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1. Compliance of low-cost, single-frequency GNSS receivers to standards consistent with ISO for control surveying

Author

Tsakiri Maria, Sioulis Antonis, and Piniotis George

Subjects
low-cost gnss receivers (global navigation satellite system), control surveying networks, standards, accuracy specifications, Technology
Abstract

The emergence of single-frequency, navigation-type Global Navigation Satellite System receivers capable to provide carrier phase data [the so-called high sensitivity (HS) carrier phase positioning] has been steadily growing over the recent years. The main purpose of this study is to metrologically evaluate two low-cost, HS receivers, namely the u-blox LEA-6T and NEO-7P, in control surveying specifications. The evaluation was carried out within a published framework of standards and associated guidelines that are consistent with standards from the International Standards Organisation. The survey results were obtained from sufficient independent testing and proof and achieved an accuracy classification of ‘1 cm’ at 95% confidence level. This indicates that the particular type of receiver used with geodetic antennas can provide positioning results for general purpose control surveying applications that are comparable to using geodetic receivers and with a significantly lower cost.

Published
2017
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2. Randomized Controlled Trial Comparing Everting Sutures with a Lateral Tarsal Strip for Involutional Lower Eyelid Entropion

Author

Elias A. Nakos, Konstadinos G. Boboridis, Angeliki A. Kakavouti-Doudou, Diamantis D. Almaliotis, Christos E. Sioulis, and Vasileios E. Karampatakis

Subjects
Eyelid, Everting sutures, Involutional entropion, Lateral tarsal strip, Quickert, RCT, Ophthalmology, RE1-994
Abstract

Abstract Introduction To compare the anatomical and functional outcome and changes in the quality of life (QoL) over time of the lateral tarsal strip (LTS) versus the Quickert everting sutures (ES) for the repair of primary involutional lower eyelid entropion. Methods Forty-five patients (54 eyes) with primary involutional lower eyelid entropion were recruited in a prospective randomized clinical trial over 3-year period. Twenty-six eyes were randomized to the LTS technique and 28 to the ES procedure. Primary outcome was the anatomical correction of the eyelid at the final assessment in 1 year. Secondary outcomes were function and symptoms assessment with a QoL questionnaire at 6 months. Fisher’s exact test was used for the statistical analysis of success rate and gender study and Mann–Whitney U test and logistic regression analysis were used for age study. The Wilcoxon and Mann–Whitney U tests were used for the analysis of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25). Results At the 6-month follow-up, 25 eyes (96.2%) of the LTS group and 20 (71.4%) of the ES group had favorable outcome (P = 0.025). There were one and eight eyes, respectively, with early recurrence. At the final 12-month evaluation, 23 eyes (88.5%) in the LTS group and 16 eyes (57.1%) in the ES group were successful. Three (11.5%) and 12 (42.9%) eyes respectively showed postoperative recurrence. There was a statistically significant difference between the two groups (P = 0.015) for the primary outcome, whereas age and gender did not influence success. The NEI VFQ-25 showed statistically significant subjective improvement from baseline in most categories of the QoL. No significant difference between the two procedures was detected at 6 months. Conclusion This study suggests that the LTS procedure has a superior surgical success rate and reduction of symptoms compared with the ES for the repair of involutional lower eyelid entropion. Both procedures showed similar improvement of the postoperative QoL. Trial registration International Clinical Trials Registry Platform identifier: ACTRN12616000620426.

Published
2019
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4. Serum Fas Ligand, Serum Myostatin and Urine TGF-β1 Are Elevated in Autosomal Dominant Polycystic Kidney Disease Patients with Impaired and Preserved Renal Function

Author

Vassilios Raptis, Constantinos Bakogiannis, Charalampos Loutradis, Afroditi K. Boutou, Athanasios Sioulis, Elias Balaskas, Pantelis Zebekakis, and Pantelis A. Sarafidis

Subjects
Fibrosis, Apoptosis, Endothelial dysfunction, Chronic kidney disease, Dermatology, RL1-803, Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Background/Aims: The pathophysiology of renal disease progression in autosomal dominant polycystic disease (ADPKD) is largely unknown. Recent evidence suggests microvascular dysfunction leading to renal ischemia, as an additional pathway for renal function decline. This study examined the levels of serum Fas ligand (FasL), serum myostatin and urine transforming growth factor-beta 1 (TGF-β1) and their association with markers of endothelial dysfunction, in ADPKD patients with preserved or impaired renal function. Methods: Seventy-eight participants were enrolled in the study, divided in three groups: Group A consisted of 26 ADPKD patients with impaired renal function (eGFR 45-70 ml/min/1.73m2), Group B of 26 ADPKD patients with preserved renal function (eGFR > 70 ml/min/1.73m2), and Group C of 26 age- and sex- matched controls with no history of renal disease. Serum FasL, myostatin and urine levels of TGF-β1 were measured as biomarkers of vascular dysfunction, apoptosis and fibrosis with ELISA techniques. Results: Group A patients had significantly higher levels of FasL (13.12±1.69 ng/mL), myostatin (4.62±0.59 ng/mL) and urine logTGF-β1 (3.56±0.49 ng/24h) compared to Group B (9.6±1.28 ng/mL, 3.06±0.35, and 2.09±0.37, respectively, p< 0.001 for all comparisons) or controls (6.59±1.17 ng/mL, 2.18±0.45 ng/ml, and 1.58±0.21, respectively, p< 0.001 for all comparisons). Patients in Group B had also higher levels of all markers compared to controls (p< 0.001), despite having similar renal function. In ADKPD patients negative associations of eGFR with FasL (r=-0.799, p< 0.001), myostatin (r=-0.856, p< 0.001) and TGF-β1 (r=-0.476, p< 0.001) but positive correlations of these markers with asymmetric dimethylarginine (ADMA) (r=0.825; r=0.749; and r=0.599, respectively p< 0.001) were noted. Multivariate analysis demonstrated that FasL was independently associated with high urine TGF-β1 (OR 3.774, 95%CI 1.180-12.072, p=0.025). Conclusions: ADPKD patients with moderately preserved renal function have higher levels of FasL, myostatin and urine TGF-β1 than controls. These results indicate that an interplay between endothelial dysfunction and renal ischemia with mechanisms linked to apoptosis and fibrosis may be present even in early stages of ADPKD.

Published
2018
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5. Acute Interstitial Nephritis in a Patient with Non-Small Cell Lung Cancer under Immunotherapy with Nivolumab

Author

Panagiotis I. Georgianos, Vasilios Vaios, Eleni Leontaridou, Georgia Karayannopoulou, Triantafyllia Koletsa, Athanasios Sioulis, Elias V. Balaskas, and Pantelis E. Zebekakis

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Immune-checkpoint-inhibitors (ICPIs) represent a novel class of immunotherapy against several malignancies. These agents are associated with several “immune-mediated” adverse effects, but the reported renal toxicity of ICPIs is less well defined. We present the case of a 60-year-old man with a history of non-small cell lung cancer, who developed acute kidney injury (AKI) approximately 3.5 months after initiation of immunotherapy with nivolumab. Urinalysis revealed sterile pyuria, without microscopic hematuria or proteinuria. Immunological examination was negative. A renal biopsy showed severe interstitial inflammatory infiltration of T-cells, monocytes, and eosinophils without interstitial granulomas and normal appearance of glomeruli, indicating acute interstitial nephritis (AIN) as the cause of AKI. After a short-term course of corticosteroids and permanent nivolumab discontinuation, partial recovery of renal function was noted. AIN is a rare adverse effect of ICPIs that mandates the close monitoring of renal function in patients under immunotherapy with these agents.

Published
2019
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7. Synchronous Surgical Treatment of Lower Eyelid Involutional Entropion and Ptosis

Author

D. Vasakos, E. Nakos, and C. Sioulis

Subjects
Ophthalmology, RE1-994
Abstract

Background. Involutional entropion and upper eyelid ptosis are common eyelid diseases in the elderly population. They represent a frequent cause of discomfort and often result in significant visual and functional impairment. The surgical management of these disorders includes various treatment options and techniques and is usually carried out in multiple time sessions. Case Report. We report the case of a 72 year old female patient, suffering from right eye involutional lower eyelid entropion and ptosis, who was treated synchronously for both conditions, by applying the lateral tarsal strip procedure and the levator resection technique. Conclusion. The synchronous treatment of involutional entropion and ptosis is an alternative treatment strategy, which could potentially improve surgical outcome, while reducing postoperative recovery time and treatment costs.

Published
2018
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9. Elevated Asymmetric Dimethylarginine is Associated With Oxidant Stress Aggravation in Patients With Early Stage Autosomal Dominant Polycystic Kidney Disease

Author

Vassilios Raptis, Panagiotis I. Georgianos, Pantelis A. Sarafidis, Athanasios Sioulis, Kali Makedou, Areti Makedou, Dimitrios M. Grekas, and Stergios Kapoulas

Subjects
ADPKD, Asymmetric dimethylarginine, ADMA, autosomal dominated polycystic kidney disease, eGFR, Oxidative stress, Dermatology, RL1-803, Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Background/Aims: In experimental models of polycystic kidney disease impaired bioavailability of nitric oxide (NO) and elevated mRNA expression of oxidative stress markers at the kidney level was noted. However, clinical studies investigating the potential role of endothelial dysfunction and oxidative stress in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are limited. We evaluated asymmetric dimethylarginine (ADMA) as marker of NO synthase inhibitor as well as 15-F2t-Isoprostane and oxidized-low density lipoprotein (oxidized-LDL) as measures of oxidative stress in patients with early stages ADPKD. Methods: We recruited 26 ADPKD patients (Group A) with modestly impaired renal function (eGFR 45-70 ml/min/1.73m2), 26 age- and sex-matched ADPKD patients (Group B) with relatively preserved renal function (eGFR)>70 ml/min/1.73m2), and 26 age- and sex-matched controls (Group C). Determination of circulating levels of ADMA, 15-F2t-Isoprostane, oxidized-LDL and routine biochemistry was performed. Results: Group A and B had significantly higher ADMA levels as compared to controls (1.68±0.7 vs 0.51±0.2 μmol/l, P2t-IsoP and oxidized-LDL levels were also significantly higher in Group B relative to controls (788.8±185.0 vs 383.1±86.0 pgr/ml, P2t-Isoprostane (r=0.811, PConclusion: This study shows elevation in circulating levels of ADMA along with aggravation of oxidative stress from the early stages of ADPKD.

Published
2014
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11. Relative validity and reproducibility of the CyFFQ semiquantitative food frequency questionnaire for assessing dietary intake in Cypriot adults.

Author

Philippou, Elena, Demetriou, Christiana A., Loucaides, George, Solomonidou, Nastazia, Critselis, Elena, Polykarpou, Maria, Sioulis, Spyros, Hadjisavvas, Andreas, and Kyriacou, Kyriacos

Subjects
EXPERIMENTAL design, STATISTICS, NUTRITIONAL assessment, RESEARCH evaluation, RESEARCH methodology, RESEARCH methodology evaluation, NUTRITIONAL requirements, INTERVIEWING, QUESTIONNAIRES, INTRACLASS correlation, MICRONUTRIENTS, DATA analysis
Abstract

Background: Assessment of dietary intake is fundamental for evaluating the interrelationships between diet and disease. The present study aimed to develop and validate the semiquantitative Cypriot food frequency questionnaire (CyFFQ). Methods: A 171‐item paper‐and‐pencil semiquantitative interview‐administered FFQ was developed, including local foods and culturally specific meals commonly consumed among Cypriot adults. FFQ reproducibility was assessed by comparing the energy‐adjusted daily macro‐ and micronutrients intake at baseline (FFQ1) and 1 year later (FFQ2) using a Wilcoxon matched pairs signed rank test and intraclass correlation coefficients (ICCs) in a random sample of Cypriot adults. FFQ relative validity was evaluated by comparing the intake as estimated by FFQ2 with that obtained from the average of three 24‐h recalls taken over the year between FFQ1 and FFQ2. Associations between nutrient intakes estimated using FFQ2 and the 24‐h recalls were assessed using Spearman rank correlation and Bland–Altman plots were used to assess agreement between the FFQ and the 24‐h recalls. Results: Among eligible participants, 68 (78%) completed the study (44.1% males, aged 30.5–47.5 years). The energy‐adjusted intakes of macro‐ and micronutrients did not significantly differ between the two FFQs, excluding magnesium. The FFQ2 and the averaged 24‐h recalls were significantly correlated for most macro‐ and micronutrients. The median (interquartile) ICC for all macro‐ and micronutrients was 0.46 (0.38–0.52) (p < 0.05). Agreement was satisfactory (>30%) for most micro‐ and macronutrients. Bland–Altman plots also confirmed good agreement between the two methods. Conclusions: The CyFFQ is a valid and reliable tool for assessing dietary consumption in Cypriot adults. Key points: Culturally applicable dietary intake assessment tools are necessary to evaluate the relationships between diet and health/disease aspects.The present study aimed to develop and validate the semiquantitative Cypriot food frequency questionnaire (CyFFQ).After developing a 171‐paper‐and‐pencil semiquantitative interview‐administered FFQ, including local and culturally specific meals, both reproducibility and relative validity were assessed in a random sample of Cypriot adults.In statistical analysis comparing the FFQ provided to the participants at baseline and 1 year later, energy‐adjusted intakes of macro‐ and micronutrients did not significantly differ between the two FFQs, with the exception of magnesium. A comparison between the energy‐adjusted daily macro‐ and micronutrients intake 1 year later (FFQ2) and the average of three 24‐h recalls provided between baseline and FFQ2 showed significant correlation and agreement, using various methods, for most macro‐ and micronutrients.Our findings indicate that the CyFFQ is a valid and reliable tool for assessing dietary consumption in Cypriot adults and thus can be used in future research. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Histological grading in primary membranous nephropathy is essential for clinical management and predicts outcome of patients

Author

Ioannis Stefanidis, Nikolaos Kaperonis, Panagiota Manolakaki, Demetrios Vlahakos, Kostas Stylianou, Christos Dioudis, Hara Gakiopoulou, Aikaterini Papagianni, Christina Nikolaidou, Paraskevi-Evi Andronikidi, George Moustakas, Spyridon Golfinopoulos, Irene Grapsa, Dimitrios S. Goumenos, Vasiliki Choulitoudi, Evangelos Papachristou, Synodi Zerbala, John Boletis, Christina Vourlakou, Evangelia Dounousi, Athanasios Sioulis, Paraskevi Pavlakou, Maria Tsilivigkou, Kyriaki Kolovou, Christos Iatrou, Dimitra Galitsiou, Ioanna-Theologia Lampropoulou, George Liapis, Theofanis Apostolou, Efstathios Mitsopoulos, Christos Paliouras, Stylianos Panagoutsos, Eugene Dafnis, Aimilios Andrikos, Olga Balafa, Smaragdi Marinaki, Panagiota Papadea, Sophia Spaia, Apostolos Papadogianakis, Panagiotis Pateinakis, Maria Stangou, Ioannis Tzanakis, and Eufemia Balassi

Subjects
0301 basic medicine, focal sclerosis, Adult, Male, medicine.medical_specialty, Histology, Adolescent, medicine.medical_treatment, Biopsy, Renal function, Disease, Kidney, Gastroenterology, Glomerulonephritis, Membranous, Pathology and Forensic Medicine, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Membranous nephropathy, Internal medicine, medicine, Humans, Grading (tumors), Aged, Retrospective Studies, Aged, 80 and over, business.industry, vascular hyalinosis, Histocytochemistry, Immunosuppression, General Medicine, Original Articles, interstitial fibrosis, Middle Aged, medicine.disease, Prognosis, primary membranous nephropathy, 030104 developmental biology, 030220 oncology & carcinogenesis, outcome, Immunohistochemistry, Original Article, Female, Kidney Diseases, tubular atrophy, business, Nephrotic syndrome, Immunosuppressive Agents
Abstract

Aims Diagnosis of primary membranous nephropathy (PMN) is mainly based on immunofluorescence/immunohistochemistry findings. However, assessment of specific features on optical microscopy can help to estimate the severity of the disease, guide treatment and predict the response. The aim of this study was to identify, classify and grade the precise histological findings in PMN to predict renal function outcome and guide treatment. Methods and results Histological parameters, including focal segmental sclerosis (FSGS), tubular atrophy (TA), interstitial fibrosis (IF) and vascular hyalinosis (VH), were re‐evaluated in 752 patients with PMN. Their predictive value was estimated separately, and also in a combination score (FSTIV) graded from 0 to 4. Finally, the impact of histology was assessed in the response to immunosuppressive treatment. Mean age of patients was 53.3 (15–85) years and most presented with nephrotic syndrome. FSGS was present in 32% and VH in 51% of the patients, while TA and IF were graded as stage ≥1 in 52% and 51.4%, respectively. The follow‐up period was 122.3 (112–376) months. FSGS, TA and IF and VH were associated with impaired renal function at diagnosis (P = 0.02, P 50% eGFR reduction, FSGS (P = 0.001) and TA (P = 0.02). Also, patients presented with FSGS, IF, VH and/or with FSTIV > 1 could benefit from immunosuppression, regardless of clinical presentation. Conclusions The presence and degree of four histological indices, FSGS, VH, TA and IF, assessed separately or in combination, and FSTIV score not only predict renal function outcome after long‐term follow‐up, but can also help in the choice of appropriate treatment. Decisions concerning immunosuppressive treatment can be guided by pathology regardless of clinical findings.

Published
2019

14. Performance-based functional assessment in older hospitalized patients: feasibility and clinical correlates

Author

Volpato, Stefano, Cavalieri, Margherita, Guerra, Gianluca, Sioulis, Fotini, Ranzini, Monica, Maraldi, Cinzia, Fellin, Renato, and Guralnik, Jack M.

Subjects
Aged patients -- Care and treatment, Executive function (Psychology) -- Research, Aging -- Health aspects, Physical fitness -- Research, Feasibility studies, Health, Seniors
Abstract

Background. Functional evaluation is a cornerstone of multidimensional geriatric assessment; however, little is known of the clinical value of standardized performance-based assessment in the acute care setting. The aim of this study was to evaluate the clinical correlates and short-term predictive value of the Short Physical Performance Battery (SPPB) in older patients admitted to the hospital for an acute medical event. Methods. We enrolled 92 women and men 65 years old or older who were able to walk, who had a Mini-Mental State Examination (MMSE) score [greater than or equal to] 18, and who were admitted to the hospital with a clinical diagnosis of congestive heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), or minor stroke. The SPPB was assessed at hospital admission and discharge. Self-report functional assessment included basic activities of daily living (ADL) and instrumental activities of daily living (IADL). Spearman's rank correlation coefficients and multivariable linear regression analyses were used to study the association of SPPB score and functional and clinical characteristics, including length of hospital stay. Results. The mean age was 77.7 years (range 65-94 years), 49% were female, 64.1% had congestive heart failure, 16% COPD, 13.1% pneumonia, and 6.5% minor stroke. At hospital admission the mean SPPB score was 6.0 [+ or -] 2.7. SPPB scores were inversely correlated with age, the severity of the index disease, and IADL and ADL difficulty 2 weeks before hospital admission (p < .01), and were directly correlated with MMSE score (p = .002). On average, SPPB score increased 1 point (+0.97, standard error of the mean = 0.2; p for paired t test < .001) from baseline to hospital discharge assessment. After adjustment for potential confounders, baseline SPPB score was significantly associated with the length of hospital stay (p < .007). Conclusion. In older acute care inpatients, SPPB is a valid indicator of functional and clinical status. SPPB score at hospital admission is an independent predictor of the length of hospital stay. Key Words: Short Physical Performance Battery--Functional assessment--Hospital--Feasibility--Prognosis--Aging.

Published
2008

16. Spontaneous Lens Rupture in Congenital Cataract, Presented as Lens Fragment Within the Anterior Chamber

Author

Konstantina Sorkou, Maria Eleni Manthou, Ariadni Gavriilidou, Christos Sioulis, and Soultana Meditskou

Subjects
Spontaneous rupture, medicine.medical_specialty, Visual acuity, genetic structures, medicine.medical_treatment, lens fragment, Anterior polar cataract, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Ophthalmology, Metaplasia, medicine, Pathology, lens rupture, Persistent fetal vasculature, anterior polar cataract, Histological examination, business.industry, General Engineering, Phacoemulsification, medicine.anatomical_structure, congenital cataract, Lens (anatomy), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

We report the case of a 60-year-old woman with a congenital anterior polar cataract who presented with a lens fragment within the anterior chamber of her left eye, without a medical history of surgery or trauma. Uneventful phacoemulsification with simultaneous removal of the lens fragment followed. Postoperatively, the patient's visual acuity improved from a perception of light to 20/100. Histological examination of the lens fragment revealed persistent fetal vasculature, as well as fibrous metaplasia and extensive collagenesis. To our knowledge, this is the first report of spontaneous rupture of both the anterior capsule and the lens.

Published
2020

22. Immunosuppressive regimens based on Cyclophospamide or Calcineurin inhibitors: Comparison of their effect in the long term outcome of Primary Membranous Nephropathy

Author

Christos Dioudis, Eirini Grapsa, Smaragdi Marinaki, Dimitrios S. Goumenos, Aimilios Andrikos, Karolos-Pavlos Rapsomanikis, Christos Iatrou, Synodi Zerbala, Athanasios Sioulis, Evangelos Papachristou, Maria Stangou, Ioannis Stefanidis, Ioannis Boletis, Maria Tsilivigkou, Olga Balafa, Nikolaos Kaperonis, Vasiliki Choulitoudi, Ioannis Tzanakis, Sophia Spaia, Apostolos Papadogianakis, Eugene Dafnis, Erasmia Sambani, Fani Papoulidou, Aikaperini Papagianni, Theofanis Apostolou, Dimitrios Vlachakos, Efstathios Mitsopoulos, Panagiota Manolakaki, Paraskevi-Evi Andronikidi, Christos Paliouras, Kyriaki Kolovou, Dorothea Papadopoulou, Stylianos Panagoutsos, Dimitra Galitsiou, Panagiota Papadea, Helen Liakou, Spyridon Golfinopoulos, Kostas Stylianou, and George Moustakas

Subjects
Male, medicine.medical_treatment, 030232 urology & nephrology, Spontaneous remission, 030204 cardiovascular system & hematology, Pathology and Laboratory Medicine, Glomerulonephritis, Membranous, Gastroenterology, 0302 clinical medicine, Chronic Kidney Disease, Medicine and Health Sciences, Aged, 80 and over, Multidisciplinary, Proteinuria, Drugs, Immunosuppression, Middle Aged, Immunosuppressives, 3. Good health, Treatment Outcome, Nephrology, Medicine, Female, Anatomy, medicine.symptom, Immunosuppressive Agents, Research Article, medicine.drug, Adult, medicine.medical_specialty, Histology, Adolescent, Cyclophosphamide, Science, Immunology, Calcineurin Inhibitors, Renal function, Immune Suppression, Young Adult, 03 medical and health sciences, Signs and Symptoms, Membranous nephropathy, Diagnostic Medicine, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Pharmacology, business.industry, Biology and Life Sciences, Retrospective cohort study, Renal System, medicine.disease, Fibrosis, Calcineurin, Atrophy, business, Developmental Biology
Abstract

IntroductionManagement of the Primary Membranous Nephropathy (PMN) usually involves administration of immunosuppressives. Cyclophosphamide (Cyclo) and Calcineurin Inhibitors (CNIs) are both widely used but only limited data exist to compare their efficacy in long term follow-up.AimThe aim of the present study was to estimate and compare long term effects of Cyclo and CNIs in patients with PMN.Patients-methodsClinical data, histologic findings and long term outcome were retrospectively studied. The response to treatment and rate of relapse was compared between patients treated with CNIs or Cyclo based immunosuppressive regimens.ResultsTwenty three centers participated in the study, with 752 PMN patients (Mean age 53.4(14-87) yrs, M/F 467/285), followed for 10.1±5.7 years. All patients were initially treated with Renin Angiotensin Aldosterone System inhibitors (RAASi) for at least 6 months. Based on their response and tolerance to initial treatment, patients were divided into 3 groups, group I with spontaneous remission, who had no further treatment, group II, continued on RAASi only, and group III on RAASi+immunosuppression. Immunosuppressive regimes were mainly based on CNIs or Cyclo. Frequent relapses and failure to treatment were more common between patients who had started on CNIs (n = 381) compared to those initially treated with Cyclo (n = 110), relapse rate: 25.2% vs. 6.4%, pConclusionsLong term follow up showed that administration of Cyclo in PMN is followed by better preservation of renal function, increased response rate and less frequent relapses, compared to CNIs.

Published
2019

23. Immunosuppressive regimens based on Cyclophospamide or Calcineurin inhibitors: Comparison of their effect in the long term outcome of Primary Membranous Nephropathy

Author

Stangou, M. Marinaki, S. Papachristou, E. Kolovou, K. Sambani, E. Zerbala, S. Papadea, P. Balafa, O. Rapsomanikis, K.-P. Andrikos, A. Manolakaki, P. Papadopoulou, D. Mitsopoulos, E. Liakou, H. Andronikidi, P.-E. Choulitoudi, V. Moustakas, G. Galitsiou, D. Dafnis, E. Stylianou, K. Stefanidis, I. Golfinopoulos, S. Panagoutsos, S. Tsilivigkou, M. Papadogianakis, A. Tzanakis, I. Sioulis, A. Vlachakos, D. Grapsa, E. Spaia, S. Kaperonis, N. Paliouras, C. Dioudis, C. Papoulidou, F. Apostolou, T. Iatrou, C. Boletis, I. Goumenos, D. Papagianni, A.

Abstract

Introduction Management of the Primary Membranous Nephropathy (PMN) usually involves administration of immunosuppressives. Cyclophosphamide (Cyclo) and Calcineurin Inhibitors (CNIs) are both widely used but only limited data exist to compare their efficacy in long term followup. Aim The aim of the present study was to estimate and compare long term effects of Cyclo and CNIs in patients with PMN. Patients-methods Clinical data, histologic findings and long term outcome were retrospectively studied. The response to treatment and rate of relapse was compared between patients treated with CNIs or Cyclo based immunosuppressive regimens. Results Twenty three centers participated in the study, with 752 PMN patients (Mean age 53.4(14- 87) yrs, M/F 467/285), followed for 10.1±5.7 years. All patients were initially treated with Renin Angiotensin Aldosterone System inhibitors (RAASi) for at least 6 months. Based on their response and tolerance to initial treatment, patients were divided into 3 groups, group I with spontaneous remission, who had no further treatment, group II, continued on RAASi only, and group III on RAASi+immunosuppression. Immunosuppressive regimes were mainly based on CNIs or Cyclo. Frequent relapses and failure to treatment were more common between patients who had started on CNIs (n = 381) compared to those initially treated with Cyclo (n = 110), relapse rate: 25.2% vs. 6.4%, p

Published
2019

24. Acute Interstitial Nephritis in a Patient with Non-Small Cell Lung Cancer under Immunotherapy with Nivolumab

Author

Georgia Karayannopoulou, Eleni Leontaridou, Panagiotis I. Georgianos, Triantafyllia Koletsa, Elias V. Balaskas, Vasilios Vaios, Pantelis Zebekakis, and Athanasios Sioulis

Subjects
medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, Renal function, Case Report, 030204 cardiovascular system & hematology, urologic and male genital diseases, lcsh:RC870-923, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Lung cancer, Adverse effect, Proteinuria, medicine.diagnostic_test, business.industry, Acute kidney injury, Immunotherapy, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Nephrology, Renal biopsy, Nivolumab, medicine.symptom, business
Abstract

Immune-checkpoint-inhibitors (ICPIs) represent a novel class of immunotherapy against several malignancies. These agents are associated with several “immune-mediated” adverse effects, but the reported renal toxicity of ICPIs is less well defined. We present the case of a 60-year-old man with a history of non-small cell lung cancer, who developed acute kidney injury (AKI) approximately 3.5 months after initiation of immunotherapy with nivolumab. Urinalysis revealed sterile pyuria, without microscopic hematuria or proteinuria. Immunological examination was negative. A renal biopsy showed severe interstitial inflammatory infiltration of T-cells, monocytes, and eosinophils without interstitial granulomas and normal appearance of glomeruli, indicating acute interstitial nephritis (AIN) as the cause of AKI. After a short-term course of corticosteroids and permanent nivolumab discontinuation, partial recovery of renal function was noted. AIN is a rare adverse effect of ICPIs that mandates the close monitoring of renal function in patients under immunotherapy with these agents.

Published
2019

25. Histological grading in primary membranous nephropathy is essential for clinical management and predicts outcome of patients

Author

Stangou, M.J. Marinaki, S. Papachristou, E. Liapis, G. Pateinakis, P. Gakiopoulou, H. Nikolaidou, C. Kolovou, K. Lampropoulou, I.-T. Zerbala, S. Papadea, P. Dounousi, E. Balafa, O. Pavlakou, P. Andrikos, A. Balassi, E. Manolakaki, P. Moustakas, G. Galitsiou, D. Mitsopoulos, E. Vourlakou, C. Choulitoudi, V. Andronikidi, P.-E. Stefanidis, I. Golfinopoulos, S. Dafnis, E. Stylianou, K. Panagoutsos, S. Papadogianakis, A. Tzanakis, I. Sioulis, A. Vlahakos, D. Grapsa, I. Tsilivigkou, M. Kaperonis, N. Paliouras, C. Dioudis, C. Spaia, S. Apostolou, T. Iatrou, C. Boletis, J. Goumenos, D. Papagianni, A.

Abstract

Aims: Diagnosis of primary membranous nephropathy (PMN) is mainly based on immunofluorescence/immunohistochemistry findings. However, assessment of specific features on optical microscopy can help to estimate the severity of the disease, guide treatment and predict the response. The aim of this study was to identify, classify and grade the precise histological findings in PMN to predict renal function outcome and guide treatment. Methods and results: Histological parameters, including focal segmental sclerosis (FSGS), tubular atrophy (TA), interstitial fibrosis (IF) and vascular hyalinosis (VH), were re-evaluated in 752 patients with PMN. Their predictive value was estimated separately, and also in a combination score (FSTIV) graded from 0 to 4. Finally, the impact of histology was assessed in the response to immunosuppressive treatment. Mean age of patients was 53.3 (15–85) years and most presented with nephrotic syndrome. FSGS was present in 32% and VH in 51% of the patients, while TA and IF were graded as stage ≥1 in 52% and 51.4%, respectively. The follow-up period was 122.3 (112–376) months. FSGS, TA and IF and VH were associated with impaired renal function at diagnosis (P = 0.02, P 50% eGFR reduction, FSGS (P = 0.001) and TA (P = 0.02). Also, patients presented with FSGS, IF, VH and/or with FSTIV > 1 could benefit from immunosuppression, regardless of clinical presentation. Conclusions: The presence and degree of four histological indices, FSGS, VH, TA and IF, assessed separately or in combination, and FSTIV score not only predict renal function outcome after long-term follow-up, but can also help in the choice of appropriate treatment. Decisions concerning immunosuppressive treatment can be guided by pathology regardless of clinical findings. © 2019 The Authors. Histopathology published by John Wiley & Sons Ltd

Published
2019

26. Acute Interstitial Nephritis in a Patient with Non-Small Cell Lung Cancer under Immunotherapy with Nivolumab

Author

Georgianos, Panagiotis I., Vaios, Vasilios, Leontaridou, Eleni, Karayannopoulou, Georgia, Koletsa, Triantafyllia, Sioulis, Athanasios, Balaskas, Elias V., and Zebekakis, Pantelis E.

Subjects
Article Subject, urologic and male genital diseases
Abstract

Immune-checkpoint-inhibitors (ICPIs) represent a novel class of immunotherapy against several malignancies. These agents are associated with several “immune-mediated” adverse effects, but the reported renal toxicity of ICPIs is less well defined. We present the case of a 60-year-old man with a history of non-small cell lung cancer, who developed acute kidney injury (AKI) approximately 3.5 months after initiation of immunotherapy with nivolumab. Urinalysis revealed sterile pyuria, without microscopic hematuria or proteinuria. Immunological examination was negative. A renal biopsy showed severe interstitial inflammatory infiltration of T-cells, monocytes, and eosinophils without interstitial granulomas and normal appearance of glomeruli, indicating acute interstitial nephritis (AIN) as the cause of AKI. After a short-term course of corticosteroids and permanent nivolumab discontinuation, partial recovery of renal function was noted. AIN is a rare adverse effect of ICPIs that mandates the close monitoring of renal function in patients under immunotherapy with these agents.

Published
2019
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31. Antipsychotic prescription and mortality in hospitalized older persons

Author

Deborah, Chiesa, Alessandra, Marengoni, Alessandro, Nobili, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Codjo, D Djade, Salvatore, Corrao, Francesco, Salerno, Maura, Marcucci, Giuseppe, Romanelli, Pier Mannuccio Mannucci, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Tommaso, Barnini, Giuseppe, Delitala, Stefano, Carta, Sebastiana, Atzori, Gianfranco, Guarnieri, Michela, Zanetti, Annalisa, Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Laura, Gasbarrone, Giorgio, Maniscalco, Massimo, Gunelli, Daniela, Tirotta, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giancarlo, Agnelli, Emanuela, Marchesini, Elmo, Mannarino, Graziana, Lupattelli, Pamela, Rondelli, Francesco, Paciullo, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Maria Cristina Baroni, Marianna, Zardo, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa, Salvatore, Ferdinando Carlo Sasso, Riccardo, Utili, Emanuele Durante Mangoni, Daniela, Pinto, Oliviero, Olivieri, Anna Maria Stanzial, Fellin, Renato, Volpato, Stefano, Sioulis, Fotini, Mario, Barbagallo, Ligia, Dominguez, Lidia, Plances, Daniela, D’Angelo, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Claudio, Borghi, Enrico, Strocchi, Elisa Rebecca Rinaldi, Marco, Zoli, Elisa, Fabbri, Donatella, Magalotti, Alberto, Auteri, Anna Laura Pasqui, Luca, Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Carlo, Sabbà, Francesco Saverio Vella, Alessandro, Marseglia, Chiara Valentina Luglio, Giuseppe, Palasciano, Maria Ester Modeo, Annamaria, Aquilino, Pallante, Raffaele, Stefania, Pugliese, Caterina, Capobianco, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi, Fenoglio, Chiara, Brignone, Christian, Bracco, Alessia, Giraudo, Giuseppe, Musca, Olga, Cuccurullo, Luigi, Cricco, Alessandra, Fiorentini, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Silvia, Fargion, Paola, Bonara, Mara, Bulgheroni, Rosa, Lombardi, Marianna, Porzio, Giulia, Periti, Fabio, Magrini, Ferdinando, Massari, Tatiana, Tonella, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Guido, Moreo, Barbara, Ferrari, Luisa, Roncari, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Silvia, Prolo, Maria Sole Lilleri, Giuliana, Micale, Mauro, Podda, Carlo, Selmi, Francesca, Meda, Silvia, Accordino, Alessio, Conca, Valentina, Monti, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Giovanni, Murialdo, Marta, Bovio, Franco, Dallegri, Luciano, Ottonello, Alessandra, Quercioli, Alessandra, Barreca, Maria Beatrice Secchi, Davide, Ghelfi, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Elisabetta, Bergami, Emanuela, Rizzioli, Carlo, Cagnoni, Luca, Bertone, Antonio, Manucra, Alberto, Buratti, Tiziana, Tognin, Nicola Lucio Liberato, Giordano, Bernasconi, Barbara, Nardo, Giovanni Battista Bianchi, Sabrina, Giaquinto, Giampiero, Benetti, Michela, Quagliolo, Giuseppe Riccardo Centenaro, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Francesco, Gullo, Michele, Cortellaro, Marina, Magenta, Francesca, Perego, Maria Rachele Meroni, Marco, Cicardi, Antonio Gidaro Marina Magenta, Andrea, Sacco, Antonio, Bonelli, Gaetano, Dentamaro, Renzo, Rozzini, Lina, Falanga, Alessandro, Giordano, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Giacomo, Fera, Maria Loreta Di Luca, Donatella, Renna, Antonio, Perciccante, Alessia, Coralli, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giorgio, Menardo, Stefania, Bottone, Elsa, Sferrazzo, Claudio, Ferri, Rinaldo, Striuli, Rosa, Scipioni, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Franco, Ricci, Cosimo, Morabito, Roberto, Fava, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Filippo Rossi Fanelli, Massimo, Delfino, Antonio, Amoroso, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Pietro, Serra, Vincenzo, Fontana, Marco, Falcone, Raffaele, Landolfi, Antonio, Grieco, Antonella, Gallo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Caterina, Pirali, Claudia, Amolini, Enrico Agabiti Rosei, Damiano, Rizzoni, Luana, Castoldi, Antonio, Picardi, Umberto Vespasiani Gentilucci, Chiara, Mazzarelli, Paolo, Gallo, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Sara, Contini, Marta, Molaro, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Marco, Bertolotti, Chiara, Mussi, Roberto, Scotto, Maria Alice Ferri, Francesca, Veltri, Franco, Arturi, Elena, Succurro, Giorgio, Sesti, Umberto, Gualtieri, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Lorenzo Mauro Carozza, Fabio, Pignatti., Chiesa, D., Marengoni, A., Nobili, A., Tettamanti, M., Pasina, L., Franchi, C., Djade, C., Corrao, S., Salerno, F., Marcucci, M., Romanelli, G., and Mannucci, P.

Subjects
Male, Socio-culturale, Older person, Antipsychotic, Cognition, Economica, Antipsychotics, Hospitalization, Mortality, Older persons, Gerontology, Geriatrics and Gerontology, Psychiatry and Mental Health, Humans, Psychomotor Agitation, Aged, antipsychotics, hospitalization, mortality, older persons, Aged, 80 and over, Mental Disorders, Patient Discharge, antipsychotics, Italy, hospitalization, mortality, older persons, Dementia, Female, Antipsychotic Agents
Abstract

Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score ≥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score

Published
2017

32. Compliance of low-cost, single-frequency GNSS receivers to standards consistent with ISO for control surveying

Author

Maria Tsakiri, Antonis Sioulis, and George Piniotis

Subjects
Engineering, Technology, Control (management), control surveying networks, Survey result, Satellite system, 02 engineering and technology, 01 natural sciences, low-cost gnss receivers (global navigation satellite system), 0202 electrical engineering, electronic engineering, information engineering, Sensitivity (control systems), Safety, Risk, Reliability and Quality, Remote sensing, business.industry, 010401 analytical chemistry, Geodetic datum, 020206 networking & telecommunications, 0104 chemical sciences, Reliability engineering, General purpose, GNSS applications, standards, accuracy specifications, Lower cost, business
Abstract

The emergence of single-frequency, navigation-type Global Navigation Satellite System receivers capable to provide carrier phase data [the so-called high sensitivity (HS) carrier phase positioning] has been steadily growing over the recent years. The main purpose of this study is to metrologically evaluate two low-cost, HS receivers, namely the u-blox LEA-6T and NEO-7P, in control surveying specifications. The evaluation was carried out within a published framework of standards and associated guidelines that are consistent with standards from the International Standards Organisation. The survey results were obtained from sufficient independent testing and proof and achieved an accuracy classification of ‘1 cm’ at 95% confidence level. This indicates that the particular type of receiver used with geodetic antennas can provide positioning results for general purpose control surveying applications that are comparable to using geodetic receivers and with a significantly lower cost.

Published
2017

33. Elevated Asymmetric Dimethylarginine is Associated With Oxidant Stress Aggravation in Patients With Early Stage Autosomal Dominant Polycystic Kidney Disease

Author

Areti Makedou, V. Raptis, Dimitrios Grekas, Stergios Kapoulas, Panagiotis I. Georgianos, Pantelis Sarafidis, Kali Makedou, and Athanasios Sioulis

Subjects
Adult, Male, medicine.medical_specialty, Asymmetric dimethylarginine, lcsh:Diseases of the circulatory (Cardiovascular) system, Adolescent, Autosomal dominant polycystic kidney disease, Renal function, Oxidative phosphorylation, Isoprostanes, Biology, Arginine, Dinoprost, Kidney Function Tests, medicine.disease_cause, lcsh:RC870-923, autosomal dominated polycystic kidney disease, Nitric oxide, Young Adult, chemistry.chemical_compound, Internal medicine, medicine, Polycystic kidney disease, eGFR, lcsh:Dermatology, Humans, Aged, ADPKD, General Medicine, Middle Aged, lcsh:RL1-803, Polycystic Kidney, Autosomal Dominant, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Bioavailability, Lipoproteins, LDL, ADMA, Endocrinology, chemistry, Nephrology, Oxidative stress, lcsh:RC666-701, Disease Progression, Female, Cardiology and Cardiovascular Medicine, Glomerular Filtration Rate
Abstract

Background/Aims: In experimental models of polycystic kidney disease impaired bioavailability of nitric oxide (NO) and elevated mRNA expression of oxidative stress markers at the kidney level was noted. However, clinical studies investigating the potential role of endothelial dysfunction and oxidative stress in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are limited. We evaluated asymmetric dimethylarginine (ADMA) as marker of NO synthase inhibitor as well as 15-F2t-Isoprostane and oxidized-low density lipoprotein (oxidized-LDL) as measures of oxidative stress in patients with early stages ADPKD. Methods: We recruited 26 ADPKD patients (Group A) with modestly impaired renal function (eGFR 45-70 ml/min/1.73m2), 26 age- and sex-matched ADPKD patients (Group B) with relatively preserved renal function (eGFR)>70 ml/min/1.73m2), and 26 age- and sex-matched controls (Group C). Determination of circulating levels of ADMA, 15-F2t-Isoprostane, oxidized-LDL and routine biochemistry was performed. Results: Group A and B had significantly higher ADMA levels as compared to controls (1.68±0.7 vs 0.51±0.2 μmol/l, P2t-IsoP and oxidized-LDL levels were also significantly higher in Group B relative to controls (788.8±185.0 vs 383.1±86.0 pgr/ml, P2t-Isoprostane (r=0.811, PConclusion: This study shows elevation in circulating levels of ADMA along with aggravation of oxidative stress from the early stages of ADPKD.

Published
2014

35. Heart failure and chronic kidney disease in a registry of internal medicine wards

Author

Rosa Di Costanzo, Roberto Corinaldesi, Federica Quaglia, Umberto Vespasiani Gentilucci, Giancarlo Agnelli, M. Vanoli, Roberta Forlano, Valeria Savojardo, Luca Bertone, Elisa Fabbri, Antonino Di Pino, Claudia Amolini, Giampiera Bertolino, Paolo Cavallo Perin, Paola Bonara, Tommaso Barnini, Fabrizio Fabris, Paola Di Corato, Maria Rosaria Barbella, Francesco Franceschi, Elisabetta Bergami, Roberto Manfredini, Sonia Seghezzi, Enrico Strocchi, Maria Domenica Cappellini, Antonio Manucra, Alberto Tedeschi, Maurizio Corsi, Gabriella Gruden, Giuseppe Licata, Marianna Zardo, Emanuela Marchesini, Luca Pasina, Maria Ester Modeo, Mosè Bartone, Barbara Nardo, Umberto Gualtieri, Sabbatini Marta, Caterina Cenci, Alessia Coralli, Giorgio Annoni, Lucrezia De Feudis, V. Monti, Pietro Serra, Anna Maria Stanzial, Antonio Bonelli, Gianpaolo Reboldi, Francesco Paciullo, Ferdinando Massari, Graziana Lupattelli, Giorgio Sesti, Silvia Fargion, Angela Sciacqua, Giovanna Fabio, Silvia Di Carlo, Maria Grazia Serra, Emanuele Durante Mangoni, Salvatore Corrao, Maria Angela Becchi, Margherita Migone De Amicis, Francesco Gullo, Silvia Cappelli, Flora Peyvandi, Paolo Gallo, Chiara Mazzarelli, Daniela Calipari, Ferdinando Carlo Sasso, Carlo Cagnoni, Laura Carassale, Donatella Renna, Paola Loria, Davide Ghelfi, Alessandra Quercioli, Maria Teresa Guagnano, Luana Castoldi, Massimo Delfino, Cosimo Morabito, Giuseppe Musca, Francesca Turatto, Silvia Prolo, Lina Falanga, Michela Zanetti, Antonio Perciccante, Francesco Purrello, Marco Cicardi, Maria Beatrice Secchi, Mauro Tettamanti, Maria Rosaria Rizzo, Luigi Anastasio, C. Masala, Andrea Maria Maresca, Elena Silvestri, Domenico Prisco, Filippo Pedrazzoli, Marco Bertolotti, Guido De Marco, Giancarlo Traisci, Maria Carmela Carbone, Filippo Rossi Fanelli, Maria Valenti, Ilenia Pepe, Deborah Melis, Christian Bracco, Giorgio Maniscalco, Antonella Gallo, Daniela D'Angelo, Alfonso Iorio, Gianfranco Martucci, Tatiana Tonella, Ilaria Serio, Wu Sheng Chin, Michela Quagliolo, Cordischi Chiara, Andrea Sacco, Pietro Tizzani, Antonio Mammarella, Donatella Setti, Damiano Rizzoni, Lucia Gottardo, Olga Cuccurullo, Gino Roberto Corazza, Rinaldo Striuli, Elmo Mannarino, Guido Moreo, Luana Castiglioni, G. Vaudo, Teresa Salvatore, Maurizio Bicchi, Raffaella Rossio, Francesco Violi, Donatella Magalotti, Giuseppe Zuccalà, Luca Puccetti, Luigi Fenoglio, Daniela Tirotta, Alessandra Fiorentini, Oliviero Olivieri, Christian Folli, Alberto Buratti, Francesco Saverio Vella, Vincenzo Fontana, Giulia Grignani, Laura Gasbarrone, Sara Zazzetta, Antonio Brucato, Marco Zoli, Michele Cortellaro, Stella Provini, Claudio Borghi, Mario Barbagallo, Rodolfo Tassara, Sara Contini, Elisa Rebecca Rinaldi, Lidia Plances, Stefano Volpato, Alessandra Barreca, Ludovica Perri, Stefania Alborghetti, Chiara Valentina Luglio, Donatella Padula, Codjo Djignefa Djade, Maria Rachele Meroni, Mara Bulgheroni, Giuseppe Riccardo Centenaro, Chiara Bagnato, Salvatore Piro, Nicola Lucio Liberato, Luigi Bolondi, Franco Ricci, Annalisa Spalluti, Luciano Ottonello, Giordano Bernasconi, Antonio Picardi, Michela Carlon, Riccardo Utili, Maria Alice Ferri, Roberto Valenti, Francesca Veltri, Giorgio Menardo, Giuliana Micale, Maria Cristina Baroni, Piergiorgio Gaudenzi, Pallante Raffaele, Simona Sestili, Giuseppe Romanelli, Roberto De Giorgio, L. Rasciti, Franco Arturi, Marta Bovio, Alessandro Squizzato, Leonella Pasqualini, Pier Leopoldo Capecchi, Alfredo Postiglione, Maura Marcucci, Antonio Amoroso, Sarah Damanti, Lucia Sofia, E Mannarino, Francesca Perego, Silvia Caporotundo, Giuseppe Delitala, Gaetano Serviddio, Barbara Ferrari, Lorenzo Mauro Carozza, Raffaella Salmi, Giacomo Fera, Pier Mannuccio Mannucci, Daniela Mari, Pasquale Mansueto, Carlotta Franchi, Silvia Li Bassi, Luca Santi, Michele Quero, Graziella Bruno, Elsa Sferrazzo, Martino Bellusci, Sebastiana Atzori, Mauro Maurantonio, Mauro Bernardi, Maria Sole Lilleri, Maria Loreta Di Luca, Carlo Sabbà, Luigi Cricco, Mancuso G, Alessia Valentina Giraudo, Giovanni Battista Bianchi, Valentina Grasso, Chiara Mussi, Giovanni Murialdo, Chiara Brignone, Marco Pala, Marina Magenta, Franco Dallegri, Giuseppe Montrucchio, Pamela Rondelli, Carlo L. Balduini, P. M. Mannucci, Giampiero Benetti, Fabio Fabbian, Massimo Gunelli, Fabio Pignatti, Emanuela Miceli, Tiziana Tognin, Stefania Pugliese, Franco Laghi Pasini, Francesco Salerno, Alessandra Marengoni, Rosa Scipioni, A. Nobili, Maria Antonietta Bleve, Gianluca Casella, Francesca Meda, Elisabetta Greco, Antonio Gidaro Marina Magenta, Fabio Magrini, Elena Succurro, Emanuela Rizzioli, Valeria Raparelli, Susanna Gamberini, Caterina Pirali, Ligia J. Dominguez, Stefania Basili, Matteo Pirro, Luigi Calvo, Bartolomeo Lorenzati, Ranuccio Nuti, Francesco Perticone, Claudio Ferri, Giovanbattista Rini, Christian Molino, Stefano Carta, Marta Molaro, Francesco De Stefano, Maria Teresa Laieta, Annamaria Aquilino, Sabrina Giaquinto Ospedale, Gaetano Dentamaro, Martina Ruvio, Raffaele Landolfi, Renzo Rozzini, Mauro Serra, Giovanni Davì, Carlo Selmi, Renato Fellin, G. Lupattelli, Silvia Ghidoni, Marco Vincenzo Lenti, Alberto Auteri, Alessandro Giordano, Eleonora Sparacio, Marco Falcone, Roberto Fava, Anna Laura Pasqui, Giuseppe Palasciano, Daniela Di Pinto, Gianfranco Guarnieri, Rosa Lombardi, F. Paciullo, Luigina Guasti, Sioulis Fotini, Maria Magnini, Mauro Podda, Alessandro Marseglia, Silvia Accordino, Enrico Agabiti Rosei, Caterina Capobianco, Alessio Conca, Giuseppe Paolisso, Lara Rebella, Alessandra Fantuzzi, Paolo Rossi, Andrea Semplicini, Gianluigi Vendemiale, Luisa Roncari, Antonio Grieco, Roberto Scotto, Alessandro Nobili, Valter Monzani, Eugenio Ruggeri, Stefania Bottone, Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Reboldi, G, Vaudo, G, Pirro, M, Pasqualini, L, Mannucci, Pier Mannuccio, Nobili, Alessandro, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Iorio, Alfonso, Marcucci, Maura, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Djade, Codjo Djignefa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Zanetti, Michela, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Sabbà, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Conca, Alessio, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Ospedale, Sabrina Giaquinto, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Lupattelli, G., Reboldi, G., Paciullo, F., Vaudo, G., Pirro, M., Pasqualini, L., Nobili, A., Mannucci, P. M., Mannarino, E., Mannucci, PM, REPOSI, Investigators, Barbagallo, M, and Dominguez Rodríguez, LJ

Subjects
medicine.medical_specialty, Chronic kidney disease, Elderly, Heart failure, REPOSI, Gerontology, Geriatrics and Gerontology, Humans, Sleep Apnea Syndromes, Noninvasive Ventilation, Renal function, chronic kidney disease, elderly, registry, Tertiary care, Sleep Apnea Syndrome, Internal medicine, Epidemiology, medicine, business.industry, medicine.disease, Heart failure, Elderly, Chronic kidney disease, REPOSI, Icd codes, business, Clinical record, Body mass index, Kidney disease, Human
Abstract

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were significantly older (P

Published
2014

36. Eosinophilic Gastroenteritis Cured with Helicobacter pylori Eradication: Case Report and Review of Literature

Author

Michele Caselli, Cecilia Soavi, Giovanni Lanza, Francesca Cassol, Giovanni Zuliani, and Fotini Sioulis

Subjects
medicine.medical_specialty, biology, business.industry, Helicobacter pylori Eradication, Gastroenterology, Eosinophilic Gastroenteritis, General Medicine, Helicobacter pylori, biology.organism_classification, medicine.disease, Infectious Diseases, Internal medicine, Eosinophilic gastroenteritis, Medicine, business
Published
2014

38. Subsyndromal Delirium and Its Determinants in Elderly Patients Hospitalized for Acute Medical Illness

Author

Giovanni Zuliani, Francesco Bonetti, Antonio Cherubini, Fotini Sioulis, Stefano Prandini, Beatrice Gasperini, Marco D'Amato, Stefania Magon, and Elena Zampi

Subjects
Male, Aging, medicine.medical_specialty, Acute illness, Elderly, Subsyndromal delirium, Systemic inflammation, Cognition, Risk Factors, Internal medicine, mental disorders, Prevalence, medicine, Humans, Dementia, Effects of sleep deprivation on cognitive performance, Stroke, Aged, Aged, 80 and over, Mini–Mental State Examination, biology, medicine.diagnostic_test, business.industry, C-reactive protein, Delirium, medicine.disease, Comorbidity, Hospitalization, Oxygen, Italy, Case-Control Studies, Acute Disease, biology.protein, Physical therapy, Female, Geriatrics and Gerontology, medicine.symptom, Mental Status Schedule, business, Altered level of consciousness
Abstract

Background In older individuals, acute medical illnesses and admission to hospital are often associated with a deterioration of cognitive status, also in the absence of dementia and full-blown delirium. We evaluated the prevalence of subsyndromal delirium (SSD) and its correlates in a sample of elderly medical inpatients. Methods From 763 consecutive inpatients, 325 participants with known dementia or delirium were excluded, whereas 438 (mean age: 80.6 years; female participants: 60.1%) were enrolled. SSD was diagnosed within 48 hour from admission, when at least two DSM-IV delirium criteria including disorientation, attention or memory deficit, altered level of consciousness, or perceptual disturbances were present. Cognitive performance was evaluated by Mini Mental Status Examination (MMSE). General, clinical, and laboratory parameters were also registered. Results One hundred and sixty-six patients (37%) had SSD. Compared with controls, SSD patients were older individuals, had less formal education, higher comorbidity, lower hemoglobin/lymphocytes counts, and higher creatinine levels. A trend toward higher prevalence of previous stroke and widowhood was observed. A MMSE score of less than 24/30 identified SSD with 88% sensitivity and 78% specificity. In SSD patients, MMSE independently correlated with years of education, high-sensitivity C reactive protein levels, and O2 arterial saturation (model adjusted r (2) = 0.30, p = .001); conversely, only years of education were associated with MMSE in controls (adjusted r (2) = 0.06, p = .01). Conclusions Our data suggest that SSD is common in hospitalized older medical inpatients, and low MMSE score might be useful for identification of participants at risk of SSD. Current inflammatory response and reduced O2 arterial saturation were the only independent determinants of cognitive performance in SSD patients.

Published
2013

39. Serum Fas Ligand, Serum Myostatin and Urine TGF-β1 Are Elevated in Autosomal Dominant Polycystic Kidney Disease Patients with Impaired and Preserved Renal Function.

Author

Raptis, Vassilios, Bakogiannis, Constantinos, Loutradis, Charalampos, Boutou, Afroditi K., Sioulis, Athanasios, Balaskas, Elias, Zebekakis, Pantelis, and Sarafidis, Pantelis

Subjects
DISEASE progression, POLYCYSTIC kidney disease, MICROCIRCULATION disorders, MYOSTATIN, TRANSFORMING growth factors-beta, APOPTOSIS
Abstract

Background/Aims: The pathophysiology of renal disease progression in autosomal dominant polycystic disease (ADPKD) is largely unknown. Recent evidence suggests microvascular dysfunction leading to renal ischemia, as an additional pathway for renal function decline. This study examined the levels of serum Fas ligand (FasL), serum myostatin and urine transforming growth factor-beta 1 (TGF-β1) and their association with markers of endothelial dysfunction, in ADPKD patients with preserved or impaired renal function. Methods: Seventy-eight participants were enrolled in the study, divided in three groups: Group A consisted of 26 ADPKD patients with impaired renal function (eGFR 45-70 ml/min/1.73m2), Group B of 26 ADPKD patients with preserved renal function (eGFR > 70 ml/min/1.73m2), and Group C of 26 age- and sex- matched controls with no history of renal disease. Serum FasL, myostatin and urine levels of TGF-β1 were measured as biomarkers of vascular dysfunction, apoptosis and fibrosis with ELISA techniques. Results: Group A patients had significantly higher levels of FasL (13.12±1.69 ng/mL), myostatin (4.62±0.59 ng/mL) and urine logTGF-β1 (3.56±0.49 ng/24h) compared to Group B (9.6±1.28 ng/mL, 3.06±0.35, and 2.09±0.37, respectively, p< 0.001 for all comparisons) or controls (6.59±1.17 ng/mL, 2.18±0.45 ng/ml, and 1.58±0.21, respectively, p< 0.001 for all comparisons). Patients in Group B had also higher levels of all markers compared to controls (p< 0.001), despite having similar renal function. In ADKPD patients negative associations of eGFR with FasL (r=-0.799, p< 0.001), myostatin (r=-0.856, p< 0.001) and TGF-β1 (r=-0.476, p< 0.001) but positive correlations of these markers with asymmetric dimethylarginine (ADMA) (r=0.825; r=0.749; and r=0.599, respectively p< 0.001) were noted. Multivariate analysis demonstrated that FasL was independently associated with high urine TGF-β1 (OR 3.774, 95%CI 1.180-12.072, p=0.025). Conclusions: ADPKD patients with moderately preserved renal function have higher levels of FasL, myostatin and urine TGF-β1 than controls. These results indicate that an interplay between endothelial dysfunction and renal ischemia with mechanisms linked to apoptosis and fibrosis may be present even in early stages of ADPKD. [ABSTRACT FROM AUTHOR]

Published
2018
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40. Levels of Endocan, Angiopoietin-2, and Hypoxia-Inducible Factor-1a in Patients with Autosomal Dominant Polycystic Kidney Disease and Different Levels of Renal Function.

Author

Raptis, Vassilios, Bakogiannis, Constantinos, Loutradis, Charalampos, Boutou, Afroditi K., Lampropoulou, Ioanna, Intzevidou, Elena, Sioulis, Athanasios, Balaskas, Elias, Sarafidis, Pantelis A., Boutou, Afroditi K, and Sarafidis, Pantelis A

Subjects
ENDOTHELIUM diseases, ENDOTHELIAL cells, VASOCONSTRICTION, ANGIOPOIETIN-2, POLYCYSTIC kidney disease
Abstract

Background: Endothelial dysfunction leading to unbalanced vasoconstriction and ischemia of renal parenchyma is increasingly proposed as an alternative pathway of renal damage in autosomal dominant polycystic kidney disease (ADPKD). However, human studies investigating the evolution of such phenomena are limited. This study investigated the levels of emerging biomarkers of endothelial function, angiogenesis and hypoxia, in ADPKD patients with different renal function.Methods: The study population consisted of three groups: 26 ADPKD patients with impaired renal function (Group A; estimated glomerular filtration rate [eGFR] 45-70 mL/min/1.73 m2), 26 ADPKD patients with preserved renal function (Group B; eGFR >70 mL/min/1.73 m2), and 26 age- and sex-matched controls with no history of renal disease. Circulating levels of endocan (endothelial cell-specific molecule-1) angiopoietin-2, and hypoxia-inducible factor-1a (HIF-1a) were determined by enzyme-linked immunosorbent assay techniques.Results: Patients in Group A had significantly higher levels of endocan (7.17 ± 0.43 ng/mL), angiopoietin-2 (5,595.43 ± 3,390), and HIF-1a (163.68 ± 37.84 pg/mL) compared to patients in Group B (6.86 ± 0.59 ng/mL, p = 0.017, 3,854.41 ± 3,014.30, p = 0.018, 136.84 ± 42.10 pg/mL, p = 0.019 respectively) or controls (4.83 ± 0.69 ng/mL, 1,069 ± 427.88 pg/mL, 70.20 ± 17.49 pg/mL, p < 0.001 for all comparisons). Of note, patients in Group B had also higher levels of all markers compared to controls (p < 0.001) despite having similar renal function. In correlation analyses within ADPKD patients, we noted strong correlations of all studied markers with asymmetric dimethylarginine (ADMA; endocan r = 0.908, p < 0.001, angiopoietin-2 r = 0.983, p < 0.001 and HIF-1a r = 0.998, p < 0.001), and only weak or modest correlations with eGFR.Conclusions: This study suggests that endothelial dysfunction causing microcirculatory changes, linked to angiogenesis and hypoxia, may come early in the course of ADPKD and could be a key regulator of renal injury progression. [ABSTRACT FROM AUTHOR]

Published
2018
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41. The use of low-cost, single-frequency GNSS receivers in mapping surveys.

Author

Tsakiri, M., Sioulis, A., and Piniotis, G.

Subjects
*GLOBAL Positioning System, *CARTOGRAPHY, *SURVEYS, *GPS receivers, *GEODESY
Abstract

The emergence of low-cost, navigation-type receivers capable to provide carrier-phase data (the so-called high-sensitivity carrier-phase positioning) has been steadily growing over the recent years. The aim of this study was to evaluate the positioning performance of a high-sensitivity receiver in a network real-time kinematic environment for mapping surveying applications. Specifically, using as rover receiver the u-blox NEO-7P module and the low-cost antenna Tallysman TW2410, sets of data were collected for the purpose of mapping surveying. The external accuracy of the obtained solutions is considered using different positioning techniques and the internal indicators of the system during real-time kinematic (RTK) positioning are assessed. The assessment indicates that in benign environments this type of receivers produce results that are comparable to RTK positioning using geodetic receivers and with a significantly lower cost. [ABSTRACT FROM AUTHOR]

Published
2018
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43. Predictive Value of the Short Physical Performance Battery Following Hospitalization in Older Patients

Author

Stefano Volpato, Giovanni Zuliani, Cinzia Maraldi, Fotini Sioulis, G. Guerra, Jack M. Guralnik, Margherita Cavalieri, and Renato Fellin

Subjects
Male, Aging, medicine.medical_specialty, Activities of daily living, Disability Evaluation, Predictive Value of Tests, Acute care, Epidemiology, Activities of Daily Living, Medicine, Outpatient clinic, Humans, Disabled Persons, Mortality, Adverse effect, Geriatric Assessment, Aged, SPPB, Aged, 80 and over, Mini–Mental State Examination, Disability, medicine.diagnostic_test, business.industry, medicine.disease, Prognosis, Comorbidity, Hospitalization, Predictive value of tests, Physical therapy, Journal of Gerontology: MEDICAL SCIENCES, Female, Geriatrics and Gerontology, business
Abstract

HOSPITALIZATION for an acute medical event represents a stressful and potentially hazardous event for older persons. After discharge from the hospital, older patients often experience negative short- and long-term consequences, including functional decline, disability, rehospitalization, nursing home admission, and mortality (1–4). For example, the Hospital Outcomes Projects for the Elderly estimated that in a sample of acutely ill medical patients, as many as 19% had activity of daily living (ADL) decline and 40% had instrumental activity of daily living (IADL) decline in the 3 months after hospital discharge compared with their disability status prior to the index hospitalization (5). Identification of patients at high risk of functional decline or other adverse events after hospital discharge is of paramount importance for posthospital discharge assessment and management and for the prevention of these common negative outcomes. Very old frail patients and those with preadmission functional limitation are at higher risk of posthospital complications; nevertheless, the ability of medical diagnoses and traditional clinical assessment to discriminate high- and low-risk groups is limited (6). Objective measures of physical performance may prove an additional and useful clinical tool for risk stratification. Despite a large body of evidence demonstrating the predictive value of different mobility performance tests in terms of various adverse outcomes (7–11), the use of physical performance measures in the acute care clinical setting has received little attention so far (12). The Short Physical Performance Battery (SPPB), a set of objective measures of lower extremity physical performance, was highly predictive of subsequent disability, hospitalization, institutionalization, and mortality in community-dwelling elders in epidemiological studies and outpatient clinics (13,14). Recently, we have demonstrated that the SPPB can be feasibly and safely used to evaluate the functional status of acutely ill geriatric patients admitted to the hospital for serious medical conditions and that the SPPB score can provide important short-term prognostic information (15). What has not been evaluated is whether this simple battery of performance tests can capture change in function in the immediate period posthospitalization and predict long-term outcomes after hospital discharge. The aim of the present project was to determine whether SPPB score assessed at hospital discharge and sequential SPPB assessment in the first month after discharge are predictive of subsequent functional decline and risk of rehospitalization and mortality over a 12-month follow-up. We hypothesized that, even after adjusting for the presence of multiple medical conditions, patients with poorer SPPB score at discharge and those with immediate decline in SPPB score after discharge would be at greater risk of ADL decline, rehospitalization, and death.

Published
2010

44. Lower extremity performance measures predict long-term prognosis in older patients hospitalized for heart failure

Author

Stefano Volpato, Francesca Tarantini, Giuseppe Pepe, Niccolò Marchionni, Daniela Chiarantini, Fotini Sioulis, Mauro Di Bari, Francesca Bartalucci, Laura Del Bianco, Andrea Berni, and Irene Mangani

Subjects
Male, Risk, medicine.medical_specialty, Aging, Time Factors, Psychometrics, Frail Elderly, elderly, survival, Short Physical Performance Battery, cardiac failure, Internal medicine, Activities of Daily Living, medicine, Confidence Intervals, Health Status Indicators, Humans, Prospective Studies, Prospective cohort study, Aged, Proportional Hazards Models, Ultrasonography, Aged, 80 and over, Heart Failure, Leg, Ejection fraction, Proportional hazards model, business.industry, Hazard ratio, Confounding, Age Factors, medicine.disease, Prognosis, Comorbidity, Confidence interval, Hospitalization, Italy, Heart failure, Multivariate Analysis, Physical therapy, Regression Analysis, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background In older heart failure (HF) patients, survival depends on the severity of their cardiac condition and on their functional status. Lower extremity performance, assessed with the Short Physical Performance Battery (SPPB), predicts survival in older persons, both in epidemiologic and clinical settings. We evaluated whether SPPB predicts long-term survival in older subjects hospitalized for HF, independent of traditional measures of HF severity. Methods and Results Subjects aged 65+ years were enrolled on discharge after hospitalization for decompensated HF. Participants underwent echocardiography, comprehensive geriatric assessment, and SPPB. Cox proportional hazards regression models were used to predict survival over a 30-month follow-up. Of 157 participants (mean age 80 years, range 65–101; 50% men), 61 died. After adjustment for potential confounders, including demographics, ejection fraction, New York Heart Association classification, and comorbidity, we found a graded independent association between SBBP score and mortality risk: compared with an SPPB score of 9–12, scores of 0, 1–4, and 5–8 were associated with hazard ratios (HR) and 95% confidence interval (CI) of death of 6.06 (2.19–16.76), 4.78 (1.63–14.02), and 1.95 (0.67–5.70), respectively. Conclusions SPPB is an independent predictor of long-term survival of older subjects hospitalized for decompensated HF.

Published
2010

46. Childhood and parental obesity in the poorest district of Greece

Author

P, Malindretos, E, Doumpali, M, Mouselimi, N, Papamichail, Ch, Doumpali, O, Sianaba, G, Orfanaki, and A, Sioulis

Subjects
Letter, Original Article
Abstract

Childhood obesity represents a rising threat in southern Europe. It is widely accepted that childhood obesity is an important risk factor for the appearance of obesity in adulthood. Our aim was to estimate the prevalence of obesity in school aged children living in one of the poorest districts of Europe, as well as to estimate the association between the frequency of obesity observed in these children and their parents.We examined and calculated the body mass index (BMI) in 107 children aged 12.2+/-0.78 years. BMI was adjusted for age and sex and it was correlated with children parents' weight status.Obesity was diagnosed in 16% of the children. The relationship between children's and their parents weight status was very strong. In 40% of the obese parents, their children were found to be obese also (p0.001).In the present study a strong relationship between children weight status and their parents' weight status was confirmed. Additionally, this correlation was proven at a district with very low house income. Knowing that it is easier to prevent obesity, rather than to cure it, our aim should be, when a child is brought to the doctor, independently of the cause, to assess both the child as well as its parents' weight status.

Published
2009

48. Coagulation factors as biological risk markers of endothelial dysfunction. Association with the thrombotic episodes of chronic hemodialysis patients

Author

Sioulis, A, Malindretos, P, Makedou, A, Makris, P, and Grekas, D

Subjects
Original Article
Abstract

The aim of our study was to assess the coagulation factors as endothelial dysfunction markers and prospectively their association with thrombotic episodes in chronic hemodialysis patients.Fifty-four randomly selected patients on chronic hemodialysis (HD), 34 men and 20 women were included in this study. Their mean age was 56 years and the mean hemodialysis duration was 53.0861.92 months. The variations of tissue factor pathway inhibitor (TFPI), thrombomodulin (TM) and von Willebrand factor (vWF) were studied. The above-mentioned parameters were measured before and after HD session. Low molecular weight heparin (tinzaparin) was administered to all patients during hemodialysis. The results were compared with those obtained from 20 healthy volunteer-controls, age and sex matched. After the initial assessment, all patients were followed for a period of 15 months.Two patients experienced one hemorrhagic event each, regarding the upper and/or the lower gastrointestinal tract. Twenty patients showed at least one thrombotic episode. Eleven patients presented fistula thrombosis, four angina pectoris incidents and five thrombosis of the lower limbs. The rest of the patients did not experience any clinical symptomatology that could be attributed to coagulation disorders. Parameter differences between patients and controls were statistically significant (p0.005 for TFPI and p0.001 for TM and vWF) and were improved after hemodialysis session. The age and the elevated levels of the vWF were found to be significantly different (p0.03 and p0.02 respectively) between the groups of patients who experienced or not thrombotic episodes.Coagulation factors TFPI, TM, and vWF are increased in hemodialysis patients and the clinical disorders are mainly thrombotic episodes. The age of patients and the elevated levels of vWF are associated with the thrombotic incidents. Hemodialysis contributes in the improvement of these coagulation factors, which could be considered as biological risk markers of endothelial dysfunction in chronic HD patients.

Published
2009

49. Synchronous Surgical Treatment of Lower Eyelid Involutional Entropion and Ptosis.

Author

Vasakos, D., Nakos, E., and Sioulis, C.

Subjects
BLEPHAROPTOSIS, EYELID diseases, VISION disorders, SURGICAL excision, POSTOPERATIVE care
Abstract

Background. Involutional entropion and upper eyelid ptosis are common eyelid diseases in the elderly population. They represent a frequent cause of discomfort and often result in significant visual and functional impairment. The surgical management of these disorders includes various treatment options and techniques and is usually carried out in multiple time sessions. Case Report. We report the case of a 72 year old female patient, suffering from right eye involutional lower eyelid entropion and ptosis, who was treated synchronously for both conditions, by applying the lateral tarsal strip procedure and the levator resection technique. Conclusion. The synchronous treatment of involutional entropion and ptosis is an alternative treatment strategy, which could potentially improve surgical outcome, while reducing postoperative recovery time and treatment costs. [ABSTRACT FROM AUTHOR]

Published
2018
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50. Elevated Asymmetric Dimethylarginine is Associated With Oxidant Stress Aggravation in Patients With Early Stage Autosomal Dominant Polycystic Kidney Disease.

Author

Raptis, Vassilios, Georgianos, Panagiotis I., Sarafidis, Pantelis a., Sioulis, athanasios, Makedou, Kali, Makedou, areti, Grekas, Dimitrios M., and Kapoulas, Stergios

Subjects
POLYCYSTIC kidney disease, OXIDATIVE stress, BIOMARKERS, NITRIC oxide, MESSENGER RNA, ENDOTHELIAL cells, ARGININE, NITRIC-oxide synthases
Abstract

Background/Aims: In experimental models of polycystic kidney disease impaired bioavailability of nitric oxide (NO) and elevated mRNA expression of oxidative stress markers at the kidney level was noted. However, clinical studies investigating the potential role of endothelial dysfunction and oxidative stress in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are limited. We evaluated asymmetric dimethylarginine (ADMA) as marker of NO synthase inhibitor as well as 15-F2t-Isoprostane and oxidized-low density lipoprotein (oxidized-LDL) as measures of oxidative stress in patients with early stages ADPKD. Methods: We recruited 26 ADPKD patients (Group A) with modestly impaired renal function (eGFR 45-70 ml/min/1.73m2), 26 age- and sex-matched ADPKD patients (Group B) with relatively preserved renal function (eGFR)>70 ml/min/1.73m2), and 26 age- and sex-matched controls (Group C). Determination of circulating levels of ADMA, 15-F2t-Isoprostane, oxidized-LDL and routine biochemistry was performed. Results: Group A and B had significantly higher ADMA levels as compared to controls (1.68±0.7 vs 0.51±0.2 μmol/l, P<0.001 and 1.26±0.7 vs 0.51±0.2 μmol/l, P<0.001, respectively). 15-F2t-IsoP and oxidized-LDL levels were also significantly higher in Group B relative to controls (788.8±185.0 vs 383.1±86.0 pgr/ml, P<0.001 and 11.4±6.6 vs 6.4±2.6 EU/ml, P<0.05 respectively) and were further elevated in Group A. In correlation analysis, ADMA levels exhibited strong associations with levels of 15-F2t-Isoprostane (r=0.811, P<0.001) and oxidized-LDL (r=0.788, P<0.001), whereas an inverse correlation was evident between ADMA and eGFR (r=-0.460, P<0.001). Conclusion: This study shows elevation in circulating levels of ADMA along with aggravation of oxidative stress from the early stages of ADPKD. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2014
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