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Machairiotis N, Ntali G, Kouroutou P, Michala L. Clinical evidence of the effect of bisphosphonates on pregnancy and the infant. Horm Mol Biol Clin Investig 2019; 40:/j/hmbci.ahead-of-print/hmbci-2019-0021/hmbci-2019-0021.xml. [DOI: 10.1515/hmbci-2019-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/18/2019] [Indexed: 01/05/2023]
Abstract
Abstract
Bisphosphonates (BPs) are potent inhibitors of osteoclast mediated bone resorption. These drugs are widely used in the management of osteoporosis and other diseases, characterized by high bone turnover. The effect of BPs on gestation and lactation, when they are used as therapeutic agents in premenopausal women, is yet unknown. We conducted a detailed literature review and identified the cases of BPs use in young women, as well as, the effects of this therapy on the gestation and the embryo. The published data, regarding the use of BPs in premenopausal women and their effects on the pregnancy outcome, are limited. However, we could identify the outcomes of 40 pregnant women, who had received BPs prior to or during pregnancy, that have been documented in the literature. All women had valid indications to receive BPs for serious bone metabolism conditions. We could not identify any prospective trials, which focus on pregnancy outcomes following after the in-utero exposure to BPs. In total, no serious adverse effects were reported. Problems related to the offspring, such as hypocalcemia and a tendency for low body weight (LBW), were self-resolving. In addition, no serious adverse outcomes were reported for women having completed pregnancy. Nevertheless, follow-up was limited for both outcomes suggesting the necessity of national and international registries.
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Machairiotis N, Stylianaki A, Kouroutou P, Sarli P, Alexiou NK, Efthymiou E, Maras A, Alexiou NG, Nikolaou SE, Courcoutsakis N, Papakonstantinou E, Zarogoulidis P, Barbetakis N, Paliouras D, Gogakos A, Machairiotis C. Massive ovarian oedema: a misleading clinical entity. Diagn Pathol 2016; 11:18. [PMID: 26843454 PMCID: PMC4739401 DOI: 10.1186/s13000-016-0469-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 12/10/2015] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
Background Massive ovarian oedema is a rare non-neoplastic clinicopathologic entity has a higher incidence in women during their second and third life decade. The oedema can be presented in one or both ovaries as a result of partial intermittent torsion of the ovarian pedicle that interferes to the venal and lymphatic drainage of the ovary. Case presentation We present a clinical case of a 16 year old with massive ovarian oedema and we performed a review of the literature. The pathophysiology of this entity is very complex. We tried to perform a complete review of the literature and focus on the complexity of this entity as far as its pathophysiological backround is concerned and as far as its clinical presentation is concerned. Conclusions In conclusion, massive ovarian oedema is a rare, multi disease mimicking clinical entity, with an acute or progressive clinical presentation. It has also to be a part of our differential diagnosis in cases of acute abdominal pain and we have to try to treat her conservatively, in order to preserve fertility.
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Affiliation(s)
- Nikolaos Machairiotis
- Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Aikaterini Stylianaki
- Trauma Surgery Department, " Centre Hospitalier de Luxembourg", General Hospital of Luxemburg, 4 Rue de Marble, Luxembourg, Belgium
| | - Paraskevi Kouroutou
- 1st Internal Medicine Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Polixeni Sarli
- Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | | | - Elias Efthymiou
- Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Athanasios Maras
- Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Nikolaos Georgios Alexiou
- 1st Internal Medicine Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Spyridon Evaggelos Nikolaou
- 1st Internal Medicine Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Nikolaos Courcoutsakis
- Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Dragana, Greece
| | - Eleni Papakonstantinou
- Pathology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Dimitrios Paliouras
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Apostolos Gogakos
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Christodoulos Machairiotis
- Obstetric - Gynecology Department, "Thriassio" General Hospital of Athens, George Genimata, 19600, Athens, Greece
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Machairiotis N, Stylianaki A, Dryllis G, Zarogoulidis P, Kouroutou P, Tsiamis N, Katsikogiannis N, Sarika E, Courcoutsakis N, Tsiouda T, Gschwendtner A, Zarogoulidis K, Sakkas L, Baliaka A, Machairiotis C. Extrapelvic endometriosis: a rare entity or an under diagnosed condition? Diagn Pathol 2013; 8:194. [PMID: 24294950 PMCID: PMC3942279 DOI: 10.1186/1746-1596-8-194] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [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: 11/15/2013] [Accepted: 11/23/2013] [Indexed: 12/16/2022] Open
Abstract
Endometriosis is a clinical entity characterized by the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. Endometriosis can be either endopelvic or extrapelvicdepending on the location of endometrial tissue implantation. Despite the rarity of extrapelvic endometriosis, several cases of endometriosis of the gastrointestinal tract, the urinarytract, the upper and lower respiratory system, the diaphragm, the pleura and the pericardium, as well as abdominal scars loci have been reported in the literature. There are several theories about the pathogenesis and the pathophysiology of endometriosis. Depending on the place of endometrial tissue implantation, endometriosis can be expressed with a wide variety of symptoms. The diagnosis of this entity is neither easy nor routine. Many diagnostic methods clinical and laboratory have been used, but none of them is the golden standard. The multipotent localization of endometriosis in combination with the wide range of its clinical expression should raise the clinical suspicion in every woman with periodic symptoms of extrapelvic organs. Finally, the therapeutic approach of this clinical entity is also correlated with the bulk of endometriosis and the locum that it is found. It varies from simple observation, to surgical treatment and treatment with medication as well as a combination of those.
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Affiliation(s)
| | | | | | - Paul Zarogoulidis
- Pulmonary Department, "G, Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Exohi 1100, 57010 Thessaloniki, Greece.
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Linos A, Petralias A, Christophi CA, Christoforidou E, Kouroutou P, Stoltidis M, Veloudaki A, Tzala E, Makris KC, Karagas MR. Oral ingestion of hexavalent chromium through drinking water and cancer mortality in an industrial area of Greece--an ecological study. Environ Health 2011; 10:50. [PMID: 21609468 PMCID: PMC3123268 DOI: 10.1186/1476-069x-10-50] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 05/24/2011] [Indexed: 05/21/2023]
Abstract
BACKGROUND Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance. METHODS We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population. RESULTS A total of 474 deaths were observed. The SMR for all cause mortality was 98 (95% CI 89-107) and for all cancer mortality 114 (95% CI 94-136). The SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value < 0.001). Furthermore, statistically significantly higher SMRs were identified for lung cancer (SMR = 145, 95% CI 100-203, p-value = 0.047) and cancer of the kidney and other genitourinary organs among women (SMR = 368, 95% CI 119-858, p-value = 0.025). Elevated SMRs for several other cancers were also noted (lip, oral cavity and pharynx 344, stomach 121, female breast 134, prostate 128, and leukaemias 168), but these did not reach statistical significance. CONCLUSIONS Elevated cancer mortality in the Oinofita area of Greece supports the hypothesis of hexavalent chromium carcinogenicity via the oral ingestion pathway of exposure. Further studies are needed to determine whether this association is causal, and to establish preventive guidelines and public health recommendations.
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Affiliation(s)
- Athena Linos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, 7 Fragoklisias str., Maroussi, 15125, Greece
| | - Athanassios Petralias
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, 7 Fragoklisias str., Maroussi, 15125, Greece
- Department of Statistics, Athens University of Economics and Business, 76 Patission str., Athens, 10434, Greece
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Eirinis 95 str., Limassol, 3041, Cyprus
- Department of Environmental Health, Harvard School of Public Health, 401 Park Drive str., Boston, MA, 02215, USA
- The Biostatistics Center, George Washington University, 6110 Executive Boulevard, Rockville, MD, 20852, USA
| | - Eleni Christoforidou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
| | - Paraskevi Kouroutou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
| | - Melina Stoltidis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
| | - Afroditi Veloudaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str., Athens, 11527, Greece
- Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, 7 Fragoklisias str., Maroussi, 15125, Greece
| | - Evangelia Tzala
- Hellenic Cancer Registry, Hellenic Centre for Disease Control & Prevention, 3-5 Agrafon str., Maroussi, 15123, Greece
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Eirinis 95 str., Limassol, 3041, Cyprus
- Department of Environmental Health, Harvard School of Public Health, 401 Park Drive str., Boston, MA, 02215, USA
| | - Margaret R Karagas
- Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, Dartmouth Medical School, 1 Medical Center Drive, Hanover, NH, 03756, USA
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