Hippocration Hospital

Athens, Greece

Hippocration Hospital

Athens, Greece
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Patrikakos P.,Hippocration Hospital | Toutouzas K.G.,Hippocration Hospital | Gazouli M.,National and Kapodistrian University of Athens | Perrea D.,National and Kapodistrian University of Athens | And 3 more authors.
Obesity Surgery | Year: 2011

Background: Sleeve gastrectomy (SG) is a gaining ground operation amongst the ones applied for treatment of morbid obesity. Though SG is a food limiting operation, the removal of the gastric fundus where ghrelin is mainly produced may indicate a hormonal impact of the procedure. The purpose of this experiment is to study how SG affects the levels of ghrelin and leptin. Methods: Twenty-four male, adult, diet induced obese Wistar rats were divided randomly into groups, one submitted to SG and the other to a sham operation. Fasting blood samples were taken before the operation and 14 weeks after the operation (leptin and acylated and des-acyl ghrelin levels were measured). Tissue samples from the gastric fundus were taken during the operation and at the end of the experiment, and ghrelin expression was measured with RT-PCR. Results: Statistically significant weight loss was achieved comparing the weight progress of the SG group and the sham operation group. Serum leptin levels were significantly reduced in the SG group (p∈<∈0.05) but not in the sham operation group. Serum acylated ghrelin was not significantly affected in both groups, but a significant decrease was documented in serum des-acyl ghrelin in the SG group (p∈<∈0.05). RT-PCR analysis of the gastric fundus documented a significant decrease (p∈<∈0.0001) in the expression of ghrelin in the SG group. Conclusions: SG may lead in significant long-term weight loss. SG affects the serum levels of leptin and des-acyl ghrelin but not the levels of acylated ghrelin in this animal model. © 2011 Springer Science + Business Media, LLC.

Kargiotis K.,Aristotle University of Thessaloniki | Katsiki N.,Aristotle University of Thessaloniki | Athyros V.G.,Aristotle University of Thessaloniki | Giouleme O.,Aristotle University of Thessaloniki | And 4 more authors.
Current Vascular Pharmacology | Year: 2014

Background: There is no widely accepted treatment for non-alcoholic fatty liver disease (NAFLD) or its advanced form, non-alcoholic steatohepatitis (NASH). Methods: We administered rosuvastatin (10 mg/day) for 1 year in patients with metabolic syndrome (MetS), NASH on liver biopsy and dyslipidaemia (but without diabetes or arterial hypertension). Patients also received lifestyle advice. Results: We report preliminary results for 6 patients. The second biopsy (at the end of the study) showed complete resolution of NASH in 5 patients, while the 6th, which had no improvement, developed arterial hypertension and substantial rise in triglyceride levels during the study. We suspect alcohol abuse despite advice to abstain. Serum alanine transaminase (ALT) and aspartate transaminase (AST) activities were reduced by 76 and 61%, respectively (p < 0.001 for both), during treatment, whileγ-glutamyl transpeptidase (γ -GT), and alkaline phosphatase (AP) showed smaller non significant reductions. Fasting plasma glucose and glycated haemoglobin (HbA1c) were significantly reduced (p<0.05). Lipid values were totally normalised and liver ultrasonography showed a complete resolution of NASH in 5 patients. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function should be attributed to treatment with rosuvastatin. A substantial limitation of the study is the small number of patients. Conclusions: These preliminary findings suggest that rosuvastatin could ameliorate NASH within a year of treatment in MetS patients with dyslipidaemia. © 2014 Bentham Science Publishers.

Athyros V.G.,Aristotelian University | Kakafika A.I.,Aristotelian University | Papageorgiou A.A.,Aristotelian University | Tziomalos K.,University College London | And 4 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2011

Background and aims: Mediterranean diet is associated with a reduced risk for cardiovascular disease (CVD). Use of plant stanols decreases low density lipoprotein cholesterol (LDL-C) concentrations. We compared the effects of the Mediterranean diet and plant stanol esters on vascular risk factors and estimated CVD (eCVD) risk. Methods and results: In this prospective, randomized, placebo-controlled study, 150 mildly hypercholesterolaemic subjects were randomized to Mediterranean diet, a spread containing plant stanol esters (2. g/day) or a placebo spread. Vascular risk factors were assessed every month for 4 months and the eCVD risk was calculated using the PROspective- Cardiovascular-Munster (PROCAM), Framingham, and Reynolds risk engines. Placebo had no significant effect on risk factors or eCVD risk. Mediterranean diet gradually induced a significant reduction in total cholesterol (TC), LDL-C, triglycerides, high sensitivity C-reactive protein (hsCRP), blood pressure and eCVD risk (24-32%). The plant stanol ester spread reduced (by 1 month) TC (-14%), LDL-C (-16%), hsCRP (-17%), and estimated CVD risk (26-30%). eCVD risk reduction was sustained at 4th months when the gradual Mediterranean diet eCVD risk reduction became comparable to that of the stanol group. Conclusions: Plant stanol esters yielded an early, by 1st treatment month, reduction of eCVD risk that resulted from a TC, LDL-C, and hsCRP decrease. eCVD risk reduction on the Mediterranean diet resulted from a change in several CVD risk factors and equaled that of plant stanol at 4 months. The consumption of plant stanol esters by moderately hypercholesterolaemic patients may be a useful option to reduce CVD risk in those who do not adopt a Mediterranean diet. © 2009 Elsevier B.V.

Drimousis P.G.,Hippocration Hospital | Theodorou D.,Hippocration Hospital | Toutouzas K.,Hippocration Hospital | Stergiopoulos S.,National and Kapodistrian University of Athens | And 3 more authors.
Resuscitation | Year: 2011

Objective: The purpose of this study was to evaluate the impact of ATLS® on trauma mortality in a non-trauma system setting. ATLS represents a fundamental element of trauma training in every trauma curriculum. Nevertheless, there are limited studies in the literature as for the impact of ATLS training in trauma mortality, especially outside the US. Design: This is a prospective observational study. The primary end point was to investigate factors that affect mortality of trauma patients in our health care system. We performed a multivariate analysis for this purpose and we identified ATLS certification as a predictor of overall mortality. Following this finding we stratified patients according to the severity of injury as expressed by the ISS score and we compared outcome between those treated by an ATLS certified physician and those treated by non-certified ones. Main outcome measures: Trauma volume and demographics of trauma patients, factors that affect mortality of traumatized patients and mortality between patients treated by ATLS® certified and non-certified physicians. Results: In total, 8862 trauma patients were included in the analysis. The majority of trauma patients (5988, 67.6%) were treated by a general surgeon, followed by those treated by an orthopedic surgeon (2194, 24.8%). There were 446 deaths in the registry but, 260 arrived dead in the Emergency Department and were excluded from the analysis. Multivariate analysis of the 186 deaths that occurred in the hospital revealed age, high ISS score, low GCS score, urban location of injury, neck injury and ATLS® certification as factors predisposing to mortality. Cross tabulation of ATLS® certification and ISS of the trauma patients shows that those treated by certified physicians died more often in all subcategories of ISS score (p<0.05). Conclusions: In Greece, with no formal trauma system implementation, ATLS® certified physicians achieve worse outcomes than their non-certified colleagues when managing trauma patients. We believe that these findings must be interpreted in the context of the National health care system. There is considerable room for improvement in our country, and further analysis is required. © 2010 Elsevier Ireland Ltd.

Giza E.,Aristotle University of Thessaloniki | Katsarou Z.,Hippocration Hospital | Georgiadis G.,Hippocration Hospital | Bostantjopoulou S.,Aristotle University of Thessaloniki
Neurophysiologie Clinique | Year: 2012

Objectives: This study aims to evaluate sympathetic sudomotor activity in Parkinson's disease (PD) by means of the sympathetic skin response (SSR) and explore its possible changes due to mental stress. Methods: Sudomotor function was evaluated using SSR in 29 patients with PD (Hoehn and Yahr stage I-IV) without any clinical evidence of autonomic dysfunction. Twenty-seven healthy matched controls were also evaluated. SSR was elicited by electrical stimulation of the right median nerve and simultaneously recorded on the palms of both hands. Arithmetic mental stress was evoked by means of the WAIS-R arithmetic subscale. Latency and amplitude of SSR were evaluated before and after arithmetic mental stress. Results: The SSR was obtained in all patients and controls. There were no significant differences in its mean latency and amplitude between patients and controls. SSR parameters were significantly correlated with disease duration, UPDRS score, and disease stage. There were also significant correlations with rigidity and bradykinesia, but not with tremor. Mental stress had no effect on SSR parameters in any group. Conclusions: SSR parameters in PD without autonomic dysfunction were comparable to matched controls. Although PD patients are sensitive to mental stress, the arithmetic task had no effect on SSR parameters. Consequently, SSR as a method of evaluation of sympathetic sudomotor function is not sufficient for exploration of subclinical autonomic dysfunction in PD, but should be combined with other tests of autonomous nervous system. © 2011 Elsevier Masson SAS.

Papailiou J.,Hippocration Hospital | Albanopoulos K.,Hippocration Hospital | Toutouzas K.G.,Hippocration Hospital | Tsigris C.,Laikon Hospital | And 2 more authors.
Obesity Surgery | Year: 2010

Laparoscopic sleeve gastrectomy is known to be a safe and effective procedure for treating morbid obesity and is performed with increasing frequency both in Europe and the USA. Despite its broad use, many questions about the remaining gastric tube diameter, its long-term efficacy, its effects on gastric emptying, and the hormones involved still remain to be answered. In order to use such a relatively new surgical procedure wisely, it is essential for every surgeon and physician to understand how sleeve gastrectomy acts in obesity and what its potential benefits on the patients' metabolism are. This review focuses on the most important pathophysiologic questions referred to sleeve gastrectomy on the literature so far, in an attempt to evaluate the different issues still pending on the subject. © 2010 Springer Science + Business Media, LLC.

Kargiotis K.,Aristotle University of Thessaloniki | Athyros V.G.,Aristotle University of Thessaloniki | Giouleme O.,Aristotle University of Thessaloniki | Katsiki N.,Aristotle University of Thessaloniki | And 6 more authors.
World Journal of Gastroenterology | Year: 2015

AIM: To investigate the effect of rosuvastatin mono-therapy on non-alcoholic steatohepatitis (NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form NASH. METHODS: This prospective study included 20 biopsy proven patients with NASH, metabolic syndrome (MetS) and dyslipidaemia. Biochemical parameters of the blood of the patients and an ultrasonography of the liver were performed at baseline. Then patients received lifestyle advice and were treated for a 12 mo period with rosuvastatin (10 mg/d) monotherapy. Patients were re-evaluated during the study at 3 mo intervals, during which biochemical parameters of the blood were measured including liver enzymes. A repeat biopsy and ultrasonography of the liver were performed at the end of the study in all 20 patients. Changes in liver enzymes, fasting plasma glucose, serum creatinine, serum uric acid (SUA), high sensitivity C reactive protein (hsCRP) and lipid profile were assessed every 3 mo. The primary endpoint was the resolution of NASH and the secondary endpoints were the changes in liver enzyme and lipid values. RESULTS: The repeat liver biopsy and ultrasonography showed complete resolution of NASH in 19 patients, while the 20th, which had no improvement but no deterioration either, developed arterial hypertension and substantial rise in triglyceride levels during the study, probably due to changes in lifestyle including alcohol abuse. Serum alanine transaminase, aspartate transaminase, and γ-glutamyl transpeptidase were normalised by the 3rd treatment month (ANOVA P < 0.001), while alkaline phosphatase activities by the 6th treatment month (ANOVA, P = 0.01). Fasting plasma glucose and glycated haemoglobin were significantly reduced (P < 0.001). Lipid values were normalised by the 3rd treatment month. No patient had MetS by the 9th treatment month. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function should be attributed solely to rosuvastatin treatment. A limitation of the study is the absence of a control group. CONCLUSION: These findings suggest that rosu-vastatin monotherapy could ameliorate biopsy proven NASH and resolve MetS within 12 mo. These effects and the reduction of fasting plasma glucose and SUA levels may reduce the risk of vascular and liver morbidity and mortality in NASH patients. These findings need confirmation in larger studies. © The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.

Athyros V.G.,Aristotelian University | Ganotakis E.S.,University of Crete | Tziomalos K.,Aristotelian University | Papageorgiou A.A.,Aristotelian University | And 6 more authors.
Current Medical Research and Opinion | Year: 2010

There is a need to evaluate the prevalence of metabolic syndrome (MetS) diagnosed by the new Joint Interim Societies (JIS) MetS definition. The JIS definition was compared with three previous definitions to assess their ability to predict cardiovascular disease (CVD) risk. A cross-sectional analysis of a representative sample of Greek adults (n Combining double low line9669) was performed to estimate the prevalence of MetS and CVD using the JIS vs. the three older definitions of MetS: the National Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATP-III), the International Diabetes Federation (IDF) and the American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) definitions. The age-adjusted MetS prevalence was 45.7, 43.4, 24.5 and 26.3 (ANOVA p <0.001) with the JIS, IDF, NCEP and AHA/NHLBI definitions. The prevalence of CVD was 11.4 in the whole study population and 17.6, 18.3, 23.3, 22.6 and in subjects with MetS according to the JIS, IDF, NCEP and AHA/NHLBI definitions (ANOVA p <0.001). The prevalence of CVD was only 10.4 (i.e., lower than in the whole study population) in subjects with MetS according to the JIS but not according to the NCEP-ATP-III and AHA/NHLBI definitions (p <0.001 vs. subjects with MetS as defined by NCEP-ATP-III or AHA/NHLBI). When diagnosed according to the new JIS definition, the prevalence of MetS was high in a Greek Mediterranean cohort (nearly half of the adult population). The NCEP-ATP-III and AHA/NHLBI definitions were more predictive of CVD risk than the new JIS definition. These findings, though limited by the cross sectional analysis, may have implications regarding the choice of the definition to diagnose MetS. © 2010 Informa UK Ltd.

Kalinderi K.,Aristotle University of Thessaloniki | Fidani L.,Aristotle University of Thessaloniki | Katsarou Z.,Hippocration Hospital | Bostantjopoulou S.,Aristotle University of Thessaloniki
International Journal of Clinical Practice | Year: 2011

Parkinson disease (PD) is a progressive movement disorder marked by tremor, rigidity, bradykinesia and postural instability. Levodopa (l-dopa), usually combined with a peripheral dopa decarboxylase inhibitor, has been proved to provide the best symptomatic benefit for PD. However, its long-term efficacy is limited because of motor complications and drug-induced dyskinesia. Dopamine agonists, catechol-O-methyltransferase inhibitors and monoamine oxidase-B inhibitors are anti-parkinsonian (anti-PD) drugs that have been found to further improve the potency of l-dopa and prevent the onset of motor complications. However, as PD is a progressive disorder, all the drugs used for its therapy, manifest reduced efficacy and adverse effects with time. Research on the field of pharmacogenetics has pointed out that the genetic variability of each individual determines to a large extent the inter-individual variability in response to anti-PD drugs. Clinicogenetic trials show that drug efficacy or toxicity or susceptibility to side effects are features governed by genetic principles. This article is a review of the present pharmacological treatment of PD and current pharmacogenetic data for PD. © 2011 Blackwell Publishing Ltd.

PubMed | Technological Educational Institute of Athens and Hippocration Hospital
Type: | Journal: Scientific reports | Year: 2016

The refractive index is an optical constant that plays a significant role in the description of light-matter interactions. When it comes to biological media, refraction is understudied despite recent advances in the field of bio-optics. In the present article, we report on the measurement of the refractive properties of freshly excised healthy and cancerous human liver samples, by use of a prism-coupling technique covering the visible and near-infrared spectral range. Novel data on the wavelength-dependent complex refractive index of human liver tissues are presented. The magnitude of the real and imaginary part of the refractive index is correlated with hepatic pathology. Notably, the real index contrast is pointed out as a marker of discrimination between normal liver tissue and hepatic metastases. In view of the current progress in optical biosensor technologies, our findings may be exploited for the development of novel surgical and endoscopic tools.

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