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Augoustis C.,Polykliniki General Hospital | Alevizaki M.,National and Kapodistrian University of Athens
Hormones | Year: 2012

OBJECTIVE: Previous neck surgery (PNS) in patients with primary hyperparathyroidism (PHP) is considered as a contraindication for minimally invasive parathyroidectomy (MIP). The purpose of our study was to determine the effectiveness of MIP in such patients. DESIGN: From January 2003 to June 2011, 380 patients with PHP were treated in our department; 42 had had previous neck surgery. Twenty-seven (27/42) were selected to have MIP; the remaining 15 patients had traditional neck explorations. Selection criteria for MIP were unilateral single or two gland disease localized preoperatively with at least two imaging techniques and patient's informed consent. Imaging studies included high resolution neck ultrasound and sestamibi scan in the majority, and CT scan, selective venous sampling and MRI in seven patients. The type of operation done included unilateral approach under local anesthesia (UALA) (22 cases) with one conversion to general anesthesia and minimally invasive parathyroidectomy under general anesthesia (MIPG) (5 cases). RESULTS: Twenty-six of the 27 patients became normocalcemic after the operation. The patient with persistent hypercalcemia underwent successful parathyroidectomy 8 months later via mesothoracoscopy, since the parathyroid gland was localized correctly but was beyond access via neck. A single adenoma was found in 21 cases and hyperplasia in six. There were no conversions to traditional exploration and no postoperative complications. Mean duration of the procedure and length of stay were similar to MIP in patients without PNS. Mean follow-up of 40 months (4-89 months) did not reveal any recurrence. CONCLUSION: These results illustrate that MIP is a valuable option in selected patients with PHP and PNS associated with no morbidity (0%), high biochemical cure rate (96.3% in this series) and rapid recovery, while it also substantially lowers the cost of the procedure. Preoperative localization with two or more agreeing imaging techniques eliminates the need for intraoperative sestamibi or qPTH test.


Evangelopoulos A.A.,Polykliniki General Hospital | Vallianou N.G.,Polykliniki General Hospital | Bountziouka V.,Harokopio University | Katsagoni C.,Harokopio University | And 6 more authors.
Internal Medicine Journal | Year: 2012

Background: Cystatin C is a marker of renal function that appears to be associated with inflammation. The aim of the present study was to investigate whether there is any relationship between cystatin C, total and differential leukocyte count and other inflammatory markers. Methods: Cystatin C, creatinine, high sensitivity C-reactive protein (hs-CRP), haptoglobin, ferritin, serum albumin, glucose, total cholesterol, HDL and triglycerides together with total and differential leukocyte count were determined in 490 adults (46 ± 16 years, 40% men) who underwent a typical health examination. Glomerular filtration rate was estimated by the simplified Modification of Diet in Renal Disease formula. Anthropometric and lifestyle characteristics were also recorded. Results: After adjustment for demographic risk factors, comorbid health conditions and renal function, a positive and independent relationship of serum cystatin C levels with peripheral monocyte blood count (regression coefficient ± SE: 12 ± 3.38, P < 0.001) and white blood count (0.616 ± 0.278, P= 0.027) was evident. In this multiple linear regression analysis, other inflammatory markers (i.e. hs-CRP, haptoglobin, ferritin, albumin) did not seem to affect cystatin C blood levels. Conclusion: The results of this study demonstrated that monocytes, which play an important role in chronic inflammation and atherosclerosis, were independently related with cystatin C concentrations. This finding may provide a plausible link for the usefulness of cystatin C in predicting increased cardiovascular risk. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.


Vallianou N.G.,Polykliniki General Hospital | Evangelopoulos A.A.,Polykliniki General Hospital | Panagiotakos D.B.,Harokopio University | Georgiou A.T.,Polykliniki General Hospital | And 3 more authors.
Medical Science Monitor | Year: 2010

Background: Metabolic syndrome, i.e. the clustering of visceral obesity, dyslipidemia, hyperglycemia, and hypertension, has become a major public-health challenge worldwide. An acute-phase reactant is one whose level increases by 25% of the standard value during inflammation. Associations of acutephase reactants with the components of metabolic syndrome among overweight or obese patients has rarely been examined. Material/Methods: The CRP, ferritin, fibrinogen, haptoglobin, and ESR levels of 117 consecutive overweight or obese patients were measured. Metabolic syndrome was defined if central obesity was combined with at least two of the following factors: triglyceride level >150 mg/dl or specific treatment for this abnormality, HDL cholesterol <40 mg/dl in males and <50 mg/dl in females or specific treatment for this abnormality, systolic/diastolic blood pressures >130/85 mmHg or treatment of previously diagnosed hypertension, and fasting plasma glucose >100 mg/dl or previously diagnosed type 2 diabetes. Results: Eighty-two patients were characterized as having metabolic syndrome and 35 as healthy controls. CRP, haptoglobin, and ESR levels increased with increasing number of components of metabolic syndrome. Ferritin and fibrinogen, in contrast, were increased in patients with metabolic syndrome but did not correlate with the number of components. Conclusions: CRP, haptoglobin, and ESR may add significant information regarding the severity of metabolic syndrome among overweight and obese patients. © Med Sci Monit, 2010.


Evangelopoulos A.A.,Polykliniki General Hospital | Vallianou N.G.,Polykliniki General Hospital | Bountziouka V.P.,Harokopio University | Giotopoulou A.N.,Harokopio University | And 4 more authors.
Cardiology Research and Practice | Year: 2011

Background. The aim of the present study was to examine sources of variation for serum cystatin C in a healthy Greek population. Methods. Cystatin C together with basic clinical chemistry tests was measured in a total of 490 adults (46 ± 16 yrs, 40% males) who underwent an annual health check. Demographic, anthropometric, and lifestyle characteristics were recorded. Results. Higher values of cystatin C were observed among males (P =.04), participants aged over 65 years (P <.001), current smokers (P =.001) and overweight/obese participants (P =.03). On the contrary, alcohol consumption and physical activity seemed to have no influence on cystatin C levels (P =.61; P =.95, resp.). Conclusions. In interpreting serum cystatin C values in a healthy adult population, age, gender, Body Mass Index, and cigarette smoking need to be considered, and determination of reference ranges among distinct subpopulations seem to be prudent. Copyright © 2011 Angelos A. Evangelopoulos et al.


Vallianou N.G.,Polykliniki General Hospital | Evangelopoulos A.A.,Polykliniki General Hospital | Bountziouka V.,Harokopio University | Vogiatzakis E.D.,Polykliniki General Hospital | And 4 more authors.
Diabetes/Metabolism Research and Reviews | Year: 2013

Background: Neck circumference, beyond a measure of obesity, is a unique fat depot with increasing significance. This study aimed to investigate the association between neck circumference and biomarkers, indicators of cardiovascular risk. Methods: During 2009, 490 volunteers (46±16years, 40% men) were consecutively enrolled to the study (participation rate 85%). Biochemical analyses were performed through established procedures, and after 12-h fasting and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, cystatin C, uric acid and high-sensitivity C-reactive protein were measured. Anthropometric, lifestyle and dietary characteristics were also recorded to account for potential confounders. Additive linear and logistic regression models were used to evaluate the association between neck circumference and biomarkers of cardiometabolic risk. Results: A positive association between neck circumference and systolic and diastolic blood pressure, glucose, triglycerides, uric acid and high-sensitivity C-reactive protein, and a negative association with high-density lipoprotein cholesterol were revealed (all ps<0.05); models were adjusted for age, gender, years of school, smoking, physical activity status, MedDietScore and alcohol intake. The relationship between neck circumference and high-density lipoprotein cholesterol, glucose, triglycerides and uric acid remained significant when models were further stratified by body mass index class and abnormal waist circumference. Conclusion: Neck circumference was found to be a powerful indicator of atherogenic dyslipidaemia above and beyond central obesity indicators. © 2012 John Wiley & Sons, Ltd.


Sthongos E.,Polykliniki General Hospital | Vallianou N.G.,Polykliniki General Hospital | Avgerinos P.C.,Polykliniki General Hospital
Archives of Hellenic Medicine | Year: 2016

The case is reported of a patient who developed pericardial effusion, both early, at 24 hours, and late, at 3 weeks, after the implantation of a pacemaker. The late effusion was accompanied by manifestations of pericarditis. Pericarditis occurring a few weeks after the insertion of a pacemaker is a variant of the post-cardiac injury syndrome (PCIS). This form of pericarditis, which is considered to be autoimmune in origin, was originally described following myocardial infarction and cardiac surgery. In these conditions the incidence of the PCIS is increased among patients with an early pericardial reaction, which is considered traumatic in origin and occurs from hours to a few days after the precipitating event. Although both early and late forms of pericarditis have been documented following the insertion of a pacemaker, no report was found of early and late pericardial reaction occurring sequentially in the same patient. The course of this patient supports the hypothesis that, in agreement with the other forms of the PCIS, there may be a connection between the early and late forms of pericardial reaction following the implantation of a pacemaker. © Athens Medical Society.


Vallianou N.G.,Polykliniki General Hospital | Evangelopoulos A.A.,Polykliniki General Hospital | Bountziouka V.,Harokopio University | Bonou M.S.,Polykliniki General Hospital | And 5 more authors.
Journal of Cardiovascular Medicine | Year: 2014

Background: Although butyrylcholinesterase is widely distributed in different tissues of the human body, its physiological role has not yet been defined. This study aimed to explore the relationship between butyrylcholinesterase and lipids levels, among apparently healthy adults. Methods: During 2009, 490 volunteers (46 ± 16 years, 40% men) who visited the outpatients' office of our hospital for routine examinations were consecutively enrolled in the study (participation rate 85%). Biochemical analyses were performed through established procedures, after 12 h fasting, and haematological as well as biochemical parameters were measured. Anthropometric, lifestyle and dietary characteristics were also recorded to account for potential confounding. Results: Butyrylcholinesterase activity was positively correlated with glucose, low-density lipoprotein (LDL)-cholesterol, total cholesterol, triglycerides, uric acid, haptoglobin and platelet count, after age-sex adjustments (all Ps<0.05). Further adjustment for a series of anthropometric, lifestyle and clinical characteristics revealed that only BMI, LDL-cholesterol, total cholesterol and triglycerides were positively associated with serum butyrylcholinesterase activity. Conclusions: This study demonstrated the positive association of serum butyrylcholinesterase activity with BMI, LDL-cholesterol, total cholesterol and triglycerides, a fact that could state a hypothesis for a novel marker of atherosclerotic disease that could - together with other biomarkers - improve our potential to assess cardiovascular disease risk. © 2014 Italian Federation of Cardiology.


Klimis T.,Third Hospital of Social Insurance Institute | Roukounakis N.,Polykliniki General Hospital | Kafetzis I.,Third Hospital of Social Insurance Institute | Mouziouras V.,Polykliniki General Hospital | And 2 more authors.
Journal of the Pancreas | Year: 2011

Context Heterotopic pancreas of the gallbladder is an extremely rare entity, especially when pancreatic tissue appears histologically with an exclusively exocrine structure. Case report We report the case of a 35-year-old man who presented with symptoms of acalculous gallbladder disease with high levels of amylasuria. Immunohistochemical analysis of the surgical specimen of the cholecystectomy revealed pancreatic tissue at the gallbladder wall. Conclusions Heterotopic pancreatic tissue is a rare pathological finding in the gallbladder. It requires consideration and sensitization in the differential diagnosis of acalculous gallbladder disease, which can explain hyperamylasuria in cases of unknown origin.


PubMed | Polykliniki General Hospital
Type: Journal Article | Journal: Medical science monitor : international medical journal of experimental and clinical research | Year: 2010

Metabolic syndrome, i.e. the clustering of visceral obesity, dyslipidemia, hyperglycemia, and hypertension, has become a major public-health challenge worldwide. An acute-phase reactant is one whose level increases by 25% of the standard value during inflammation. Associations of acute-phase reactants with the components of metabolic syndrome among overweight or obese patients has rarely been examined.The CRP, ferritin, fibrinogen, haptoglobin, and ESR levels of 117 consecutive overweight or obese patients were measured. Metabolic syndrome was defined if central obesity was combined with at least two of the following factors: triglyceride level > or = 150 mg/dl or specific treatment for this abnormality, HDL cholesterol < 40 mg/dl in males and < 50 mg/dl in females or specific treatment for this abnormality, systolic/diastolic blood pressures > or = 130/85 mmHg or treatment of previously diagnosed hypertension, and fasting plasma glucose > or = 100 mg/dl or previously diagnosed type 2 diabetes.Eighty-two patients were characterized as having metabolic syndrome and 35 as healthy controls. CRP, haptoglobin, and ESR levels increased with increasing number of components of metabolic syndrome. Ferritin and fibrinogen, in contrast, were increased in patients with metabolic syndrome but did not correlate with the number of components.CRP, haptoglobin, and ESR may add significant information regarding the severity of metabolic syndrome among overweight and obese patients.


PubMed | Polykliniki General Hospital
Type: Journal Article | Journal: Diabetes/metabolism research and reviews | Year: 2013

Neck circumference, beyond a measure of obesity, is a unique fat depot with increasing significance. This study aimed to investigate the association between neck circumference and biomarkers, indicators of cardiovascular risk.During 2009, 490 volunteers (4616years, 40% men) were consecutively enrolled to the study (participation rate 85%). Biochemical analyses were performed through established procedures, and after 12-h fasting and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, cystatin C, uric acid and high-sensitivity C-reactive protein were measured. Anthropometric, lifestyle and dietary characteristics were also recorded to account for potential confounders. Additive linear and logistic regression models were used to evaluate the association between neck circumference and biomarkers of cardiometabolic risk.A positive association between neck circumference and systolic and diastolic blood pressure, glucose, triglycerides, uric acid and high-sensitivity C-reactive protein, and a negative association with high-density lipoprotein cholesterol were revealed (all ps<0.05); models were adjusted for age, gender, years of school, smoking, physical activity status, MedDietScore and alcohol intake. The relationship between neck circumference and high-density lipoprotein cholesterol, glucose, triglycerides and uric acid remained significant when models were further stratified by body mass index class and abnormal waist circumference.Neck circumference was found to be a powerful indicator of atherogenic dyslipidaemia above and beyond central obesity indicators.

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