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Ymittos Athens, Greece

Dimitroulias A.,Aristotle University of Thessaloniki | Tsonidis C.,Aristotle University of Thessaloniki | Natsis K.,Aristotle University of Thessaloniki | Venizelos I.,Ippokration General Hospital | And 2 more authors.
Journal of Clinical Neuroscience | Year: 2010

There are limited data concerning mechanoreceptors in normal human lumbar intervertebral discs. The aim of our study was to determine the types of mechanoreceptors in the two lower intervertebral discs in normal adult cadaveric donors and to review the literature. Twenty-five lumbar (L4-5 and L5-S1) intervertebral discs were retrieved from 15 fresh cadavers. We utilized immunoreactivity against the S-100 protein to localize specialized nerve endings. Immunoreactivity showed receptors in 92% of discs. The most frequent type had morphology resembling the Ruffini type receptor (88%), followed by the Golgi type. Free nerve fibers were frequently present. All neural structures were found in the superficial layers of the annulus fibrosus, in longitudinal ligaments, or between these two. The anterior part of the L5-S1 disc had a greater frequency of encapsulated receptors than the other parts (p = 0.022), which may be correlated with the high shear forces to which the lumbosacral junction is subjected. © 2009 Elsevier Ltd. All rights reserved. Source


Koutras G.,Alexander Technological Educational Institute of Thessaloniki | Terzidis I.P.,Ippokration General Hospital | Papadopoulos P.,Aristotle University of Thessaloniki | Georgoulis A.,University of Ioannina | And 2 more authors.
Journal of Science and Medicine in Sport | Year: 2016

Objectives: Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Design: Case series. Methods: Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Results: Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p < 0.001). Conclusions: Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method. © 2015 Sports Medicine Australia. Source


Altenberger J.,Paracelsus Medical University | Parissis J.T.,National and Kapodistrian University of Athens | Costard-Jaeckle A.,University of Hamburg | Winter A.,Hospital of the Sisters of Charity Linz | And 8 more authors.
European Journal of Heart Failure | Year: 2014

Aims The aim of this study was to determine whether intermittent ambulatory treatment with levosimendan would improve functional capacity, quality of life, and event-free survival in patients with advanced heart failure. Methods and results This was a prospective, randomized, double-blind, placebo-controlled, multicentre, parallel-group trial of pulsed infusions of levosimendan in 120 outpatients with advanced heart failure (EF ≤35%, NYHA class III or IV). The study was conducted at 11 centres in Austria, Greece, and Germany. Levosimendan (0.2 μg/kg/min) or placebo was administered for 6 h at 2-week intervals over 6 weeks, in addition to standard care therapy. The primary outcome was the proportion of patients with a ≥20% improvement in the 6 min walk test and a ≥15% score increase on the Kansas City Cardiomyopathy Questionnaire at the end of the 24-week study period. Secondary outcomes included event-free survival after 24 weeks. Analyses were performed on an intention-to-treat basis. The primary endpoint was reached in 19% of patients receiving levosimendan and 15.8% of patients receiving placebo (odds ratio 1.25; 95% confidence interval 0.44-3.59; P = 0.810). Cardiac death (four vs. one), heart transplants (two vs. one), and acute heart failure (14 vs. nine) were more frequent with placebo as compared with levosimendan. The incidence of side effects was comparable between groups. Conclusion Intermittent ambulatory treatment with levosimendan in patients with advanced heart failure did not improve significantly functional capacity or quality of life as compared with placebo. An adequately powered, event-driven trial is warranted to enlarge on our findings. Trial registration: NCT01065194. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology. Source


Polyzos S.A.,Aristotle University of Thessaloniki | Kountouras J.,Aristotle University of Thessaloniki | Anastasilakis A.D.,424 General Military Hospital | Litsas I.,Ippokration General Hospital | And 4 more authors.
Osteoporosis International | Year: 2011

Bisphosphonate (BP)-induced hepatotoxicity is very rare. There are only a few reports of liver injury after BP treatment, including aledronate and risedronate in postmenopausal osteoporosis patients. We describe hereby the case of a patient with Paget's disease of bone accompanied by nonalcoholic fatty liver disease (NAFLD) who developed transient hepatotoxicity after zoledronic acid (ZOL) treatment. NAFLD had been diagnosed 1 year before presentation, based on liver ultrasonography (US). One day after infusion, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma- glutamyltransferase (GGT) were increased by 8.1, 6.7, and 6.7 times, respectively, compared with pretreatment values. Serum bilirubin remained normal. US revealed hepatic mild homogenous brightness without focal lesion of the liver or biliary ducts. Subsequent biochemical and serologic investigation did not reveal a specific liver or systematic disease. The patient remained asymptomatic, and ALT, AST, and GGT were normalized 7 days post-treatment. Although the mechanism by which ZOL may cause liver damage is elusive, physicians should be aware of this possible adverse effect and ZOL cautiously administered in NAFLD patients. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation. Source


Polyzos S.A.,Ippokration General Hospital | Anastasilakis A.D.,424 General Military Hospital | Litsas I.,Ippokration General Hospital | Efstathiadou Z.,Ippokration General Hospital | And 5 more authors.
Journal of Bone and Mineral Metabolism | Year: 2010

Juvenile Paget's disease (JPD) is a rare, autosomal recessive osteopathy. Although it has phenotypic overlap with Paget's disease of bone (PDB), it is probably a distinct entity. Because of its rarity, optimal disease management has not yet been established by randomized controlled trials. However, clinical, biochemical, and radiographic improvement has been reported after treatment with antiresorptive agents, including calcitonin and bisphosphonates (BPs). Compared with other BPs, zoledronic acid (ZOL) has a higher affinity to bone mineral and is a stronger inhibitor of the enzyme farnesyl pyrophosphate synthase (the main target of nitrogen-containing BPs), properties that explain the prolonged effect of ZOL on bone turnover and render it a therapeutic option for JPD, similar to PDB. We describe hereby, for the first time in the literature, the case of a patient with JPD who developed severe hypocalcemia and secondary hyperparathyroidism following effective treatment with ZOL. © 2010 The Japanese Society for Bone and Mineral Research and Springer. Source

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