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Ymittos Athens, Greece

Metabolic syndrome (MS) is a constellation of metabolic derangements associated with vascular endothelial dysfunction and oxidative stress and is widely regarded as an inflammatory condition, accompanied by an increased risk for cardiovascular disease. The present study tried to investigate the implications of telomerase activity with inflammation and impaired endothelial function in patients with metabolic syndrome. Telomerase activity in circulating peripheral blood mononuclear cells (PBMC), TNF-α, IL-6 and ADMA were monitored in 39 patients with MS and 20 age and sex-matched healthy volunteers. Telomerase activity in PBMC, TNF-α, IL-6 and ADMA were all significantly elevated in patients with MS compared to healthy volunteers. PBMC telomerase was negatively correlated with HDL and positively correlated with ADMA, while no association between TNF-α and IL-6 was observed. IL-6 was increasing with increasing systolic pressure both in the patients with MS and in the healthy volunteers, while smoking and diabetes were positively correlated with IL-6 only in the patients' group. In conclusion, in patients with MS characterised by a strong dyslipidemic profile and low diabetes prevalence, significant telomerase activity was detected in circulating PBMC, along with elevated markers of inflammation and endothelial dysfunction. These findings suggest a prolonged activity of inflammatory cells in the studied state of this metabolic disorder that could represent a contributory pathway in the pathogenesis of atherosclerosis.

Koutsokera A.,Amalia Fleming General Hospital | Kiagia M.,Oncology Unit GPP | Saif M.W.,Tufts University | Souliotis K.,Oncology Unit GPP | Syrigos K.N.,Oncology Unit GPP
Clinical Lung Cancer | Year: 2013

Lung cancer is the leading cause of cancer death worldwide. Because of high incidence rates and low survival rates, it is important to study the risk factors that may help prevent the disease from developing. It has been well established that cigarette smoking is the most important risk factor for lung cancer. Nonetheless it is likely that there are other modifiable risk factors that would assist in the prevention of lung cancer. Research on factors such as nutrition and physical activity and their influence on lung cancer has been carried out for nearly 3 decades. A systematic review in the MEDLINE database of published studies was conducted, focusing on systematic reviews, meta-analyses, and large prospective studies. The association between physical activity and lung cancer has been conflicting. Among the researched studies, 10 showed an inverse association, whereas 11 reported no association. A meta-analysis that was conducted from 1996 to October 2003 showed that leisure physical activity (LPA) prevents lung cancer. Data from 11 cohort and case-control studies showed an inverse relationship between fruit and vegetable consumption and lung cancer. Evidence from case-control studies suggests a positive association between meat intake and risk of lung cancer, although several more recent studies have presented doubts about these findings. The possible association of physical activity, nutrition, and the risk of lung cancer development remains controversial. Further prospective studies should be conducted to determine the potential influence of these 2 risk factors. © 2013 Elsevier Inc.

Tsarouhas K.,Amalia Fleming General Hospital
European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology | Year: 2011

Few studies have addressed the impact of moderate unsupervised everyday physical activity in patients with chronic heart failure (CHF). We investigated the effects of a 12-week walking programme as the sole exercise intervention on heart rate recovery (HRR), index of the autonomic system equilibrium, serum modulators of endothelial function (i.e. asymmetric dimethylarginine (ADMA) and homocysteine), markers of inflammation and oxidative stress and quality of life measures (i.e. SF-36 and the Zung depression scale) in CHF patients. Twenty-eight stabilized CHF patients of ΝYHΑ class II and III volunteered to participate either in the exercise (n = 18) or in the non-exercise (n = 10) groups. Ten age-matched healthy volunteers provided reference values. The exercise programme consisted of unsupervised 40-minute walking for five days per week. Repeated measures ANOVA revealed significant improvements in HRR (p < 0.001) in the exercise patients compared to their non-exercise counterparts. ADMA levels in CHF patients at baseline were found higher than the healthy reference volunteers (p < 0.03), while a decrease in ADMA levels after walking was associated with HRR changes (r = 0.74, p = 0.007). Homocysteine levels both at baseline and at the end of the walking intervention decreased in the exercise group, but were still higher than in the healthy individuals. Average walking distance positively correlated with homocysteine decrease (p < 0.05). Total SF-36 score significantly improved (p < 0.02) mainly due to enhancements in the physical component score (p < 0.026). A 12-week unsupervised walking programme exhibits a pronounced HRR amelioration, possibly attenuates endothelial damage and induces a concomitant improvement in perceived quality of life in CHF patients.

Loukides S.,National and Kapodistrian University of Athens | Bartziokas K.,Amalia Fleming General Hospital | Vestbo J.,University of Southern Denmark | Singh D.,University of Manchester
Current Drug Targets | Year: 2013

Inflammation plays a central role in chronic obstructive pulmonary disease (COPD). COPD related inflammation is less responsive to inhaled steroids compared to asthma. There are three major novel anti-inflammatory approaches to the management of COPD. The first approach is phosphodiesterase inhibitors, such as roflumilast which provides additional clinical benefit either as a single agent or as an additive treatment to long-acting bronchodilators. The second approach involves novel strategies using drugs licensed for other indications, such as statins and macrolides; limited prospective studies on these strategies exist at the moment. A third potential approach involves novel agents whose mechanism of action is closely related to COPD mechanisms and pathophysiology. Such novel treatments are of great interest since they may treat both COPD and co-morbidities. Several novel agents are currently under development and may be of importance in the future. © 2013 Bentham Science Publishers.

Sgourakis G.,Red Cross | Dedemadi G.,Amalia Fleming General Hospital
World Journal of Gastroenterology | Year: 2014

Thirty-six randomized controlled trials and two meta-analyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation (OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroid-free groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT. © 2014 Baishideng Publishing Group Inc. All rights reserved.

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