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Papadopoulos D.P.,National and Kapodistrian University of Athens | Mourouzis I.,National and Kapodistrian University of Athens | Thomopoulos C.,Helena Venizelou Maternity Hospital | Makris T.,Helena Venizelou Maternity Hospital | Papademetriou V.,Georgetown University
Blood Pressure | Year: 2010

Hypertensive crises (76% urgencies, 24% emergencies) represented more than one fourth of all medical urgencies/emergencies. Hypertensive urgencies frequently present with headache (22%), epistaxis (17%), faintness, and psychomotor agitation (10%) and hypertensive emergencies frequently present with chest pain (27%), dyspnea (22%) and neurological deficit (21%). Types of end-organ damage associated with hypertensive emergencies include cerebral infarction (24%), acute pulmonary edema (23%) and hypertensive encephalopathy (16%), as well as cerebral hemorrhage (4.5%). The most important factor that limits morbidity and mortality from these disorders is prompt and carefully considered therapy. Unfortunately, hypertensive emergencies and urgencies are among the most misunderstood and mismanaged of acute medical problems seen today. The primary goal of intervention in a hypertensive crisis is to safely reduce BP. Immediate reduction in BP is required only in patients with acute end-organ damage (i.e. hypertensive emergency). This requires treatment with a titratable short-acting intravenous (IV) antihypertensive agent, while severe hypertension with no acute end-organ damage is usually treated with oral antihypertensive agents. Patients with hypertensive emergencies are best treated in an intensive care unit (ICU) with titratable IV hypotensive agents. The aim of this review is to summarize the details regarding the definition-impact, causes, clinical condition and management of hypertensive crises. © 2010 Scandinavian Foundation for Cardiovascular Research.


Voskakis I.,Helena Venizelou Maternity Hospital | Tsekoura C.,Helena Venizelou Maternity Hospital | Keramitsoglou T.,Helena Venizelou Maternity Hospital | Tsantoulas E.,Helena Venizelou Maternity Hospital | And 3 more authors.
American Journal of Reproductive Immunology | Year: 2016

Problem: Vγ9Vδ2 T cells (γ9δ2) are involved in antibacterial immune responses. The aim of this study was to look for associations between peripheral blood (PB) γ9δ2 T cells and cervix/vaginal Chlamydia trachomatis (Ct) infection in women with recurrent spontaneous abortions (RSA). Method of study: Peripheral blood samples were obtained from 201 RSA women within 10 days after they experienced a new miscarriage. γ9δ2 T cells and their percentage in total γδ T cells were compared between women who had been found and women who had not been found infected with Ct (last 6 months). Fertile women (82) served as control subjects. Results: The difference of mean percentages of γ9δ2 T cells between the abortion and control groups, and the Chlamydia (+) and Chlamydia (−) groups was highly statistically significant (P<.00001). Significant difference was also found between the Chlamydia (+) and Chlamydia (−) group and the control group (ANOVA). Conclusion: The measurement of γ9δ2T cells may be useful to suspect possibly undiagnosed chlamydial infection in RSA women. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd


Pantazi A.,National and Kapodistrian University of Athens | Tzonis P.,Helena venizelou Maternity Hospital | Perros G.,Helena venizelou Maternity Hospital | Graphou O.,National and Kapodistrian University of Athens | And 4 more authors.
American Journal of Reproductive Immunology | Year: 2010

Problem: Changes in endometrial Natural Killer (NK) cells during the luteal phase of the ovarian cycle are important in initiating/maintaining a subsequent pregnancy. In the present study it was investigated whether during the menstrual cycle changes occur also in peripheral blood (PB) NKs. Method of study: Blood samples during the follicular and the luteal phase were collected from 30 women without fertility problems. Samples were analyzed by flow-cytometry for: (1) NK cells (CD3-CD16+CD56+) and (2) intracellular production of interferon-γ (IFN-γ) by NK cells. For the comparison and correlation of the two populations between the two phases, Wilcoxon signed-rank test and Spearman's Coefficient were used. Results: The differences in percentages of CD3-CD16+CD56+ cells and that of CD3-CD16+CD56+/IFN-γ+ cells between the follicular and the luteal phase were not statistically significant (10.61 ± 5.11 versus 9.76 ± 4.57 and 6.48 ± 7.90 versus 7.30 ± 6.77, respectively, P > 0.05). The correlation between the two variables (NK% and NK/IFN-γ%) was weakly positive (P = 0.07) only in the follicular phase. Conclusion: The study did not reveal menstrual cycle-depended changes in PB NK cells. Thus, a suggestion to measure these cells in a specific phase of the cycle in order to predict the outcome of a subsequent pregnancy in women with fertility problems is objected. © 2009 John Wiley & Sons A/S.


PubMed | Helena Venizelou Maternity Hospital and National and Kapodistrian University of Athens
Type: Journal Article | Journal: American journal of reproductive immunology (New York, N.Y. : 1989) | Year: 2016

V9V2 T cells (92) are involved in antibacterial immune responses. The aim of this study was to look for associations between peripheral blood (PB) 92 T cells and cervix/vaginal Chlamydia trachomatis (Ct) infection in women with recurrent spontaneous abortions (RSA).Peripheral blood samples were obtained from 201 RSA women within 10days after they experienced a new miscarriage. 92 T cells and their percentage in total T cells were compared between women who had been found and women who had not been found infected with Ct (last 6months). Fertile women (82) served as control subjects.The difference of mean percentages of 92 T cells between the abortion and control groups, and the Chlamydia (+) and Chlamydia (-) groups was highly statistically significant (P<.00001). Significant difference was also found between the Chlamydia (+) and Chlamydia (-) group and the control group (ANOVA).The measurement of 92T cells may be useful to suspect possibly undiagnosed chlamydial infection in RSA women.


Varla-Leftherioti M.,Helena Venizelou Maternity Hospital | Keramitsoglou T.,Helena Venizelou Maternity Hospital | Parapanissiou E.,Hippokration General Hospital | Kurpisz M.,Polish Academy of Sciences | And 8 more authors.
Tissue Antigens | Year: 2010

This aim of the study was to investigate whether human leukocyte antigen (HLA)-DQA1*0505 sharing or the maternal killer immunoglobulin-like receptor (KIR) repertoire is associated with recurrent spontaneous abortion (RSA) or repeated implantation failure (RIF). The study included 224 couples with RSA, 61 couples with RIF, 182 fertile couples, and 10 couples with successful in vitro fertilization and embryo transfer (IVF)/ET at first cycle. HLA-DQA1*0505 typing using polymerase chain reaction-sequence-specific oligonucleotide (PCR-SSO) was performed in 185 RSA (117 with alloimmune abnormalities and 68 of autoimmune etiology), 61 RIF and 182 control couples, and KIR genotyping using polymerase chain reaction-sequence-specific primer (PCR-SSP) in 167 RSA and 55 RIF cases as well as 46 RSA and 10 IVF controls. No differences in DQA1*0505 sharing were found between patients and controls. In RSA and RIF women, the ratio of inhibitory to activating KIRs was slightly lower (1.53 and 1.85 vs 2.03 in controls). The analysis of maternal inhKIR and fetal HLA-C molecule pairs showed that the 'less inhibiting' combination KIR2DL3-C1 was found in higher percentage in subfertile (mainly RIF) than in fertile couples. In contrast, the percentage of cases possessing the 'strong inhibiting' combination KIR2DL1-C2 was lower in the RSA and RIF groups in comparison with that in the control groups (17.36% vs 23.91 and 16.36% vs 40%, respectively). In women with ≥ 6 implantation failures, the KIR2DL1-C2 combination was not found in any of them (P = 0.0014), and the KIR2DL3-C1 combination was not found in the control IVF group. The results oppose the suggestion that increased HLA-DQA1*0505 sharing predispose to RSA or RIF. The KIR2DL3-C1 combination (or lack of the KIR2DL1-C2 one) is associated with implantation failure. © 2010 John Wiley & Sons A/S.


Anastasopoulou E.A.,Saint Savas Cancer Hospital | Voutsas I.F.,Saint Savas Cancer Hospital | Keramitsoglou T.,Helena Venizelou Maternity Hospital | Gouttefangeas C.,University of Tübingen | And 5 more authors.
Cancer Immunology, Immunotherapy | Year: 2015

Recently, several types of immunotherapies have been shown to induce encouraging clinical results, though in a restricted number of patients. Consequently, there is a need to identify immune biomarkers to select patients who will benefit from such therapies. Such predictive biomarkers may be also used as surrogates for overall survival (OS). We have recently found correlations between immunologic parameters and clinical outcome in prostate cancer patients who had been vaccinated with a HER-2/neu hybrid polypeptide vaccine (AE37) and received one booster 6 months post-primary vaccinations. Herein, we aimed to expand these retrospective analyses by studying the predictive impact of HLA-A*24 and HLA-DRB1*11 alleles, which are expressed at high frequencies among responders in our vaccinated patients, for clinical and immunological responses to AE37 vaccination. Our data show an increased OS of patients expressing the HLA-DRB1*11 or HLA-A*24 alleles, or both. Vaccine-induced immunological responses, measured as interferon γ (IFN-γ) responses in vitro or delayed-type hypersensitivity reactions in vivo, were also higher in these patients and inversely correlated with suppressor elements. Preexisting (i.e., before vaccinations with AE37) levels of vaccine-specific IFN-γ immunity and plasma TGF-β, among the HLA-A*24 and/or HLA-DRB1*11 positive patients, were strong indicators for immunological responses to AE37 treatment. These data suggest that HLA-DRB1*11 and HLA-A*24 are likely to be predictive factors for immunological and clinical responses to vaccination with AE37, though prospective validation in larger cohorts is needed. © 2015, Springer-Verlag Berlin Heidelberg.

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