for early than late PE for all four biomarkers. Combined screening by maternal factors, UtA-PI, MAP and PlGF predicted 90% of early PE, 75% of preterm PE and 41% of term PE, at a screen-positive rate of 10%; inclusion of PAPP-A did not improve the performance of screening. The performance of screening depended on the racial origin of the women; on screening by a combination of maternal factors, MAP, UtA-PI and PlGF and using a risk cut-off of 1 in 100 for PE at < 37 weeks in Caucasian women, the screen-positive rate was 10% and detection rates for early, preterm and term PE were 88%, 69% and 40%, respectively. With the same method of screening and risk cut-off in women of Afro-Caribbean racial origin, the screen-positive rate was 34% and detection rates for early, preterm and term PE were 100%, 92% and 75%, respectively. CONCLUSION Screening by maternal factors and biomarkers at 11-13 weeks' gestation can identify a high proportion of pregnancies that develop early and preterm PE. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.
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Affiliation(s)
- M Y Tan
- King's College Hospital, London, UK
- King's College London, London, UK
| | | | - L C Poon
- King's College Hospital, London, UK
- King's College London, London, UK
| | | | | | - J L Delgado
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - R Akolekar
- Medway Maritime Hospital, Gillingham, UK
| | | | | | - S Galeva
- University Hospital Lewisham, London, UK
| | - U Ajdacka
- Southend University Hospital, Essex, UK
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - E Greco
- Royal London Hospital, London, UK
| | | | - A Wright
- University of Exeter, Exeter, UK
| | - D Wright
- University of Exeter, Exeter, UK
| | - K H Nicolaides
- King's College Hospital, London, UK
- King's College London, London, UK
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18
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Tan MY, Poon LC, Rolnik DL, Syngelaki A, de Paco Matallana C, Akolekar R, Cicero S, Janga D, Singh M, Molina FS, Persico N, Jani JC, Plasencia W, Greco E, Papaioannou G, Wright D, Nicolaides KH. Prediction and prevention of small-for-gestational-age neonates: evidence from SPREE and ASPRE. Ultrasound Obstet Gynecol 2018; 52:52-59. [PMID: 29704277 DOI: 10.1002/uog.19077] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA. METHODS The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo. In this study, we used the data from the ASPRE trial to estimate the effect of aspirin on the incidence of SGA with birth weight < 10th , < 5th and < 3rd percentile for gestational age. We also used the data from SPREE to estimate the proportion of SGA in the pregnancies with a risk for preterm PE of > 1 in 100. RESULTS In SPREE, screening for preterm PE by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor identified a high-risk group that contained about 46% of SGA neonates < 10th percentile born at < 37 weeks' gestation (preterm) and 56% of those born at < 32 weeks (early); the overall screen-positive rate was 12.2% (2014 of 16 451 pregnancies). In the ASPRE trial, use of aspirin reduced the overall incidence of SGA < 10th percentile by about 40% in babies born at < 37 weeks' gestation and by about 70% in babies born at < 32 weeks; in babies born at ≥ 37 weeks, aspirin did not have a significant effect on incidence of SGA. The aspirin-related decrease in incidence of SGA was mainly due to its incidence decreasing in pregnancies with PE, for which the decrease was about 70% in babies born at < 37 weeks' gestation and about 90% in babies born at < 32 weeks. On the basis of these results, it was estimated that first-trimester screening for preterm PE and use of aspirin in the high-risk group would potentially reduce the incidence of preterm and early SGA by about 20% and 40%, respectively. CONCLUSION First-trimester screening for PE by the combined test identifies a high proportion of cases of preterm SGA that can be prevented by the prophylactic use of aspirin. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.
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Affiliation(s)
- M Y Tan
- Kings College Hospital, London, UK
- Kings College London, London, UK
- University Hospital Lewisham, London, UK
| | - L C Poon
- Kings College London, London, UK
- Chinese University of Hong Kong, Hong Kong SAR
| | | | | | | | - R Akolekar
- Medway Maritime Hospital, Gillingham, UK
| | - S Cicero
- Homerton University Hospital, London, UK
| | - D Janga
- North Middlesex University Hospital, London, UK
| | - M Singh
- Southend University Hospital, Essex, UK
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - E Greco
- Royal London Hospital, London, UK
| | | | - D Wright
- University of Exeter, Exeter, UK
| | - K H Nicolaides
- Kings College Hospital, London, UK
- Kings College London, London, UK
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19
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Poon LC, Rolnik DL, Tan MY, Delgado JL, Tsokaki T, Akolekar R, Singh M, Andrade W, Efeturk T, Jani JC, Plasencia W, Papaioannou G, Blazquez AR, Carbone IF, Wright D, Nicolaides KH. ASPRE trial: incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm. Ultrasound Obstet Gynecol 2018; 51:738-742. [PMID: 29380918 DOI: 10.1002/uog.19019] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/23/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To report the incidence of preterm pre-eclampsia (PE) in women who are screen positive according to the criteria of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), and compare the incidence with that in those who are screen positive or screen negative by The Fetal Medicine Foundation (FMF) algorithm. METHODS This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancy who underwent prospective screening for preterm PE by means of the FMF algorithm, which combines maternal factors and biomarkers at 11-13 weeks' gestation. The incidence of preterm PE in women fulfilling the NICE and ACOG criteria was estimated; in these patients the incidence of preterm PE was then calculated in those who were screen negative relative to those who were screen positive by the FMF algorithm. RESULTS A total of 34 573 women with singleton pregnancy delivering at ≥ 24 weeks' gestation underwent prospective screening for preterm PE, of which 239 (0.7%) cases developed preterm PE. At least one of the ACOG criteria was fulfilled in 22 287 (64.5%) pregnancies and the incidence of preterm PE was 0.97% (95% CI, 0.85-1.11%); in the subgroup that was screen positive by the FMF algorithm the incidence of preterm PE was 4.80% (95% CI, 4.14-5.55%), and in those that were screen negative it was 0.25% (95% CI, 0.18-0.33%), with a relative incidence in FMF screen negative to FMF screen positive of 0.051 (95% CI, 0.037-0.071). In 1392 (4.0%) pregnancies, at least one of the NICE high-risk criteria was fulfilled, and in this group the incidence of preterm PE was 5.17% (95% CI, 4.13-6.46%); in the subgroups of screen positive and screen negative by the FMF algorithm, the incidence of preterm PE was 8.71% (95% CI, 6.93-10.89%) and 0.65% (95% CI, 0.25-1.67%), respectively, and the relative incidence was 0.075 (95% CI, 0.028-0.205). In 2360 (6.8%) pregnancies fulfilling at least two of the NICE moderate-risk criteria, the incidence of preterm PE was 1.74% (95% CI, 1.28-2.35%); in the subgroups of screen positive and screen negative by the FMF algorithm the incidence was 4.91% (95% CI, 3.54-6.79%) and 0.42% (95% CI, 0.20-0.86%), respectively, and the relative incidence was 0.085 (95% CI, 0.038-0.192). CONCLUSION In women who are screen positive for preterm PE by the ACOG or NICE criteria but screen negative by the FMF algorithm, the risk of preterm PE is reduced to within or below background levels. The results provide further evidence to support the personalized risk-based screening method that combines maternal factors and biomarkers. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- L C Poon
- King's College London, London, UK
- Chinese University of Hong Kong, Hong Kong SAR
| | | | - M Y Tan
- King's College Hospital, London, UK
- Lewisham University Hospital, London, UK
| | - J L Delgado
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - T Tsokaki
- King's College Hospital, London, UK
- North Middlesex University Hospital, London, UK
| | - R Akolekar
- King's College Hospital, London, UK
- Medway Maritime Hospital, Gillingham, UK
| | - M Singh
- King's College Hospital, London, UK
- Southend University Hospital, Essex, UK
| | | | - T Efeturk
- King's College Hospital, London, UK
- Homerton University Hospital, London, UK
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | | | - A R Blazquez
- Hospital Universitario San Cecilio, Granada, Spain
| | | | - D Wright
- University of Exeter, Exeter, UK
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20
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Mammas IN, Greenough A, Theodoridou M, Kramvis A, Rusan M, Melidou A, Korovessi P, Papaioannou G, Papatheodoropoulou A, Koutsaftiki C, Liston M, Sourvinos G, Spandidos DA. Paediatric Virology and its interaction between basic science and clinical practice (Review). Int J Mol Med 2018; 41:1165-1176. [PMID: 29328393 PMCID: PMC5819919 DOI: 10.3892/ijmm.2018.3364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/28/2018] [Indexed: 12/25/2022] Open
Abstract
The 3rd Workshop on Paediatric Virology, which took place on October 7th, 2017 in Athens, Greece, highlighted the role of breast feeding in the prevention of viral infections during the first years of life. Moreover, it focused on the long-term outcomes of respiratory syncytial virus and rhinovirus infections in prematurely born infants and emphasised the necessity for the development of relevant preventative strategies. Other topics that were covered included the vaccination policy in relation to the migration crisis, mother‑to‑child transmission of hepatitis B and C viruses, vaccination against human papilloma viruses in boys and advances on intranasal live‑attenuated vaccination against influenza. Emphasis was also given to the role of probiotics in the management of viral infections in childhood, the potential association between viral infections and the pathogenesis of asthma, fetal and neonatal brain imaging and the paediatric intensive care of children with central nervous system viral infections. Moreover, an interesting overview of the viral causes of perinatal mortality in ancient Greece was given, where recent archaeological findings from the Athenian Agora's bone well were presented. Finally, different continuing medical educational options in Paediatric Virology were analysed and evaluated. The present review provides an update of the key topics discussed during the workshop.
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Affiliation(s)
- Ioannis N. Mammas
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Anne Greenough
- Division of Asthma, Allergy and Lung Biology, King’s College London, London SE5 9RS, UK
| | - Maria Theodoridou
- 1st Department of Paediatrics, ‘Aghia Sophia’ Children’s Hospital, University of Athens School of Medicine, Athens 11527, Greece
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Maria Rusan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | - Angeliki Melidou
- 2nd Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124
| | | | - Georgia Papaioannou
- Department of Paediatric Radiology, ‘Mitera’ Children’s Hospital, Athens 15123
| | | | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), ‘Penteli’ Children’s Hospital, Penteli 15236, Greece
| | - Maria Liston
- Department of Anthropology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - George Sourvinos
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Demetrios A. Spandidos
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
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Rolnik DL, Wright D, Poon LCY, Syngelaki A, O'Gorman N, de Paco Matallana C, Akolekar R, Cicero S, Janga D, Singh M, Molina FS, Persico N, Jani JC, Plasencia W, Papaioannou G, Tenenbaum-Gavish K, Nicolaides KH. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet Gynecol 2017; 50:492-495. [PMID: 28741785 DOI: 10.1002/uog.18816] [Citation(s) in RCA: 215] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/19/2017] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the performance of screening for preterm and term pre-eclampsia (PE) in the study population participating in the ASPRE (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) trial. METHODS This was a prospective first-trimester multicenter study on screening for preterm PE in 26 941 singleton pregnancies by means of an algorithm that combines maternal factors, mean arterial pressure, uterine artery pulsatility index and maternal serum pregnancy-associated plasma protein-A and placental growth factor at 11-13 weeks' gestation. Eligible women with an estimated risk for preterm PE of > 1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs placebo from 11-14 until 36 weeks' gestation, which showed that, in the aspirin group, the incidence of preterm PE was reduced by 62%. In the screened population, the detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 37 and ≥ 37 weeks were estimated after adjustment for the effect of aspirin in those receiving this treatment. We excluded 1144 (4.2%) pregnancies because of loss to follow-up or study withdrawal (n = 716), miscarriage (n = 243) or termination (n = 185). RESULTS The study population of 25 797 pregnancies included 180 (0.7%) cases of preterm PE, 450 (1.7%) of term PE and 25 167 (97.6%) without PE. In combined first-trimester screening for preterm PE with a risk cut-off of 1 in 100, the DR was 76.7% (138/180) for preterm PE and 43.1% (194/450) for term PE, at screen-positive rate of 10.5% (2707/25 797) and FPR of 9.2% (2375/25 797). CONCLUSION The performance of screening in the ASPRE study was comparable with that of a study of approximately 60 000 singleton pregnancies used for development of the algorithm; in that study, combined screening detected 76.6% of cases of preterm PE and 38.3% of term PE at a FPR of 10%. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
| | - D Wright
- University of Exeter, Exeter, UK
| | - L C Y Poon
- King's College Hospital, London, UK
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | | | | | - R Akolekar
- Medway Maritime Hospital, Gillingham, Kent, UK
| | - S Cicero
- Homerton University Hospital, London, UK
| | - D Janga
- North Middlesex University Hospital, London, UK
| | - M Singh
- Southend University Hospital, Essex, UK
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
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O'Gorman N, Wright D, Poon LC, Rolnik DL, Syngelaki A, de Alvarado M, Carbone IF, Dutemeyer V, Fiolna M, Frick A, Karagiotis N, Mastrodima S, de Paco Matallana C, Papaioannou G, Pazos A, Plasencia W, Nicolaides KH. Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations. Ultrasound Obstet Gynecol 2017; 49:756-760. [PMID: 28295782 DOI: 10.1002/uog.17455] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/08/2017] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF), which uses Bayes' theorem to combine the a-priori risk from maternal factors, derived by a multivariable logistic model, with the results of various combinations of biophysical and biochemical measurements. METHODS This was a prospective multicenter study of screening for PE in 8775 singleton pregnancies at 11-13 weeks' gestation. A previously published FMF algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 32, < 37 and ≥ 37 weeks were estimated and compared with those derived from application of NICE guidelines and ACOG recommendations. According to NICE, all high-risk pregnancies should be offered low-dose aspirin. According to ACOG, use of aspirin should be reserved for women with a history of PE in at least two previous pregnancies or PE requiring delivery < 34 weeks' gestation. RESULTS In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE < 32, < 37 and ≥ 37 weeks, respectively. Screening with use of the FMF algorithm based on a combination of maternal factors, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and serum placental growth factor (PlGF) detected 100% (95% CI, 80-100%) of PE < 32 weeks, 75% (95% CI, 62-85%) of PE < 37 weeks and 43% (95% CI, 35-50%) of PE ≥ 37 weeks, at a 10.0% FPR. Screening with use of NICE guidelines detected 41% (95% CI, 18-67%) of PE < 32 weeks, 39% (95% CI, 27-53%) of PE < 37 weeks and 34% (95% CI, 27-41%) of PE ≥ 37 weeks, at 10.2% FPR. Screening with use of ACOG recommendations detected 94% (95% CI, 71-100%) of PE < 32 weeks, 90% (95% CI, 79-96%) of PE < 37 weeks and 89% (95% CI, 84-94%) of PE ≥ 37 weeks, at 64.2% FPR. Screening based on the ACOG recommendations for use of aspirin detected 6% (95% CI, 1-27%) of PE < 32 weeks, 5% (95% CI, 2-14%) of PE < 37 weeks and 2% (95% CI, 0.3-5%) of PE ≥ 37 weeks, at 0.2% FPR. CONCLUSION Performance of screening for PE at 11-13 weeks' gestation by the FMF algorithm using a combination of maternal factors, MAP, UtA-PI and PlGF, is by far superior to the methods recommended by NICE and ACOG. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- N O'Gorman
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
| | - D Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - L C Poon
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
- Chinese University of Hong Kong, Hong Kong, China
| | - D L Rolnik
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
| | - A Syngelaki
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
| | - M de Alvarado
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
- Homerton University Hospital, London, UK
| | | | - V Dutemeyer
- Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - M Fiolna
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
- Medway Maritime Hospital, Gillingham, UK
| | - A Frick
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
- Lewisham University Hospital, London, UK
| | - N Karagiotis
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
| | - S Mastrodima
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
- North Middlesex University Hospital, London, UK
| | | | | | - A Pazos
- Hospital Universitario San Cecilio, Granada, Spain
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - K H Nicolaides
- Harris Birthright Center for Fetal Medicine, King's College Hospital, London, UK
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Mammas IN, Theodoridou M, Kramvis A, Thiagarajan P, Gardner S, Papaioannou G, Melidou A, Koutsaki M, Kostagianni G, Achtsidis V, Koutsaftiki C, Calachanis M, Zaravinos A, Greenough A, Spandidos DA. Paediatric Virology: A rapidly increasing educational challenge. Exp Ther Med 2017; 13:364-377. [PMID: 28352303 PMCID: PMC5348700 DOI: 10.3892/etm.2016.3997] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/16/2016] [Indexed: 12/12/2022] Open
Abstract
The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood. A brief historical overview of the anti-vaccination movement was also provided, as well as presentations on the educational challenge of Paediatric Virology as a new subspecialty of Paediatrics. This review highlights selected lectures and discussions of the workshop.
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Affiliation(s)
- Ioannis N. Mammas
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Maria Theodoridou
- 1st Department of Paediatrics, ‘Aghia Sophia’ Children's Hospital, University of Athens School of Medicine, Athens 11527, Greece
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Prakash Thiagarajan
- Neonatal Unit, Division for Women's and Children's Health, Noble's Hospital, Douglas, Isle of Man IM4 4RJ, British Isles
| | - Sharryn Gardner
- Department of Children's Accident and Emergency, Southport and Ormskirk Hospital NHS Trust, Ormskirk L39 2AZ, UK
| | - Georgia Papaioannou
- Department of Paediatric Radiology, ‘Mitera’ Children's Hospital, Athens 15123, Greece
| | - Angeliki Melidou
- 2nd Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Maria Koutsaki
- Paediatric Neurology Division, 3rd Department of Paediatrics, School of Medicine, University of Athens, ‘Attikon’ University Hospital, Athens 12462, Greece
| | - Georgia Kostagianni
- Department of Otorhinolaryngology - Head and Neck Surgery, ‘Triassio’ General Hospital, Elefsina 19200, Greece
| | - Vassilis Achtsidis
- Department of Ophthalmology, Royal Cornwall Hospitals, Truro, Cornwall TR1 3LQ, UK
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), ‘Penteli’ Children's Hospital, Penteli 15236, Greece
| | - Marcos Calachanis
- Department of Paediatric Cardiology, ‘Penteli’ Children's Hospital, Penteli 15236, Greece
| | - Apostolos Zaravinos
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
| | - Anne Greenough
- Division of Asthma, Allergy and Lung Biology, King's College London, London SE5 9RS, UK
| | - Demetrios A. Spandidos
- Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
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Boulestreau R, Cremer A, Laine M, Gaillard P, Papaioannou G, Gosse P. Primary aldosteronism and left ventricle in 2D echocardiography: new insights. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30276-8] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Paschou E, Gavriilaki E, Papaioannou G, Tsompanakou A, Kalaitzoglou A, Sabanis N. Febuxostat hypersensitivity: another cause of DRESS syndrome in chronic kidney disease? Eur Ann Allergy Clin Immunol 2016; 48:251-255. [PMID: 27852432] [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: 06/06/2023]
Abstract
Febuxostat is a xanthine oxidase inhibitor that during the last years has successfully replaced allopurinol treatment in patients with chronic kidney disease (CKD) and hyperuricemia. Several adverse events have been observed during therapy with febuxostat. DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome induced by febuxostat has been poorly described, mainly in patient with CKD who previously developed allopurinol hypersensitivity syndrome. DRESS syndrome is characterized by manifold cutaneous reactions and systemic disorders with potential devastating consequences. The underlying pathogenetic mechanisms remain unidentified, though immune responses are often complicated. P-i concept can partially explain the phenomenon. The role of renal insufficiency appears to be crucial and further investigation is required. The present article describes the case of a CKD patient that developed febuxostat-related DRESS syndrome.
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Affiliation(s)
- E Paschou
- Department of General Practice and Family Medicine, General Hospital of Pella, Edessa, Greece. E-mail:
| | - E Gavriilaki
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Papaioannou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - A Tsompanakou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - A Kalaitzoglou
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Sabanis
- Department of Nephrology, General Hospital of Pella, Edessa, Greece
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Papadimitriou DT, Dermitzaki E, Papagianni M, Papaioannou G, Papaevangelou V, Papadimitriou A. Anastrozole plus leuprorelin in early maturing girls with compromised growth: the "GAIL" study. J Endocrinol Invest 2016; 39:439-46. [PMID: 26507391 PMCID: PMC4799269 DOI: 10.1007/s40618-015-0399-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 10/07/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE Aromatase inhibitors have been used to increase predicted adult height (PAH) in boys but in girls only in McCune-Albright syndrome. We investigated whether anastrozole combined with leuprorelin for up to 2 years is safe and effective in improving PAH in girls with early puberty and compromised growth, compared to leuprorelin alone. METHODS The "GAIL" study: girls treated with an aromatase inhibitor and an LHRH analogue, ISRCTN11469487, was a 7-year prospective phase IIa study with parallel design, performed at Athens Medical Center (C-A), and Attikon University Hospital, Athens, Greece (C-B). Forty girls, consecutively referred for early puberty (onset 7.5-9 years) with a PAH <-2 or >1.5 SD lower than their target height (TH), were included. Twenty started on leuprorelin sc/im 0.3 mg/kg/month plus anastrozole 1 mg/d p.o. (group-A, C-A) and 20 on leuprorelin (group-B, C-B) for 2 years or until the age of 10 years. Groups did not differ in age, height, BMI, bone age advancement (BAA), and distance of PAH from TH. Follow-up was at 6, 12, 18, and 24 m. RESULTS Reduction in BAA was significantly higher in group-A compared to group-B already by 6 m. Despite the transiently significant decrease in height velocity in group-A, gain in PAH SD was almost double by 12 and 18 m vs group-B and reached the maximum of +1.21 ± 0.45 (7.51 cm) vs +0.31 ± 0.37 (1.92 cm, p = 0.001) in group-B at 24 m. Group-A had no clinical or biochemical hyperandrogenism, unchanged normal bone density, and lumbar spine X-rays. CONCLUSION The co-administration of anastrozole with leuprorelin safely improves PAH in girls with compromised growth.
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Affiliation(s)
- D T Papadimitriou
- Department of Pediatric-Endocrinology and Diabetes, Athens Medical Center, 58, av. Kifissias, Maroussi, 15125, Athens, Greece.
- Third Department of Pediatrics, "Attikon" University Hospital, Haidari, 12462, Athens, Greece.
| | - E Dermitzaki
- Third Department of Pediatrics, "Attikon" University Hospital, Haidari, 12462, Athens, Greece
| | - M Papagianni
- Third Department of Pediatrics, Hippokrateion General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece
| | - G Papaioannou
- Department of Radiology, Mitera Maternity and Children's Hospital, Maroussi, 15123, Athens, Greece
| | - V Papaevangelou
- Third Department of Pediatrics, "Attikon" University Hospital, Haidari, 12462, Athens, Greece
| | - A Papadimitriou
- Third Department of Pediatrics, "Attikon" University Hospital, Haidari, 12462, Athens, Greece
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Gavriilaki E, Paschou E, Kalaitzoglou A, Papaioannou G, Sabanis N. B12 deficiency in chronic kidney disease: early recognition matters. Intern Med J 2015; 45:1195-6. [PMID: 26563692 DOI: 10.1111/imj.12892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/25/2015] [Indexed: 01/13/2023]
Affiliation(s)
- E Gavriilaki
- Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Paschou
- Medical School University of Thessaly, Larisa, Greece
| | - A Kalaitzoglou
- Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Papaioannou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit G. Papanicolaou Hospital, Thessaloniki, Greece
| | - N Sabanis
- Nephrology Department General Hospital of Pella, Edessa, Greece
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Kobayashi T, Papaioannou G, Mirzamohammadi F, Kozhemyakina E, Zhang M, Blelloch R, Chong M. Early postnatal ablation of the microRNA-processing enzyme, Drosha, causes chondrocyte death and impairs the structural integrity of the articular cartilage. Osteoarthritis Cartilage 2015; 23:1214-20. [PMID: 25707934 PMCID: PMC4470813 DOI: 10.1016/j.joca.2015.02.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/07/2015] [Accepted: 02/11/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In growth plate chondrocytes, loss of Dicer, a microRNA (miRNA)-processing enzyme, causes defects in proliferation and differentiation, leading to a lethal skeletal dysplasia. However roles of miRNAs in articular chondrocytes have not been defined in vivo. To investigate the role of miRNAs in articular chondrocytes and to explore the possibility of generating a novel mouse osteoarthritis (OA) model caused by intrinsic cellular dysfunction, we ablated Drosha, another essential enzyme for miRNA biogenesis, exclusively in articular chondrocytes of postnatal mice. DESIGN First, to confirm that the essential role of miRNAs in skeletal development, we ablated the miRNA biogenesis pathway by deleting Drosha or DGCR8 in growth plate chondrocytes. Next, to investigate the role of miRNAs in articular cartilage, we deleted Drosha using Prg4-CreER(T) transgenic mice expressing a tamoxifen-activated Cre recombinase (CreER(T)) exclusively in articular chondrocytes. Tamoxifen was injected at postnatal days, 7, 14, 21, and 28 to ablate Drosha. RESULTS Deletion of Drosha or DGCR8 in growth plate chondrocytes caused a lethal skeletal defect similar to that of Dicer deletion, confirming the essential role of miRNAs in normal skeletogenesis. Early postnatal Drosha deletion in articular chondrocytes significantly increased cell death and decreased Safranin-O staining. Mild OA-like changes, including surface erosion and cleft formation, were found in male mice at 6 months of age; however such changes in females were not observed even at 9 months of age. CONCLUSIONS Early postnatal Drosha deficiency induces articular chondrocyte death and can cause a mild OA-like pathology.
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Affiliation(s)
- T. Kobayashi
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA,Address correspondence and reprint requests to: T. Kobayashi, Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - G. Papaioannou
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - F. Mirzamohammadi
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - E. Kozhemyakina
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - M. Zhang
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA 02115, USA,Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - R. Blelloch
- The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, Center for Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - M.W. Chong
- Genomics and Immunology Laboratory, St. Vincent's Institute of Medical Research, and Department of Medicine, University of Melbourne, Fitzroy, VIC 3065, Australia
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29
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Maritsi D, Vartzelis G, Papaioannou G, Balani S, Zarganis D. AB1130 An unusual aspect of bartonellosis mimicking an autoimmune disease. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1128] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Kelaidi C, Sakellari I, Tzannou I, Liga M, Spyridonidis A, Tsirigotis P, Papaioannou G, Mallouri D, Batsis I, Karakasis D, Baltadakis I, Harhalakis N, Athanasiadou A, Anagnostopoulos A. P-213 Impact of individual cytogenetic abnormalities, IPSS-R karyotype and monosomal karyotype on outcomes after allogeneic HCT for MDS/sAML. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70260-1] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Papaioannou G, Kambas I, Tsaoussoglou M, Panaghiotopoulou-Gartagani P, Chrousos G, Kaditis AG. Age-dependent changes in the size of adenotonsillar tissue in childhood: implications for sleep-disordered breathing. J Pediatr 2013; 162:269-74.e4. [PMID: 22939928 DOI: 10.1016/j.jpeds.2012.07.041] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 05/14/2012] [Accepted: 07/18/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyze age-associated changes in linear and cross-sectional area (CSA) measurements of adenoid, tonsils, and pharyngeal lumen. STUDY DESIGN Measurements were completed in head magnetic resonance imaging examinations performed for diagnostic purposes. Linear and nonlinear regression models were applied to describe the effect of age on the size of soft tissues and upper airway. RESULTS Magnetic resonance imaging data were analyzed in 149 children without snoring (aged 0-15.9 years) and in 33 children with snoring (aged 1.6-15 years). In the children without snoring, adenoid size increased during the first 7-8 years of life and then decreased gradually [% (adenoid oblique width/mental spine-clivus length) = 11.38 + 1.52 (age) - 0.11 (age)(2), R(2) = 0.22, P < .01; adenoid CSA = 90.75 + 41.93 (age) - 2.47 (age)(2); R(2) = 0.50; P < .01]. Nasopharyngeal airway CSA increased slowly up to age 8 years and rapidly thereafter. Similar patterns were noted for the tonsils and oropharyngeal airway. In contrast, in children with snoring, adenoid and tonsils were large irrespective of age, and nasopharyngeal airway size increased slowly with age. CONCLUSIONS In children without snoring, growing adenotonsillar tissue narrows the upper airway lumen to variable degrees only during the first 8 years of life. In contrast, in children with snoring, appreciable pharyngeal lymphoid tissue enlargement is present during the preschool years and persists beyond the eighth birthday.
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Affiliation(s)
- Georgia Papaioannou
- Department of Radiology, Mitera Maternity and Children's Hospital, Athens, Greece
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Lefkou E, Adamidou D, Vasilakos K, Pleki A, Pleki S, Mamopoulos A, Daglis T, Papaioannou G, Mandala E. P-088 Inherited thrombophilia in women with stillbirths. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70134-8] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zellos A, Zarganis D, Ypsiladis S, Chatzis D, Papaioannou G, Bartsocas C. Malrotation of the intestine and chronic volvulus as a cause of protein-losing enteropathy in infancy. Pediatrics 2012; 129:e515-8. [PMID: 22271689 DOI: 10.1542/peds.2011-0937] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Protein-losing enteropathy in children is caused by intestinal metabolic, inflammatory, or infectious processes, or by lymphatic obstruction (intestinal lymphangiectasia). In this report, a 17-month-old child is presented with protein-losing enteropathy due to intestinal malrotation and chronic midgut volvulus causing lymphatic obstruction and spillage of lymph in the intestine and the peritoneum. This report should alert the pediatrician that intestinal malrotation should be added to the wide list of possible causes of protein-losing enteropathy in children.
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Affiliation(s)
- Aglaia Zellos
- First Department of Pediatrics, University of Athens School of Medicine, Athens, Greece.
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Papaioannou G, Koussidis G, Michala L. Magnetic resonance imaging visualization of a vaginal septum. Fertil Steril 2011; 96:1193-4. [DOI: 10.1016/j.fertnstert.2011.08.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 06/28/2011] [Accepted: 08/26/2011] [Indexed: 10/17/2022]
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Papaioannou G, Kitsara G, Athanasatos S. Impact of global dimming and brightening on reference evapotranspiration in Greece. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2010jd015525] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Papaioannou G, Mitrogiannis C, Nianios G, Fiedler G. Assessment of amputee socket–stump–residual bone kinematics during strenuous activities using Dynamic Roentgen Stereogrammetric Analysis. J Biomech 2010; 43:871-8. [DOI: 10.1016/j.jbiomech.2009.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 11/05/2009] [Accepted: 11/07/2009] [Indexed: 10/20/2022]
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Zezos P, Papaioannou G, Nikolaidis N, Patsiaoura K, Vassiliadis T, Mpoumponaris A, Giouleme O, Evgenidis N. Elevated markers of thrombin generation and fibrinolysis in patients with active and quiescent ulcerative colitis. Med Sci Monit 2009; 15:CR563-CR572. [PMID: 19865055] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Prothrombotic abnormalities within the coagulation system, the presence of microvascular thrombi in intestinal mucosa, and the increased risk of thromboembolic complications in patients with Inflammatory bowel disease, suggest that a hypercoagulable state may be an important contributing factor in disease pathogenesis. The activation of the coagulation system in a cohort of ulcerative colitis patients was investigated. MATERIAL/METHODS Markers of coagulation activation in blood (thrombin-antithrombin complex, TAT; prothrombin fragments 1 and 2, F1+2; and D-dimers) and markers of inflammation (erythrocyte sedimentation rate, ESR; C-reactive protein, CRP; and fibrinogen) were measured in 38 patients with active and 13 patients with long-standing quiescent ulcerative colitis. Disease activity was assessed by clinical, endoscopic, and histological criteria. The markers of coagulation activation were also measured in 28 healthy volunteers. RESULTS There were no differences in TAT, F1+2, and D-dimer plasma levels between active and inactive ulcerative colitis. D-dimer and F1+2 levels were significantly higher in the active ulcerative colitis patients than in the healthy controls. Plasma levels of TAT, F1+2, and D-dimers did not differ between inactive ulcerative colitis patients and healthy controls. However, both active and inactive ulcerative colitis patients had significantly higher proportions of elevated (above-normal) values of coagulation markers than the healthy controls. Correlation analyses revealed strong correlation between ESR, fibrinogen, and D-dimers, which also correlated with the severity and extent of ulcerative colitis. CONCLUSIONS A chronic low-grade activation of coagulation exists in ulcerative colitis, regardless of disease activity, and it might be implicated in disease pathogenesis.
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Affiliation(s)
- Petros Zezos
- Division of Gastroenterology, 2nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Pavlou P, Rallis M, Deliconstantinos G, Papaioannou G, Grando SA. In-vivo data on the influence of tobacco smoke and UV light on murine skin. Toxicol Ind Health 2009; 25:231-9. [PMID: 19651792 DOI: 10.1177/0748233709103209] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inhaled tobacco smoke comes in direct contact with few organs such as mouth, lungs, and stomach. Cigarette smoke (CS) in lungs has been extensively studied. However, limited data exist on its effect on skin, and there are no long-term experimental studies suggesting toxic effects on skin. Even though it is generally accepted that CS is among the main factors of skin aging, the number of experimental studies showing this aging effect is limited. We hereby studied the effect of long-term exposure to CS on the skin of hairless mice in combination with or without ultraviolet (UV) light. In addition, we investigated potential skin protection by a potent antioxidant namely procyanidine-rich French maritime pine bark extract (PBE) pycnogenol. Male and female hairless SKH-2 mice were exposed for 10 months to tobacco smoke and/or UV light in vivo, and their effects on skin were investigated. Some biophysical parameters such as development of erythema, transepidermal water loss (TEWL), and skin elasticity were measured. The results show that UV and CS may be acting synergistically, as shown by the enhanced TEWL, erythema values, epitheliomas, and squamous cell carcinomas (SCCs) observed, whereas PBE seems to protect skin against SCC.
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Affiliation(s)
- P Pavlou
- Laboratory of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
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Vandenhende M, Loizeau C, Michaux C, Lacoste D, Bernard N, Papaioannou G, Bonnet F, Morlat P. Le foramen ovale perméable, une complication méconnue des cardiopathies carcinoïdes. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.276] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Athanasiadou A, Papaioannou G, Batsis I, Iordanidis F, Kaloyannides P, Asteriou O, Anagnostopoulos A. P071 Derivative (1;7)(q10;p10) in two patients after autologous hematopoietic cell transplantation (AHCT). Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70151-1] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
‘Blastomas’ are tumors virtually unique to childhood. Controversy surrounds their nomenclature and there is no globally accepted classification. They are thought to arise from immature, primitive tissues that present persistent embryonal elements on histology, affect a younger pediatric population and are usually malignant. The ‘commoner’ blastomas (neuroblastoma, nephroblastoma, hepatoblastoma, medulloblastoma) account for approximately 25% of solid tumors in the pediatric age range. We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution. Although these rare types of blastomas individually account for <1% of pediatric malignancies, collectively they may be responsible for up to 5% of pediatric tumors in a given population of young children. Imaging is often non-specific but plays an important role in their identification, management and follow-up. Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.
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Affiliation(s)
- Georgia Papaioannou
- Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.
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Topalidou M, Dimopoulos P, Gakis D, Vasilakos K, Papadakis E, Papaioannou G. P48 The use of LMWH in multiple embryo unsuccessful implantations after in vitro fertilization. Thromb Res 2009. [DOI: 10.1016/s0049-3848(09)70093-3] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Topalidou M, Effraimidou S, Farmakiotis D, Papadakis E, Papaioannou G, Korantzis I, Garipidou V. Low protein Z levels, but not the intron F G79A polymorphism, are associated with unexplained pregnancy loss. Thromb Res 2008; 124:24-7. [PMID: 19026439 DOI: 10.1016/j.thromres.2008.09.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2008] [Revised: 08/22/2008] [Accepted: 09/27/2008] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The present case-control study was designed in order to investigate the association between plasma protein Z (PZ) levels, the intron F G79A polymorphism and unexplained pregnancy loss. MATERIALS AND METHODS 51 women with at least two consecutive or three non-consecutive fetal losses between the 8th and 12th week of gestation and 47 apparently healthy parous women of reproductive age with no history of pregnancy loss (controls) were enrolled. Allele frequencies of the PZ intron F G79A polymorphism and PZ levels were measured. RESULTS PZ levels (mg/L) were significantly lower in cases (mean +/- S.D. 1.28 +/- 0.56) than controls (1.97 +/- 0.76, p < 0.001) and in carriers of the A allele (1.46 +/- 0.62), compared to GG homozygous subjects (1.72 +/- 0.81, p = 0.044). A higher proportion of cases (41.2%) were PZ-deficient (<1 mg/L), compared to controls (10.6%, p = 0.001). No significant difference in the frequency of at least one A allele carriers was observed between cases (39.2%) and controls (40.4%). CONCLUSION(S) It is possible that low PZ levels are a novel risk factor for unexplained recurrent miscarriage or fetal death. The presence of the F 79A allele is associated with significantly lower PZ levels, but, in the present study, was unrelated to unexplained early pregnancy loss.
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Affiliation(s)
- Maria Topalidou
- Haemostasis Unit, Department of Haematology, Papageorgiou General Hospital, Thessaloniki, Greece
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Mitsiakos G, Papaioannou G, Papadakis E, Chatziioannidis E, Giougi E, Karagianni P, Evdoridou J, Malindretos P, Athanasiou M, Athanassiadou F, Nikolaidis N. Haemostatic profile of full-term, healthy, small for gestational age neonates. Thromb Res 2008; 124:288-91. [PMID: 18929397 DOI: 10.1016/j.thromres.2008.08.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Revised: 08/07/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Small for Gestational Age (SGA) neonates often appear with haemostatic alterations, principally due to hepatic dysfunction that results from chronic intrauterine hypoxia. Polycythaemia and thrombocytopenia are common findings in this neonatal population. STUDY DESIGN We performed a comparison of coagulation, natural inhibitors and fibrinolysis between SGA and Appropriate for Gestational Age (AGA) infants born full term [gestational age (G.A.) >37 weeks]. Study population consisted of 188 healthy newborns, 90 of whom were SGA (62 females and 28 males), while the rest were the control group (44 females and 54 males). Blood samples were obtained within 30 minutes following birth and before the administration of vitamin K. Investigation included: PT, INR, APTT, fibrinogen, coagulation factors II, V, VII, VIII, IX, X, XI, XII, vWillebrand factor, protein C and free protein S, antithrombin (AT), APCR, tPA and PAI-1. The independent t-test was used to compare the differences between the values of haemostatic parameters. RESULTS Statistical analysis revealed a significant prolongation in PT, INR, elevated levels of tPA (p<0.015, 0.01 and 0.002 respectively) and a decrease in the values of XII and free protein S (p<0.045 and 0.007 respectively) in SGA full term neonates. The two groups had similar demographic characteristics (except birth weight), without significant differences in the values of other haemostatic parameters. CONCLUSIONS Despite of statistically significant differences in PT, INR, values of tPA, XII and free protein S, levels of haemostatic factors range within laboratory references for healthy full term newborns. These findings were not accompanied with clinical manifestations of altered haemostasis.
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Affiliation(s)
- George Mitsiakos
- 2nd NICU and Nueonatology Department of Aristotle University of Thessaloniki, GPN Papageorgiou, Thessaloniki, Greece.
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Serasli E, Antoniadou M, Tsara V, Kalpakidis V, Megalopoulos A, Trellopoulos G, Papaioannou G, Christaki P. Successful management of acute thromboembolic disease complicated with heparin induced thrombocytopenia type II (HIT II): a case series. Thromb J 2008; 6:9. [PMID: 18597693 PMCID: PMC2467407 DOI: 10.1186/1477-9560-6-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 07/02/2008] [Indexed: 01/27/2023] Open
Abstract
Heparin-induced thrombocytopenia type II (HIT II) is a rare immune-mediated complication of heparin. The diagnosis of HIT is considered in patients exposed to heparin, presenting with thrombocytopenia and thrombosis. We present two cases with massive pulmonary embolism and HIT, successfully treated with the administration of fondaparinux, an alternative anticoagulant, combined with the insertion of an inferior vena cava filter for the prevention of new thromboembolic events. The two cases supplement the available data of the use of fondaparinux in patients with HIT and pulmonary embolism, before further large studies establish its efficacy and safety in this group of patients. Moreover, the management of these patients reveals the need for future evaluation of the combined therapy of alternative anticoagulant agents with the placement of vena cava filters.
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Affiliation(s)
- Eva Serasli
- 2nd Department of Chest Medicine, General Hospital G, Papanikolaou, Thessaloniki, Greece.
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Mitsiakos G, Giougi E, Papaioannou G, Karagianni P, Papadakis E, Nikolaidis N. Influence of smoking during pregnancy on haemostasis in healthy full term neonates. Thromb Res 2008; 123:476-81. [PMID: 18417192 DOI: 10.1016/j.thromres.2008.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 01/10/2008] [Accepted: 03/04/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Clinical and experimental researches have linked smoking to disturbances of coagulation and fibrinolysis. Several potential mechanisms are incriminated involving inflammation, fibrinogen synthesis and clotting factors. Based on the fact that the majority of tobacco components cross the placental barrier, the objective of our current study is to investigate the influence of smoking during pregnancy on neonatal haemostasis. STUDY DESIGN The study was based on a comparative evaluation of coagulation and fibronolysis between healthy full term infants of women who smoked during pregnancy and a control group. Subjects consisted of 39 newborns of smoking and 43 newborns of nonsmoking mothers. Blood samples were obtained shortly after birth and before the administration of vitamin K. Investigation included: PT, INR, aPTT, fibrinogen, coagulation factors II, V, VII, VIII, IX, X, XI, XII, vWillebrand (vWF), protein C and S, APCr, anti-thrombin (AT), t-PA and PAI-1. The independent t- test was used to compare the differences between the values of coagulation and fibrinolytic parameters at the p<0.05 level. RESULTS We discovered a statistically significant decrease in factor II and protein S levels and an elevation in t-PA and factor VIII concentrations in newborns of smoking mothers, without clinical manifestations of altered haemostasis. There were no significant differentiations in other coagulation or fibrinolytic parameters. CONCLUSION The alteration in factor II, protein S, t-PA and factor VIII in neonates exposed in utero to tobacco smoke is not accompanied by loss in the balance between coagulation and fibrinolytic pathways.
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Affiliation(s)
- George Mitsiakos
- Neonatology Department of Aristotle University of Thessaloniki, G.P.N. Papageorgiou, Thessaloniki, Greece.
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Zezos P, Papaioannou G, Nikolaidis N, Vasiliadis T, Giouleme O, Evgenidis N. Thrombophilic abnormalities of natural anticoagulants in patients with ulcerative colitis. Hepatogastroenterology 2007; 54:1417-21. [PMID: 17708267] [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: 05/16/2023]
Abstract
BACKGROUND/AIMS Ulcerative colitis patients have increased risk for thromboembolic events. Factors predisposing to thrombosis in ulcerative colitis are poorly defined. The aim of this study was to evaluate possible thrombophilic abnormalities in patients with ulcerative colitis. METHODOLOGY Fifty-one patients with ulcerative colitis and 51 healthy controls were studied. Disease activity, clinical and endoscopic, was assessed by standard criteria. Plasma levels of antithrombin, protein C, free protein S and activated protein C resistance were determined in both study groups. Genetic test for factor V Leiden was performed in cases with abnormal activated protein C resistance. Parameters of inflammation and fibrinogen were additionally measured in ulcerative colitis patients. RESULTS Mean values of free protein S were significantly lower in ulcerative colitis patients (84.01 +/- 21.57) compared to healthy controls (100.17 +/- 24.7) (p < 0.001). Mean values of protein C were higher in ulcerative colitis patients (124.6 +/- 39.03) than healthy controls (100.19 +/- 19.86) (p < 0.001). No other significant differences were observed, but there was a trend towards higher prevalence of low values for antithrombin (9.8% vs. 0%, p = 0.056) and free protein S (19.6% vs. 5.9%, p = 0.072) in ulcerative colitis patients. Three ulcerative colitis patients and three healthy controls had low activated protein C resistance ratio. All these subjects were heterozygous for factor V Leiden. No correlation was observed between abnormalities in thrombophilic parameters and clinical, endoscopic or inflammatory parameters in ulcerative colitis group. CONCLUSIONS Abnormalities in natural anticoagulants are more common in ulcerative colitis patients compared to healthy controls, irrespective of disease activity. Low activated protein C resistance ratio due to factor V Leiden is not more common in ulcerative colitis patients than in healthy controls.
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Affiliation(s)
- Petros Zezos
- Division of Gastroenterology, 2nd Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Greece.
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Papaioannou G, Papadakis E, Topalidou M, Braimi M, Korantzis I. SECONDARY THROMBOPHYLAXIS USING ANTIPLATELET AGENTS AND LONG TERM MONITORING AFTER 1ST UNPROVOKED EPISODE OF VENOUS THROMBOEMBOLISM. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02292.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
The introduction of multidetector row computed tomography (MDCT) scanners has altered the approach to imaging the paediatric thorax. In an environment where the rapid acquisition of CT data allows general hospitals to image children instead of referring them to specialist paediatric centres, it is vital that general radiologists have access to protocols appropriate for paediatric applications. Thus a dramatic reduction in the delivered radiation dose is ensured with optimal contrast bolus delivery and timing, and inappropriate repetition of the scans is avoided. This article focuses on the main principles of volumetric CT imaging that apply generically to all MDCT scanners. We describe the reconstruction techniques for imaging the paediatric thorax and the low-dose protocols used in our institution on a 16-slice detector CT scanner. Examples of the commonest clinical applications are also given.
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Affiliation(s)
- Georgia Papaioannou
- Radiology Department, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
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Papaioannou G, Chouliara I, Karatapanis AE, Kontominas MG, Savvaidis IN. Shelf-life of a Greek whey cheese under modified atmosphere packaging. Int Dairy J 2007. [DOI: 10.1016/j.idairyj.2006.04.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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