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Mavrogeni S.,Onassis Cardiac Surgery Center | Papadopoulos G.,Aglaia Kyriakou Childrens Hospital | Hussain T.,King's College London | Hussain T.,Evelina Childrens Hospital | And 4 more authors.
International Journal of Cardiovascular Imaging | Year: 2013

Kawasaki disease (KD) is a vasculitis affecting the coronary and systemic arteries. Myocardial inflammation is also a common finding in KD post-mortem evaluation during the acute phase of the disease. Coronary artery aneurysms (CAAs) develop in 15-25 % of untreated children. Although 50-70 % of CAAs resolve spontaneously 1-2 years after the onset of KD, the remaining unresolved CAAs can develop stenotic lesions at either their proximal or distal end and can develop thrombus formation leading to ischemia and/or infarction. Cardiovascular magnetic resonance (CMR) has the ability to perform non-invasive and radiation-free evaluation of the coronary artery lumen. Recently tissue characterization of the coronary vessel wall was provided by CMR. It can also image myocardial inflammation, ischemia and fibrosis. Therefore CMR offers important clinical information during the acute and chronic phase of KD. In the acute phase, it can identify myocardial inflammation, microvascular disease, myocardial infarction, deterioration of left ventricular function, changes of the coronary artery lumen and changes of the coronary artery vessel wall. During the chronic phase, CMR imaging might be of value for risk stratification and to guide treatment. © 2013 Springer Science+Business Media Dordrecht.


Mavrogeni S.,Onassis Cardiac Surgery Center | Papadopoulos G.,Aglaia Kyriakou Childrens Hospital | Papadopoulos G.,Aghia Sophia Childrens Hospital | Karanasios E.,Aglaia Kyriakou Childrens Hospital | And 4 more authors.
International Journal of Cardiology | Year: 2010

Abnormal cardiovascular magnetic resonance findings were found in a patient with microscopic polyangiitis and a patient with Kawasaki disease that presented without overt clinical cardiovascular manifestations. © 2008 Elsevier Ireland Ltd. All rights reserved.


Mavrogeni S.,Onassis Cardiac Surgery Center | Smerla R.,Aglaia Kyriakou Childrens Hospital | Grigoriadou G.,Aglaia Kyriakou Childrens Hospital | Servos G.,Aglaia Kyriakou Childrens Hospital | And 6 more authors.
Lupus | Year: 2016

Objectives: To evaluate the cardiovascular magnetic resonance (CMR) findings in a paediatric population with systemic lupus erythematosus (SLE) and cardiac symptoms. Methods: Twenty-five SLE children, aged 10.2 ± 2.6 years, with cardiac symptoms and normal routine non-invasive evaluation were examined by CMR, using a 1.5 T system and compared with sex-matched SLE adults. Left ventricular (LV) volumes, ejection fraction, T2 ratio, early (EGE) and late (LGE) gadolinium enhancement were assessed. Acute and chronic lesions were characterised as LGE-positive plus T2 > 2, EGE > 4 or T2 < 2, EGE < 4, respectively. According to LGE, lesions were characterized as: (a) diffuse subendocardial, (b) subepicardial and (c) subendocardial/transmural, due to vasculitis, myocarditis and myocardial infarction, respectively. Results: LV ejection fraction (LVEF) was normal in all SLEs. T2 > 2, EGE > 4 and positive epicardial LGE wall was identified in 5/25 children. Diffuse subendocardial fibrosis was documented in 1/25. No evidence of myocardial infarction was identified in any children. In contrast, in SLE adults, LGE indicative of myocardial infarction was identified in 6/25, myocarditis in 3/25, Libman-Sacks endocarditis in 1/25 and diffuse subendocardial fibrosis in 2/25. The incidence of heart disease in SLE children was lower compared to SLE adults (p < 0.05), with a predominance of myocarditis in children and myocardial infarction in adults. A significant correlation was documented between disease duration and CMR lesions (p < 0.05). Conclusion: CMR identifies a predominance of myocarditis in paediatric SLE with cardiac symptoms and normal routine non-invasive evaluation. However, the incidence of cardiac lesions is lower compared to SLE adults, probably due to shorter disease duration. Significance and Innovation: CMR identifies heart involvement in a significant percentage of SLE children with cardiac symptoms and normal routine noninvasive evaluation. The incidence of heart disease is lower in SLE children compared with SLE adults. Predominance of myocarditis and myocardial infarction is observed in SLE children and SLE adults, respectively. © The Author(s) 2015.


PubMed | Agia Sophia Childrens Hospital, Onassis Cardiac Surgery Center, Aglaia Kyriakou Childrens Hospital, Athens Naval Hospital and National and Kapodistrian University of Athens
Type: Journal Article | Journal: Lupus | Year: 2016

To evaluate the cardiovascular magnetic resonance (CMR) findings in a paediatric population with systemic lupus erythematosus (SLE) and cardiac symptoms.Twenty-five SLE children, aged 10.2 2.6 years, with cardiac symptoms and normal routine non-invasive evaluation were examined by CMR, using a 1.5 T system and compared with sex-matched SLE adults. Left ventricular (LV) volumes, ejection fraction, T2 ratio, early (EGE) and late (LGE) gadolinium enhancement were assessed. Acute and chronic lesions were characterised as LGE-positive plus T2 > 2, EGE > 4 or T2 < 2, EGE < 4, respectively. According to LGE, lesions were characterized as: (a) diffuse subendocardial, (b) subepicardial and (c) subendocardial/transmural, due to vasculitis, myocarditis and myocardial infarction, respectively.LV ejection fraction (LVEF) was normal in all SLEs. T2 > 2, EGE > 4 and positive epicardial LGE wall was identified in 5/25 children. Diffuse subendocardial fibrosis was documented in 1/25. No evidence of myocardial infarction was identified in any children. In contrast, in SLE adults, LGE indicative of myocardial infarction was identified in 6/25, myocarditis in 3/25, Libman-Sacks endocarditis in 1/25 and diffuse subendocardial fibrosis in 2/25. The incidence of heart disease in SLE children was lower compared to SLE adults (p < 0.05), with a predominance of myocarditis in children and myocardial infarction in adults. A significant correlation was documented between disease duration and CMR lesions (p < 0.05).CMR identifies a predominance of myocarditis in paediatric SLE with cardiac symptoms and normal routine non-invasive evaluation. However, the incidence of cardiac lesions is lower compared to SLE adults, probably due to shorter disease duration.CMR identifies heart involvement in a significant percentage of SLE children with cardiac symptoms and normal routine noninvasive evaluation.The incidence of heart disease is lower in SLE children compared with SLE adults.Predominance of myocarditis and myocardial infarction is observed in SLE children and SLE adults, respectively.


Papadimitriou M.,Aglaia Kyriakou Childrens Hospital | Voulgari E.,National and Kapodistrian University of Athens | Ranellou K.,National and Kapodistrian University of Athens | Koemtzidou E.,Aglaia Kyriakou Childrens Hospital | And 2 more authors.
Microbial Drug Resistance | Year: 2011

A carbapenem-resistant Escherichia coli isolate was recovered from rectal swab of a 12-day-old female neonate, which was admitted to a Greek neonatal intensive care unit (NICU). Phenotypic testing, polymerase chain reaction assays with sequencing, and plasmid analysis revealed that the isolate harbored a plasmid-mediated bla VIM-1 metallo-β-lactamase gene. The appearance of a metallo-β-lactamase-producing E. coli in NICU is worrisome. Further surveys are needed to determine whether such Enterobacteriaceae may also be spreading in other NICUs. Copyright © 2011, Mary Ann Liebert, Inc.


Arzoglou V.,Aristotles University Hospital of Thessaloniki | D'Angelo L.,Catholic University Hospital of Rome Agostino Gemelli | Koutzoglou M.,Aglaia Kyriakou Childrens Hospital | Rocco C.D.,Catholic University Hospital of Rome Agostino Gemelli
Neurosurgery | Year: 2011

BACKGROUND AND IMPORTANCE: We report a unique case of a toddler (the only one reported) successfully operated on for a medulla oblongata abscess and comment on the influence of neuroimaging modalities in the preoperative planning of the surgical approach. CLINICAL PRESENTATION: We report a case of a 20-month-old child with a solitary medulla oblongata abscess. The abscess appeared to be in close proximity to the anterior medulla oblongata, but preoperative planning based on diffusion tensor imaging (DTI) tractography motivated us to try to remove this lesion through a midline suboccipital approach. The ventral medulla oblongata abscess was surgically removed via a telovelar approach. At the anterior wall of the 4th ventricle, a fenestration was made with pus release and evacuation of the cavity. The child was discharged 1 week later with an uneventful and full recovery. CONCLUSION: Modern imaging modalities of the nervous system can be very helpful in preoperative planning. Functional visualization of the nervous system provided by modern imaging techniques, such as the DTI tractography, can alter the classic topographic concept of surgical approach. In the case presented, approaching an anterior medulla oblongata abscess based on DTI tractography data, through a suboccipital midline transventricular approach, proved to be an effective and safe technique. Copyright © 2011 by the Congress of Neurological Surgeons.


Petersen M.B.,Sophia Genetics | Grigoriadou M.,Sophia Genetics | Koutroumpe M.,Aglaia Kyriakou Childrens Hospital | Kokotas H.,Sophia Genetics
International Journal of Pediatric Otorhinolaryngology | Year: 2012

Non-syndromic hearing loss is one of the most common hereditary determined diseases in human, and the disease is a genetically heterogeneous disorder. Mutations in the GJB2 gene, encoding connexin 26 (Cx26), are a major cause of non-syndromic recessive hearing impairment in many countries and are largely dependent on ethnic groups. Due to the high frequency of the c.35delG GJB2 mutation in the Greek population, we have previously suggested that Greek patients with sensorineural, non-syndromic deafness should be tested for the c.35delG mutation and the coding region of the GJB2 gene should be sequenced in c.35delG heterozygotes. Here we present on the clinical and molecular genetic evaluation of a family suffering from prelingual, sensorineural, non-syndromic deafness. A novel c.247_249delTTC (p.F83del) GJB2 mutation was detected in compound heterozygosity with the c.35delG GJB2 mutation in the proband and was later confirmed in the father, while the mother was homozygous for the c.35delG GJB2 mutation. We conclude that compound heterozygosity of the novel c.247_249delTTC (p.F83del) and the c.35delG mutations in the GJB2 gene was the cause of deafness in the proband and his father. © 2012 Elsevier Ireland Ltd.


Mammas I.N.,University of Crete | Sourvinos G.,University of Crete | Vakonaki E.,University of Crete | Giamarelou P.,Aglaia Kyriakou Childrens Hospital | And 2 more authors.
European Journal of Pediatrics | Year: 2010

Introduction: Recurrent respiratory papillomatosis (RRP) is characterized by the presence of benign virally induced tumors of the larynx and respiratory epithelium that may obstruct the airway and tend to recur frequently. RRP is caused by the human papilloma virus (HPV), most frequently by HPV types 6 and 11. In this study, we present four cases of children with RRP in whom HPVs other than HPV-6 or HPV-11 were found. Material and methods: In all four cases, HPV typing was performed by polymerase chain reaction (PCR) followed by restriction digestion (RFLP) in biopsy samples collected during surgery. Results: In the first case, simultaneous HPV infection with types 13 and 39 was detected, while in the second case HPV-40 and HPV-56 were found. In cases 3 and 4, the biopsy samples were positive for unidentified 'low-risk' HPVs. Conclusions: The presence of novel HPV genotypes in children with RRP emphasizes the need for further investigation of the implication of these genotypes in the disease. © 2010 Springer-Verlag.


Mammas I.N.,University of Crete | Sourvinos G.,University of Crete | Giamarelou P.,Aglaia Kyriakou Childrens Hospital | Michael C.,Aglaia Kyriakou Childrens Hospital | Spandidos D.A.,University of Crete
International Journal of STD and AIDS | Year: 2012

Our study aimed to examine the relationship between the presence of human papillomavirus (HPV) in the oral cavity of children and their mode of delivery. We investigated the presence of HPV infection in oral biopsies from 190 children (mean age: 7 years, range: 2-14 years) using the polymerase chain reaction (PCR) technique. Sixteen of 190 children (8.4%) were HPV-positive, with no significant difference between those delivered vaginally and by Caesarean section (C-section). The majority of the HPVpositive children were infected with type 16, whereas in the younger age group HPV type 11 was detected more frequently in children delivered by normal vaginal delivery (NVD) than by C-section. Our findings demonstrate the presence of HPV in the oral cavity of children delivered by both C-section as well as NVD. Further research on the possible modes of transmission of oral HPV infection will enable us to understand the natural history of HPV infection in childhood.


PubMed | Aglaia Kyriakou Childrens Hospital
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

9569 Background: Our objective was to analyze the clinical and demographic characteristics of children with B-cell lymphoma treated in a single centre in Athens-Greece over the last two decades.Data were collected by a retrospective review of the charts of all 85 patients (pts) treated to our unit, from 1989 until end of 2009, according to FAB LMB 89, 96 protocols and 2003 modifications. We studied the therapeutic outcome in correlation with their diagnostic group, age at diagnosis, site of disease, response to initial prophase chemo (CT) and status of disease at reevaluation point.15 pts were excluded due to insufficient data. For the remaining 70 pts the median age was 7.5 years, with a male predominance 3.8:1. According to LMB staging criteria, 6 pts (8.6 %) were classified as Group A, 52 (74.3%) as Group B and 12 (17 %) as Group C all with bone marrow involvement and in 5 combined with CNS involvement. Most of our pts (43/70 - 61.4%) had abdominal tumours, 11 in ENT region, 3 in bones, 4 with cervical disease and 9 had more than one involved sites. 10 of the 58 children of A and B Group (16.3%) were upgraded to Group C due to poor response to initial CT treatment with CycloOncovinPrednizone (COP) or remaining viable tumor at the point of remission assessment after 4 cycles of CT. Regarding outcome 10 pts died (15%), 7 due to progression, 3 due to toxicity, 2 in induction and 1 post autograft. Relapse occurred in 9 children (13%), all with abdominal disease, one of them with concurrent thoracic involvement. Most relapsed patients (7/9) were initially treated as Group B (7/52, 14%), 1 as C and 1 as Group A. The outcome of relapsed children was dismal as 6/9 (67%) died, four initially classified as Group B.In our results, the survival rate is generally excellent (85 %) more than one year off treatment which generally means cure in Burkitt like lymphomas. Children from Group B with unsatisfactory initial response to COP seem to have the worse prognosis.

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