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Papaxoinis K.,National and Kapodistrian University of Athens | Triantafyllou K.,Attikon University General Hospital | Sasco A.J.,University of Bordeaux Segalen | Nicolopoulou-Stamati P.,National and Kapodistrian University of Athens | Ladas S.D.,National and Kapodistrian University of Athens
European Journal of Gastroenterology and Hepatology

Objective: This study aimed at investigating whether a differential estrogen receptor beta (ER-β) expression between the colonic subsites could correspond to a modification in proliferation, apoptosis, and adhesion of the normal colonocytes. Methods: ER-β, Ki-67, Bcl-2, and E-cadherin expressions were investigated immunohistochemically, in normal epithelium biopsies from the ascending and the descending colon of 53 individuals, who underwent colonoscopy for the investigation of anemia and in whom no local pathology was identified. Results: ER-β immunoreactivity has been shown to be stronger at the superficial epithelium than the crypts base, the difference being important only for the ascending colon. In addition, ER-β expression was higher in the superficial epithelium of the ascending colon than that of the descending colon. The variations of ER-β expression did not correspond to the alterations in Ki-67, Bcl-2, and E-cadherin expression. Conclusion: A subsite-specific variation of ER-β expression has been shown in the normal colonic epithelium. This modulation of ER-β might account for some well established specificities of colorectal cancer epidemiology like the right-sided predominance of the neoplasm in women and its gradual shift to more proximal sites over time. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Triantafyllou K.,Attikon University General Hospital | Vlachogiannakos J.,Laiko General Hospital of Athens | Ladas S.D.,Laiko General Hospital of Athens
Best Practice and Research: Clinical Gastroenterology

It is expected that the percentage of people >60 years of age will be 22% worldwide by the year 2050. Multi-morbidity and poly-pharmacy are common in individuals during old age, while adverse drug reactions are at least twice as common in the elderly compared to younger adults. Publications related to drug side effects are rather rare in this age group since most clinical trials exclude patients >75-80 years of age. Gastrointestinal adverse drug reactions studied in the elderly include non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulant-induced gastrointestinal tract mucosal injuries. Malabsorption, diarrhoea and constipation are common side effects of laxatives, antibiotics, anticholinergics and calcium channel blockers. Drug (amoxycilin/clavulanic acid, isoniazide, nitrofurantoin, diclifenac and methotrexate)-induced hepatotoxicity in the elderly is four times more common than in younger adults and may simulate almost all known liver disorders. Further clinical studies are needed to investigate gastrointestinal and hepatic side effects of drugs in elderly patients. © 2010 Elsevier Ltd. All rights reserved. Source

Rocas D.,Ed. Herriot Hospital | Asvesti C.,Private Practice | Tsega A.,Private Pathology Laboratory | Katafygiotis P.,Attikon University General Hospital | Kanitakis J.,Ed. Herriot Hospital
American Journal of Dermatopathology

Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare adnexal skin tumor first described in 1975, of which merely 62 cases have so far been studied in detail and reported in the English literature. PCACC is usually regarded as apocrine in origin/differentiation, but its precise histogenesis is still not well known. PCACC has in most cases a rather indolent course but can produce local recurrences and, more rarely, regional (lymph node) and distant (pulmonary) metastases. We report herein a Greek woman with a long-standing PCACC that grew slowly over several years and produced metastasis in the regional lymph nodes, highlighting the potentially aggressive course of this tumor. The primary and metastatic tumors were studied immunohistochemically and proved to express several (sweat gland-related) antigens (such as keratin 7, epithelial membrane antigen, CD10, and CD117) but neither hormonal receptors nor p63 or Gross Cystic disease Fluid Protein 15. The salient clinicopathologic features of this rare cutaneous adnexal tumor are reviewed. © 2013 Lippincott Williams & Wilkins. Source

Bouras G.,Attikon University General Hospital
Psychiatrikē = Psychiatriki

Trauma comes as a result of the subject's exposure to extremely negative and stressful events, such as natural or human-provoked catastrophes, wars, serious injuries, violent deaths, tortures, terrorist attacks, rapes and other sexual crimes. A child's exposure to traumatic circumstances of this level during the crucial period of self-structuring creates rather difficult conditions for its development. Moreover, if the child does not have the opportunity to elaborate and analyze all these stressful conditions and put them into words, serious consequences, both psychological and somatic, may occur in adult life. Specific factors and child characteristics, namely, the age, the developmental stage within which the trauma occurs, its type (physical or sexual abuse, neglect or traumatic social events), frequency, duration and intensity, have been proved to seriously affect the trauma's consequences. The immediate emotional impact of trauma may include isolation, fear, feeling of weakness or loss of the sense of confidence. Moreover, mood disorders such as depression and withdrawal, negative effects on cognitive ability, language development and academic performance, difficulties in creating a secure link and post-traumatic stress disorder (PTSD) are also observed. The long-term consequences for the individual's mental health can be expressed through the following: post-traumatic stress disorder (PTSD) combined or not with depression and anxiety disorder, mood disorders, personality disorders, poor control of impulsions, dissociation disorder, psychotic disorder. Finally, apart from the dramatic impact of trauma on the person itself, there is also a high social cost to be paid as a result of the individual's poor adjustment and dysfunction in the community. Early support and intervention in the child's environment may significantly minimize the negative effects of trauma. Beyond the expression of genes, good maternal care as well as psychological support, lead to normal DNA methylation and brain development. Supporting the family and break the silence that frequently covers the traumatic events and feelings, will give the opportunity for the elaboration of all these aspects which could capture and imprison the subject in a dramatic circle of psychopathology. Moreover, the effectiveness of early interventions and child psychotherapy is now a common ground, so we have to use all our clinical instruments (dialogue, symbolic play, drawing, storytelling) in order to help the child and have the best possible result. Finally, concerning clinical practice, the emergence of early childhood trauma in adult psychiatric symptomatology is so frequent that mental health experts should take it into serious account while developing an appropriate clinical treatment for such patients. Source

Fousteris E.,Diabetes Center | Melidonis A.,Diabetes Center | Panoutsopoulos G.,University of Peloponnese | Tzirogiannis K.,Diabetes Center | And 9 more authors.
Cardiovascular Diabetology

Background: Soluble ST2, a member of the of the Toll/IL-1 superfamily, is a novel biomarker with exceptional predictive value in heart failure and myocardial infarction- related mortality as well as in acute dyspneic states. Soluble ST2 is considered a decoy receptor of IL 33 that blocks the protective effects of the cytokine in atherosclerosis and cardiac remodeling. In the present study we investigated the differences in the levels of soluble ST2, BNP and hs-CRP between healthy controls and patients with type 2 diabetes with and without left ventricular diastolic dysfunction. A secondary aim was to investigate correlations between sST2 and other biomarkers of type 2 diabetes, such as HbA1c.Methods: 158 volunteers were recruited and underwent a complete Doppler-echocardiographic evaluation of both systolic & diastolic cardiac function. All subjects with ejection fraction < 50% were excluded. The study population was divided in 4 groups as follows: A: 42 healthy controls, B: 18 subjects without diabetes with LVDD, C: 48 patients with type 2 diabetes without LVDD & D: 50 patients with type 2 diabetes & LVDD. ELISA technique was performed to measure sST2 levels. Statistical analysis was performed with Kruskal-Wallis & Mann-Whitney test (continuous variables), chi squared & Fischer exact test (discrete variables), Spearman coefficient (univariate analysis) and step-wise backward method (multivariate analysis).Results: Patients with type 2 diabetes with (p < 0.001) or without LVDD (p = 0.007) had higher serum ST2 levels compared to healthy controls, state found also for hs-CRP levels but not for the corresponding BNP levels (p = 0.213 & p = 0.207 respectively). Patients with type 2 diabetes & LVDD had higher serum ST2 in relation to diabetic patients without LVDD (p = 0.001). In multivariate analysis HbA1c positively and independently correlated with sST2 levels in both groups of patients with type 2 diabetes.Conclusions: Patients with type 2 diabetes exhibit higher sST2 levels compared to healthy controls. The presence of LVDD in patients with type 2 diabetes is associated with even higher sST2 levels. A significant correlation between glycemic control and sST2 levels was also revealed. © 2011 Fousteris et al; licensee BioMed Central Ltd. Source

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