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Papadopoulos D.P.,Laiko General Hospital | Sanidas E.A.,Laiko General Hospital | Viniou N.A.,Laiko General Hospital | Gennimata V.,Laiko General Hospital | And 3 more authors.
Current Hypertension Reports | Year: 2015

Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes. © 2015, Springer Science+Business Media New York.


Dritsakou K.,Elena Venizelou Maternity Hospital | Liosis G.,Elena Venizelou Maternity Hospital | Valsami G.,National and Kapodistrian University of Athens | Polychronopoulos E.,National and Kapodistrian University of Athens | Skouroliakou M.,National and Kapodistrian University of Athens
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Objectives: To test the impact of specific maternal- and neonatal-associated factors on human milk's macronutrients and energy. Methods: This study was conducted with the use of a human milk analyzer (HMA, MIRIS, Uppsala, Sweden). Six hundred and thirty samples of raw milk and 95 samples of donor pasteurized milk were delivered from a total of 305 mothers. Results: A significant inverse correlation of fat, protein and energy content with gestational age and birth weight was established. Fat and energy were lower in colostrum, increased in transitional milk and decreased on the 30th day's mature milk compared to transitional. The rate of protein decline from colostrum to mature milk was lower in premature deliveries compared to that of full-terms, resulting in greater contents of protein in preterm mature milk. The upmost amounts of carbohydrates were found in mature milk of preterm deliveries. A positive correlation was found between maternal age and fat contents. In women with higher post-pregnancy BMI levels greater analogies of fat and energy were presented. In women suffering diet-controlled gestational diabetes (GD), lower protein and higher fat and energy levels were found. Conclusions: Prematurity, maternal age, diet-controlled GD and high post-pregnancy BMI levels were found to impose statistical significant effect on milk's macronutrients and energy. © 2016 Informa UK Limited, trading as Taylor & Francis Group.


Michalakis K.,Elena Venizelou Maternity Hospital | Ilias I.,Elena Venizelou Maternity Hospital | Triantafyllou A.,National and Kapodistrian University of Athens | Polymeris A.,Alexandra General Hospital | And 3 more authors.
Maturitas | Year: 2012

Introduction: Ideally, there will be reproducible markers easily and non-invasively available to test for malignancy, or alternative procedures when there is no accurate marker available. For prostate cancer, one of the most common cancers in men, levels of prostate-specific antigen (PSA) lack specificity and sensitivity for the determination of malignancy when they fall within a range of values termed the 'grey zone'. Objective: To examine the predictive value of sialic acid in prostate neoplasms. Study design: In our study of diagnostic accuracy we recruited 70 men complaining of urinary symptoms who presented in the urology department as outpatients or inpatients. All patients were checked with biopsy and pathology in order to relate benign and malignant lesions of the prostate to levels of sialic acid, a member of a family of acetylated products of neuraminic acid, which has so far proved to be a very sensitive and accurate marker of malignancy. Results: The sialic acid level was found to be elevated in patients with prostate cancer (mean 75.06 ± 10.4 mg/dl) and reduced in patients with benign prostate hyperplasia (mean 57.086 ± 8.7 mg/dl) (p < 0.01); it had a sensitivity of 86% and specificity of 84% in diagnosing malignancy. Conclusion: Sialic acid can be used as an adjunct in predicting prostate malignancy when PSA values fall in the grey zone. © 2012 Elsevier Ireland Ltd.


Dritsakou K.,Elena Venizelou Maternity Hospital | Liosis G.,Elena Venizelou Maternity Hospital | Valsami G.,National and Kapodistrian University of Athens | Polychronopoulos E.,National and Kapodistrian University of Athens | And 2 more authors.
Midwifery | Year: 2016

Objective: to compare hospital and health service usage costs of feeding low-birthweight (LBW) infants predominantly with their mother's milk, supplemented with donor milk, with donor milk and preterm formula. Design: prospective matching study. Setting: tertiary public perinatal centre, neonatal intensive care unit (NICU) and donor human milk bank. Participants: 100 LBW infants (Group I) fed predominantly with their mother's milk from the first hour of life, supplemented (mainly for the first week of life) with donor milk, were matched on a 1:1 basis with 100 LBW infants (Group II) who were fed with donor milk for the first 3 weeks of life followed by preterm formula until hospital discharge. Individualised targeted fortification of human milk was implemented in both study groups. Findings: the costs of hospitalisation, doctor visits and prescription drugs for viral infections until 8 months of age were calculated for each infant. Infants fed predominantly with their mother's milk had significantly shorter hospital stays and lower hospitalisation costs. In Group I infants, the duration of enteral gavage feeding was shorter, resulting in significantly lower costs. Up to 8 months of age, Group I infants experienced fewer episodes of viral infections, and the cost of each doctor visit and drug prescription was lower for these infants. Conclusions: feeding LBW infants predominantly with their mother's milk reduces hospital and health service usage costs. Implications for practice: feeding LBW infants predominantly with their mother's milk, supplemented with donor milk, followed by exclusive breast feeding seems to result in potential savings in hospital and health service usage costs. © 2016 Elsevier Ltd.


Papadopoulos D.,National and Kapodistrian University of Athens | Mourouzis I.,National and Kapodistrian University of Athens | Kotrotsou A.,National and Kapodistrian University of Athens | Papazachou U.,Elena Venizelou Maternity Hospital | And 3 more authors.
Clinical and Experimental Hypertension | Year: 2012

Prehypertension (PH) seems to be related to increased cardiovascular risk in healthy normotensive subjects, while essential hypertension is associated with hemostasis balance disturbances. The aim of our study was to examine the impact of PH on hemostasis parameters in healthy individuals with PH and to compare the findings with those of healthy normotensives with normal blood pressure (NBP) levels. This study was performed in 204 (96 M, 108 F) subjects who attended our hypertension clinic. Seventy-eight (36 M, 42 F) subjects with PH, mean age 52 ± 5 years, and body mass index (BMI) 23 ± 1.5 kg/m2 made up group A, and 126 (60 M, 66 F) subjects with NBP, mean age 53 ± 6 years, and BMI 23.2 ± 1.4 kg/m2 without any history of cardiovascular disease or diabetes mellitus made up group B. Systolic blood pressure and diastolic blood pressure were measured in three sequential visits, which were performed by the same trained nurse. Serum lipid levels, fibrinogen (F), thrombomodulin (TM), and plasminogen activator inhibitor-1 antigen, and tissue plasminogen activator antigen were determined in the whole population. Plasminogen activator inhibitor-1 antigen and tissue plasminogen activator antigen levels were significantly higher in the PH group as compared with normotensives, while in PH subjects, significantly higher plasma levels of F and TM were found compared with normotensive group. The two groups were matched for age, sex, BMI, and serum lipid levels. Our findings indicate that PH is associated with hemostasis disturbances predisposing to hypercoagulability and impaired fibrinolysis. This observation may be of prognostic value for future cardiovascular events in this group and needs further investigation. © 2012 Informa Healthcare USA, Inc.


Dritsakou K.,Elena Venizelou Maternity Hospital | Liosis G.,Elena Venizelou Maternity Hospital | Valsami G.,National and Kapodistrian University of Athens | Polychronopoulos E.,National and Kapodistrian University of Athens | Skouroliakou M.,National and Kapodistrian University of Athens
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Objectives: To investigate the benefits of treating low birth weight infants predominantly with mothers own raw milk and early initiation of breastfeeding (raw human milk/breast-fed infants), in comparison to feeding only with donor banked milk (until the third week of life) and afterwards a preterm formula until hospital discharge (donor banked/formula-fed infants).Methods: One hundred and ninety-two predominantly raw human milk-fed infants (70% of raw and 30% of donor milk) were matched to 192 donor/formula-fed ones (on 1:1 ratio). Aggressive nutrition policy and targeted fortification of human milk were implemented in both groups.Results: The two groups show similar demographic and perinatal characteristics. Predominantly raw milk-fed infants regained earlier their birth weight, suffered less episodes of feeding intolerance and presented a higher body length and head circumference at discharge (p < 0.001). Those treated mainly with their mothers milk were able to initiate breastfeeding almost 2 weeks earlier compared to those fed with donor milk who achieved to be bottle-fed later on post-conceptual age (p < 0.001). Infants being breastfed until the 8th month of life conducted less visits for a viral infection to a pediatrician compared to those in the other group (p < 0.001).Conclusions: Feeding predominantly with mothers raw milk seems to result in optimal neonatal outcomes. © 2015 Informa UK Ltd.


PubMed | Elena Venizelou Maternity Hospital and National and Kapodistrian University of Athens
Type: | Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | Year: 2016

To test the impact of specific maternal- and neonatal-associated factors on human milks macronutrients and energy.This study was conducted with the use of a human milk analyzer (HMA, MIRIS, Uppsala, Sweden). Six hundred and thirty samples of raw milk and 95 samples of donor pasteurized milk were delivered from a total of 305 mothers.A significant inverse correlation of fat, protein and energy content with gestational age and birth weight was established. Fat and energy were lower in colostrum, increased in transitional milk and decreased on the 30th days mature milk compared to transitional. The rate of protein decline from colostrum to mature milk was lower in premature deliveries compared to that of full-terms, resulting in greater contents of protein in preterm mature milk. The upmost amounts of carbohydrates were found in mature milk of preterm deliveries. A positive correlation was found between maternal age and fat contents. In women with higher post-pregnancy BMI levels greater analogies of fat and energy were presented. In women suffering diet-controlled gestational diabetes (GD), lower protein and higher fat and energy levels were found.Prematurity, maternal age, diet-controlled GD and high post-pregnancy BMI levels were found to impose statistical significant effect on milks macronutrients and energy.


PubMed | MITERA Paediatric Infirmary, Elena Venizelou Maternity Hospital, Indiana University and National and Kapodistrian University of Athens
Type: | Journal: Intensive & critical care nursing | Year: 2015

The objective of this study was to investigate the effect of relaxation techniques on the stress/anxiety of parents with hospitalised premature infants, three months following discharge from the neonatal intensive care unit.A randomised controlled trial was conducted in the neonatal intensive care unit of a tertiary maternity hospital including 59 parents, who were randomised into two groups: 31 in the intervention group and 28 in the control group. Parents in the intervention group practiced three different relaxation techniques, in addition to undergoing the same information-based training courses as did the parents of the control group.Data were collected 10-15 days post delivery and three months post discharge. The assessment measures included the Perceived Stress Scale, the State and Trait Anxiety Inventory 1 and 2 and salivary cortisol levels.The psychometric assessment at baseline was comparable between the two groups. The intervention group showed a significant reduction in trait anxiety (p=0.02) compared with the control group three months post discharge. The perceived stress decreased in both groups (p=0.699). No difference in salivary cortisol levels was detected. The multivariate analysis revealed that higher initial stress levels (p<0.001) and university/college education (p=0.003) were associated with higher parental stress, whereas moderate-to-high income satisfaction was associated with lower parental stress (p=0.003).Further long-term follow-up of families with a neonatal intensive care unit experience could assess more delayed effects of stress management by relaxation techniques.


PubMed | Elena Venizelou Maternity Hospital, National and Kapodistrian University of Athens and b Elena Venizelou Maternity Hospital
Type: Journal Article | Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | Year: 2016

To investigate the benefits of treating low birth weight infants predominantly with mothers own raw milk and early initiation of breastfeeding (raw human milk/breast-fed infants), in comparison to feeding only with donor banked milk (until the third week of life) and afterwards a preterm formula until hospital discharge (donor banked/formula-fed infants).One hundred and ninety-two predominantly raw human milk-fed infants (70% of raw and 30% of donor milk) were matched to 192 donor/formula-fed ones (on 1:1 ratio). Aggressive nutrition policy and targeted fortification of human milk were implemented in both groups.The two groups show similar demographic and perinatal characteristics. Predominantly raw milk-fed infants regained earlier their birth weight, suffered less episodes of feeding intolerance and presented a higher body length and head circumference at discharge (p < 0.001). Those treated mainly with their mothers milk were able to initiate breastfeeding almost 2 weeks earlier compared to those fed with donor milk who achieved to be bottle-fed later on post-conceptual age (p < 0.001). Infants being breastfed until the 8th month of life conducted less visits for a viral infection to a pediatrician compared to those in the other group (p < 0.001).Feeding predominantly with mothers raw milk seems to result in optimal neonatal outcomes.


Dritsakou K.,Elena Venizelou Maternity Hospital | Liosis G.,Elena Venizelou Maternity Hospital | Gioni M.,Elena Venizelou Maternity Hospital | Glynou E.,Elena Venizelou Maternity Hospital | And 2 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2015

Objective: Testing the validity of C-reactive protein (CRP) in extremely low birth weight (ELBW) infants. Methods: During a five-year period, 483 infants with probable (36%) and definite sepsis (64%) were enrolled in the study. Results: ELBW infants with definitive sepsis had CRP levels comparable with full-terms (p=0.992). However, the highest (hs) values were observed in infants >2500g, 24h after the septic work up whereas in those with birth weight (BW) <1000g after 48h. Highest CRP levels of infants with early sepsis were similar to those of the late onset ones (p=0.825). The causative microorganism had a strong influence on CRP values, as Gram negative germs produced significantly higher CRP levels in comparison to infants with Gram positive sepsis. Conclusions: Highest CRP values in <1000g infants increase in levels comparable to full terms, but with a 24-h delay. © 2014 Informa UK Ltd. All rights reserved.

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