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Paltoglou G, Stefanaki C, Chrousos GP. Functional MRI Techniques Suggesting that the Stress System Interacts with Three Large Scale Core Brain Networks to Help Coordinate the Adaptive Response: A Systematic Review. Curr Neuropharmacol 2024; 22:976-989. [PMID: 37533249 PMCID: PMC10845086 DOI: 10.2174/1570159x21666230801151718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/16/2023] [Accepted: 04/06/2023] [Indexed: 08/04/2023] [Imported: 09/13/2023] Open
Abstract
OBJECTIVE Synthesis of functional MRI (fMRI) and functional connectivity (FC) analysis data on human stress system (SS) function, as it relates to the dynamic function of the Salience (SN), Default Mode (DMN) and Central Executive (CEN) networks. METHODS Systematic search of Medline, Scopus, Clinical Trials.gov, and Google Scholar databases of studies published prior to September 2022 resulted in 28 full-text articles included for qualitative synthesis. RESULTS Acute stress changes the states of intra-/inter- neural network FCs and activities from those of resting, low arousal state in the SN, DMN and CEN, during which intra- and inter-network FCs and activities of all three networks are low. SS activation is positively linked to the activity of the SN and negatively to that of the DMN, while, in parallel, it is associated with an initial decrease and a subsequent increase of the intra- network FC and activity of the CEN. The FC between the DMN and the CEN increases, while those between the SN and the CEN decrease, allowing time for frontal lobe strategy input and "proper" CEN activity and task decision. SN activation is linked to sensory hypersensitivity, "impaired" memory, and a switch from serial to parallel processing, while trait mindfulness is associated with FC changes promoting CEN activity and producing a "task-ready state". CONCLUSION SS activation is tightly connected to that of the SN, with stress hormones likely potentiating the intra-network FC of the latter, attenuating that of the DMN, and causing a biphasic suppression- to-activation response of the CEN, all adaptive changes favoring proper decisions and survival.
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Affiliation(s)
- George Paltoglou
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “A. & P. Kyriakou” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Charikleia Stefanaki
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Bacopoulou F, Angelopoulos NG, Papadodima S, Apostolaki D, Mantzou A, Koniari E, Efthymiou V, Tsitsika A, Vlachakis D, Charmandari E, Stefanaki C. Serum concentrations of BDNF in adolescents with metabolic syndrome: a case-control study between normal - BMI adolescents and adolescents with obesity. Eur J Pediatr 2023; 182:4595-4603. [PMID: 37548699 PMCID: PMC10587278 DOI: 10.1007/s00431-023-05129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023] [Imported: 09/13/2023]
Abstract
Brain-Derived Neurotrophic Factor (BDNF) has been linked to various conditions of the cardiovascular and nervous systems. Scarce data exist about the concentrations of BDNF in children and adolescents in relation with obesity and metabolic syndrome (MetS). The aim of this study was to examine the serum BDNF concentrations in adolescents with metabolic syndrome and according to their body mass index (BMI) status. This was a case-control study, assessing BDNF concentrations between adolescents with MetS (with obesity vs. normal-BMI), in relation to sex, anthropometric, metabolic and endocrine parameters. Participants included male and female adolescents, whose anthropometric and metabolic panel, as well as serum BDNF concentrations were measured. A total of 59 adolescents (obesity: 29; normal-BMI: 30) were included in the study. Increased serum BDNF concentrations were observed in MetS adolescents with obesity when compared with normal-BMI adolescents (p < 0.001). Males exhibited higher concentrations of BDNF than females (p = 0.045). The sample was further divided into four categories by sex and BMI status, with normal-BMI females exhibiting significantly lower BDNF concentrations than females and males with obesity(p = 0.005). In the entire study sample, serum BDNF concentrations correlated positively with BMI z-scores, however, this statistical significance was preserved only in the females of the sample. No statistical difference was observed between males of different BMI z-scores categories. Conclusion: Obesity appeared as a major factor for increased serum BDNF concentrations in adolescents with MetS (vs. normal-BMI), with a higher impact on BDNF concentrations in females than males. What is Known: • The brain-derived neurotrophic factor (BDNF) is involved in metabolic syndrome in adults but data in adolescents are scarce. What is New: • Obesity (vs. normal BMI) was a major factor for increased serum BDNF in adolescents with metabolic syndrome. • Obesity had a higher impact on BDNF concentrations in females than males with metabolic syndrome.
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Affiliation(s)
- Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Nikolaos G Angelopoulos
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Stavroula Papadodima
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Despoina Apostolaki
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Aimilia Mantzou
- Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Childrens Hospital, 1 Thivon Street, Goudi, 115 27, Athens, Greece
| | - Eleni Koniari
- Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Childrens Hospital, 1 Thivon Street, Goudi, 115 27, Athens, Greece
| | - Vasiliki Efthymiou
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Artemis Tsitsika
- MSc "Strategies of Developmental and Adolescent Health", Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, 11855, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527, Athens, Greece
| | - Charikleia Stefanaki
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece.
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527, Athens, Greece.
- First Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias Str., Goudi, 11527, Athens, Greece.
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Giannouli A, Stefanaki C, Kouskoutis C, Konidari M, Mani I, Konidari K, Markantonis SL, Mantzou A, Dourakis SP, Deligeoroglou E, Bacopoulou F. Hepatokine Profile in Adolescents with Polycystic Ovary Syndrome: A Case-Control Study. J Clin Med 2023; 12:5744. [PMID: 37685811 PMCID: PMC10489115 DOI: 10.3390/jcm12175744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] [Imported: 09/13/2023] Open
Abstract
The current guidelines suggest routine screening for non-alcoholic fatty liver disease (NAFLD) in patients with polycystic ovary syndrome (PCOS). Hepatokines seem to be promising surrogate endpoints for the diagnosis and severity of NAFLD. PCOS has its onset in adolescence and its metabolic sequalae begin during the same period. There are scarce data on the hepatokine profile of adolescent PCOS patients. This case-control study examined the serum profile of the hepatokines sex hormone-binding globulin (SHBG), selenoprotein P, fibroblast growth factor 21 (FGF21), and fetuin A in a sample of adolescent PCOS patients, and their association to metabolic and hormonal parameters. The selenoprotein P and SHBG serum concentrations were significantly decreased in PCOS patients vs. the controls (median (IQR), 2.47 (0.40) vs. 2.66 (0.36) μg/mL, p = 0.025; mean ± SD, 41.71 ± 19.41 vs. 54.94 ± 22.12 nmol/L, p = 0.011, respectively), whereas selenoprotein P was significantly and positively associated with testosterone (r = 0.325, p = 0.007) and the free androgen index (r = 0.361, p = 0.002). The SHBG demonstrated multiple significant negative correlations with adverse metabolic parameters. Among the PCOS patients, the FGF21 concentrations were significantly higher in those with NAFLD, whereas a 1 pg/mL increase in the FGF21 concentration increased the odds of NAFLD diagnosis by liver ultrasound by 1%, suggesting FGF21 as a potential biomarker for hepatic disease in females with PCOS in adolescence. Fetuin A was the least differentiated hepatokine between the PCOS patients and controls with the least associations with metabolic and hormonal parameters.
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Affiliation(s)
- Aikaterini Giannouli
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (A.G.); (C.S.); (K.K.)
| | - Charikleia Stefanaki
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (A.G.); (C.S.); (K.K.)
| | - Christos Kouskoutis
- Laboratory of Biopharmaceutics and Pharmacokinetics, Department of Pharmaceutical Technology, Faculty of Pharmacy, National and Kapodistrian University of Athens, 15771 Athens, Greece; (C.K.); (S.L.M.)
| | - Marianna Konidari
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece;
| | - Iliana Mani
- Second Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Hippokratio Hospital, 11527 Athens, Greece; (I.M.); (S.P.D.)
| | - Konstantina Konidari
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (A.G.); (C.S.); (K.K.)
| | - Sophia L. Markantonis
- Laboratory of Biopharmaceutics and Pharmacokinetics, Department of Pharmaceutical Technology, Faculty of Pharmacy, National and Kapodistrian University of Athens, 15771 Athens, Greece; (C.K.); (S.L.M.)
| | - Aimilia Mantzou
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece;
| | - Spyridon P. Dourakis
- Second Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Hippokratio Hospital, 11527 Athens, Greece; (I.M.); (S.P.D.)
| | - Efthymios Deligeoroglou
- Department of Pediatric & Adolescent Gynecology, Mitera Children’s Hospital, 15123 Athens, Greece;
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (A.G.); (C.S.); (K.K.)
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Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP. Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review. Horm Res Paediatr 2023; 96:66-73. [PMID: 35144259 DOI: 10.1159/000522540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic stress is a recognized risk factor for poor health, body composition disequilibrium, impaired mental health, and deterioration of quality of life. Chronic stress-related cortisol oversecretion and circadian dysregulation and associated systemic low grade, injurious inflammation ("para-inflammation") contribute to steatosis in various metabolically active solid organs, affecting both their structure and function. The aim of this review was to summarize current knowledge on the impact of chronic stress and associated para-inflammation on skeletal muscle, bone, liver, and pancreas, leading to their steatosis. Current management of these maladaptive conditions is also included and underscored in this review. SUMMARY Steatosis of metabolically active solid organs is involved in various metabolic processes and considered a risk factor for chronic noncommunicable diseases, yet its role in chronic stress physiology and pathophysiology has been overlooked. KEY MESSAGES Chronic stress-associated steatosis of several solid organs is generally disregarded in current clinical practice. Physicians should be alert for these steatoses and should address them adequately so as to provide appropriate medical care. New guidelines generated by learned societies are needed, along with large observational studies, to offer novel solutions to this old problem.
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Affiliation(s)
- Charikleia Stefanaki
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.,University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Paltoglou
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.,University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Stefanaki C, Bacopoulou F, Chrousos GP. Gut Microsex/Genderome, Immunity and the Stress Response in the Sexes: An Updated Review. Sexes 2022; 3:533-545. [DOI: 10.3390/sexes3040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Sex has been universally acknowledged as a confounding factor in every type of biological study, while there are strong sex differences in morbidity along the lifespan. Humans have almost identical genomes (99.2%), yet minor variance in their DNA produces remarkable phenotypic diversity across the human population. On the other hand, metagenomic analysis of the human microbiome is more variable, depending on the sex, lifestyle, geography, and age of individuals under study. Immune responses in humans also exhibit variations, with an especially striking sexual dimorphism, which is at play in several other physiologic processes. Sex steroids have noticeable effects on the composition of the human microbiome along the lifespan, accompanied by parallel changes in immunity and the stress response. Gut microsex/genderome, a recently coined term, defines the sexually dimorphic gut microbiome. Apart from the sex steroids, the stress hormones are also at play in the proliferation of microbes. This review summarizes the concept of gut microsex/genderome under the prism of recent studies on the interrelations of the sexually dimorphic microbiome with immunity and stress.
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Carydias E, Tasho A, Kani C, Bacopoulou F, Stefanaki C, Markantonis SL. Systematic Review and Meta-Analysis of the Efficacy and Safety of Metformin and GLP-1 Analogues in Children and Adolescents with Diabetes Mellitus Type 2. Children (Basel) 2022; 9:children9101572. [PMID: 36291508 PMCID: PMC9600106 DOI: 10.3390/children9101572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/13/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Diabetes mellitus type 2 (DMT2) is one of the most frequent glucose metabolism disorders, in which serum glucose concentrations are increased. In most cases, changes in lifestyle and diet are considered as the first step in addressing its therapy. If changes in lifestyle and diet fail, drugs, such as metformin, must be added. Lately, apart from metformin or insulin, the FDA has approved the use of glucagon-like peptide-1 (GLP-1) analogues for children and adolescents. Little is known about their efficacy and safety at this young age. The main aim of this systematic review/meta-analysis was to assess the safety and efficacy of metformin and GLP-1 analogues, exenatide and liraglutide, compared with placebos or other antidiabetic drugs used for DMT2 in children and adolescents. Metformin did not seem to demonstrate pharmacologic superiority, while GLP-1 analogues were found superior to placebos. GLP-1 analogues may be considered a useful alternative for the treatment of DMT2 in children and adolescents.
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Affiliation(s)
- Elisabeth Carydias
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15774 Athens, Greece
| | - Andoneta Tasho
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15774 Athens, Greece
| | - Chara Kani
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15774 Athens, Greece
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Flora Bacopoulou
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Charikleia Stefanaki
- University Research Institute for the Study of Genetic and Malignant Disorders in Childhood, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sophia L. Markantonis
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15774 Athens, Greece
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Kapogiannis A, Makris G, Darviri C, Artemiadis A, Klonaris D, Tsoli S, Bachourou T, Stefanaki C, Papanikolaou K, Chrousos G, Pervanidou P. The Greek Version of the Vanderbilt ADHD Diagnostic Parent Rating Scale for Follow-up Assessment in Prepubertal Children with ADHD. International Journal of Disability, Development and Education 2022; 69:1726-1735. [DOI: 10.1080/1034912x.2020.1802647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- August Kapogiannis
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Gerasimos Makris
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Artemios Artemiadis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Dionysios Klonaris
- Center of Continuing Education and Lifelong Learning, University of Ioannina, Ioannina, Greece
| | - Sofia Tsoli
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Theodora Bachourou
- School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charikleia Stefanaki
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Katerina Papanikolaou
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - George Chrousos
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
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Stefanaki C. Osteosarcopenia as a lifetime syndrome: Could it be prevented? Osteosarcopenia 2022. [DOI: 10.1016/b978-0-12-820088-9.00012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Stefanaki C, Mastorakos G, Chrousos GP. Gut Microbiome and Mental Stress-Related Disorders: The Interplay of Classic and Microbial Endocrinology. Gut Microbiome-Related Diseases and Therapies 2021. [DOI: 10.1007/978-3-030-59642-2_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Stefanaki C, Valsamakis G, Mastorakos G. Gut Microbiome, Diabetes, and Obesity: Complex Interplay of Physiology. Gut Microbiome-Related Diseases and Therapies 2021. [DOI: 10.1007/978-3-030-59642-2_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bacopoulou F, Landis GN, Pałasz A, Tsitsika A, Vlachakis D, Tsarouhas K, Tsitsimpikou C, Stefanaki C, Kouretas D, Efthymiou V. Identifying early abdominal obesity risk in adolescents by telemedicine: A cross-sectional study in Greece. Food Chem Toxicol 2020; 144:111532. [PMID: 32645466 DOI: 10.1016/j.fct.2020.111532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 12/24/2022]
Abstract
Obesity and thus, lipotoxicity, is a major health risk factor. Modern exposure to environmental chemicals has contributed significantly to the obesity epidemic. The purpose of this study was to assess, via telemedicine and using bioelectrical impedance analysis (BIA) in schools, the levels of adiposity and other body composition parameters of Greek adolescents in relation with their metabolic syndrome (MetS) characteristics. A representative sample (1575 adolescents, 14.4 ± 1.7 years-old) of the Attica region population, underwent body composition assessment of fat mass (FM), fat-free mass (FFM), and total body water (TBW) and was evaluated for anthropometric and MetS characteristics. Males demonstrated higher FFM% and TBW% but lower FM% than females. Adolescents with abdominal obesity/MetS (n = 149/n = 40) demonstrated significantly (P < 0.001) higher body mass index (BMI 27.8 ± 3.8 kg/m2/30.2 ± 4.2 kg/m2) and FM (33.6 ± 9.7%/35.0 ± 10.5%) but significantly (P < 0.001) lower FFM (34.2 ± 5.7%/33.8 ± 6.2%) and TBW (45.6 ± 6.7%/44.6 ± 7.2%) than adolescents without abdominal obesity/MetS (BMI 20.9 ± 2.8 kg/m2/21.3 ± 3.2 kg/m2; FM 19.2 ± 6.9%/20.2 ± 8.0%; FFM 41.3 ± 4.4%/40.8 ± 4.8%; TBW 55.5 ± 4.8%/54.8 ± 5.5%). Findings suggest that early "osteosarcopenic" elements of abdominal obesity/MetS may exist even in adolescence. The application of BIA, incorporated in the new approach methodology of telemedicine in schools, identified adolescents at risk for obesity complications.
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Affiliation(s)
- Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, Athens, 11527, Greece.
| | - Georgios N Landis
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, Athens, 11527, Greece.
| | - Artur Pałasz
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland.
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, P. & A. Kyriakou Children's Hospital, Thivon & Levadeias Streets, Athens, 11527, Greece.
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Food, Biotechnology and Development, Agricultural University of Athens, Athens, Greece; Department of Informatics, Faculty of Natural and Mathematical Sciences, King's College London, London, United Kingdom.
| | | | - Christina Tsitsimpikou
- General Chemical State Laboratory of Greece, 16 An. Tsocha Street, Athens, 11521, Greece.
| | - Charikleia Stefanaki
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, Athens, 11527, Greece.
| | - Dimitrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece.
| | - Vasiliki Efthymiou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 1 Thivon Street, Athens, 11527, Greece.
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12
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Stefanaki C, Michos A, Latsios G, Tousoulis D, Peppa M, Zosi P, Boschiero D, Bacopoulou F. Sexual Dimorphism of Heart Rate Variability in Adolescence: A Case-Control Study on Depression, Anxiety, Stress Levels, Body Composition, and Heart Rate Variability in Adolescents with Impaired Fasting Glucose. Int J Environ Res Public Health 2020; 17:E2688. [PMID: 32295195 DOI: 10.3390/ijerph17082688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 12/22/2022]
Abstract
Prediabetes in the form of impaired fasting glucose, impaired glucose tolerance, or both is considered as a preliminary stage for the onset of diabetes and diabetic complications. Hormonal fluctuations in adolescence are accompanied by body composition modifications, which are associated with insulin resistance and subclinical inflammation. Bioimpedance (BIA) accurately evaluates body composition, and heart rate variability (HRV) assesses cardiac autonomic function, which are frequently afflicted by insulin resistance. We aimed at evaluating the effect of glycemic status on mental stress, anxiety, and depression status in adolescents with impaired fasting glucose, body composition, and HRV parameters. This is a case-control study to evaluate the effect of the hyperglycemia on depression, anxiety, and stress levels (DASS21 questionnaire), body composition (BIA-ACC—BIOTEKNA©), and HRV (PPG Stress Flow—BIOTEKNA©), between euglycemic adolescents (euglycemic group) and adolescents with impaired fasting glucose (prediabetic group), aged 12–20 years. No differences were found between the prediabetic (n = 13) and the euglycemic (n = 16) groups in the outcome measures, possibly due to the number of participants. Interestingly, females, irrespective of their glycemic status, exhibited altered sympathovagal function as revealed by impaired HRV. In the euglycemic group, HRV parameters were significantly correlated and in line with the DASS21 scores, but in the prediabetic group, similarities to those of adults were observed. Impaired fasting glucose had no impact on mental health, body composition, or HRV parameters in adolescents. HRV parameters were impaired in females, irrespective of their glycemic status. This finding implies that females seem to be more prone to stress disorders, even from a young age. Future studies are needed to confirm these findings.
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13
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Paltoglou G, Avloniti A, Chatzinikolaou A, Stefanaki C, Papagianni M, Papassotiriou I, Fatouros IG, Chrousos GP, Kanaka-Gantenbein C, Mastorakos G. In early pubertal boys, testosterone and LH are associated with improved anti-oxidation during an aerobic exercise bout. Endocrine 2019; 66:370-380. [PMID: 31378848 DOI: 10.1007/s12020-019-02037-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/26/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the association of the hypothalamic-pituitary-testicular (HPT) axis with pro- and anti- oxidation, in relation to puberty and obesity in boys, before and after an aerobic exercise bout. METHODS This is a cross-sectional human observational study of 92 healthy normal-weight, obese pre- and early- pubertal boys that underwent a blood sampling, before, and after an aerobic exercise bout at 70% VO2max, until exhaustion. LH, FSH, total testosterone (tT) and markers of pro- (TBARS and PCs) and anti- (GSH, GSSG, GPX, catalase, TAC) oxidation were measured. RESULTS Baseline LH, FSH, and tT concentrations were greater in early, than in pre- pubertal boys, independently of weight status. Post-exercise, LH concentrations decreased in early pubertal boys while FSH concentrations did not change in any of the studied groups. Baseline and post-exercise tT concentrations were lower in obese than in normal-weight early pubertal boys, while baseline and post-exercise LH and FSH concentrations did not differ between these groups. Post-exercise tT concentrations increased in early pubertal obese boys. Baseline LH, FSH and tT concentrations correlated positively with baseline anti-oxidation markers concentrations in pre-pubertal boys. Baseline tT concentrations correlated positively with the increase of TAC concentrations in early pubertal normal-weight boys. In all boys, baseline LH concentrations were the best positive predictors for the exercise-associated increase of TAC concentrations. CONCLUSIONS It appears that the HPT axis maturation during puberty (in particular its LH and testosterone components) is positively associated with the increase of anti-oxidation during a bout of aerobic exercise.
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Affiliation(s)
- George Paltoglou
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
| | - Alexandra Avloniti
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Athanasios Chatzinikolaou
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Charikleia Stefanaki
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
- Department of Pediatrics, General Hospital of Piraeus 'Aghios Panteleimon', Piraeus, Greece
| | - Maria Papagianni
- Third Department of Pediatrics, Aristotle University of Thessaloniki, School of Medicine, "Hippokrateion" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Ioannis G Fatouros
- Department of Physical Education and Sports Sciences, University of Thessaly, Trikala, Greece
| | - George P Chrousos
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece.
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14
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Stefanaki C, Michos A, Mastorakos G, Mantzou A, Landis G, Zosi P, Bacopoulou F. Probiotics in Adolescent Prediabetes: A Pilot RCT on Glycemic Control and Intestinal Bacteriome. J Clin Med 2019; 8:E1743. [PMID: 31640224 DOI: 10.3390/jcm8101743] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/05/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022] Open
Abstract
Dysbiosis of intestinal ecology could be implicated in prediabetes. The aim of this pilot randomized controlled trial (RCT) was to collect preliminary data on the effects of probiotic supplementation (Vivomixx©) on markers of glucose metabolism, intestinal microbiome composition, and intestinal health indices, of prediabetic adolescents. The intervention group was administered probiotic sachets twice daily for 4 months, while both intervention and control groups received weekly consultation sessions for a healthier lifestyle. Thirty-two participants were recruited (1.3 participants per month) and were randomized (16 in control and 16 in intervention group). Fifteen of them signed the inform consent and never entered the study (6 in control and 9 in intervention group). Thus, seventeen participants completed the study (10 in control and 7 in intervention group), with no serious adverse events. After the 4-month intervention, no difference was observed in the markers of glycemic control between the two groups, although a minor effect was observed for fasting glucose at 1-month, probably due to the initial higher adherence to the probiotic supplements. Modifications of the protocol procedures are warranted because of the high attrition rates and suboptimal compliance that were noted. Future studies and further RCTs with larger samples need to be conducted to fully elucidate the potential effects of probiotics in the glycemic control of prediabetic adolescents.
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15
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Stefanaki C, Bacopoulou F, Kandaraki E, Boschiero D, Diamandi-Kandarakis E. Lean Women on Metformin and Oral Contraceptives for Polycystic Ovary Syndrome Demonstrate a Dehydrated Osteosarcopenic Phenotype: A Pilot Study. Nutrients 2019; 11:nu11092055. [PMID: 31480705 PMCID: PMC6769734 DOI: 10.3390/nu11092055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/25/2019] [Accepted: 08/26/2019] [Indexed: 12/19/2022] Open
Abstract
Scarce data exist on the body composition of lean women with polycystic ovary syndrome (PCOS) on treatment with metformin and oral contraceptives (OCs). Thirty-four lean (body mass index 18.5–24.9 kg/m2) women (17 with PCOS on metformin and OCs treatment for six months and 17 controls) aged 18–40 years were assessed for body composition parameters (fat, muscle, glycogen, protein masses, bone masses, and body water compartments) and phase angles. PCOS patients demonstrated lower muscle, glycogen and protein masses (U = 60, p = 0.003), along with a lower bone mineral content and mass (U = 78, p = 0.021; U = 74, p = 0.014) than their healthy counterparts, while total and abdominal fat masses were similar between the two groups. PCOS patients also exhibited increased extracellular body water (U = 10, p < 0.001) and decreased intracellular water, compatible with low-grade inflammation and cellular dehydration. Key differences in body composition between women with PCOS and controls demonstrated an osteosarcopenic body composition phenotype in PCOS patients. A confirmation of these findings in larger studies may render osteosarcopenia management a targeted adjunct therapy in women with PCOS.
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Affiliation(s)
- Charikleia Stefanaki
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece
| | - Eleni Kandaraki
- Department of Endocrinology, Diabetes and Metabolism, Hygeia Hospital, 15123 Athens, Greece
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16
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Sokou R, Konstantinidi A, Stefanaki C, Tsantes AG, Parastatidou S, Lampropoulou K, Katsaras G, Tavoulari E, Iacovidou N, Kyriakou E, Gounaris A, Bonovas S, Tsantes AE. Thromboelastometry: studying hemostatic profile in small for gestational age neonates-a pilot observational study. Eur J Pediatr 2019; 178:551-557. [PMID: 30707363 DOI: 10.1007/s00431-019-03331-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 12/23/2022]
Abstract
Scarce data exists about the hemostatic status of small for gestational age (SGA) neonates. We aimed at evaluating the hemostatic profile of SGA neonates, using thromboelastometry (TEM). This is an observational study performed in a Greek tertiary General Hospital during an 18-month period. Ninety-three neonates were included in the study: 48 appropriate for gestational age weight (AGA) neonates and 45 SGA neonates Extrinsically activated TEM (ex-TEM) parameters, such as clotting time, clot formation time, amplitude recorded at 5 and 10 min, a angle, maximum clot firmness, lysis index at 60 min, and also platelet count, were used for the evaluation of the hemostatic profile in all neonates. No statistically significant differences were noticed regarding all ex-TEM parameters between AGA and SGA neonates, while no event of hemorrhage or thrombosis was noticed in the study population.Conclusions: The coagulation system of SGA neonates seems to be fully functional, with no evident tendency toward coagulopathy or thrombosis, when compared with AGA neonates. TEM seems to provide a promising and valid assessment of coagulation and fibrinolysis systems and may be used as a valuable biomarker, in the future. Further studies, with large samples, are necessary to confirm our results. What is Known: • SGA neonates may present coagulation disorders mainly due to hepatic dysfunction, polycythemia, and thrombocytopenia owing to long-term intrauterine hypoxia. • In the literature, despite the statistically significant differences in laboratory results between SGA and AGA neonates, no clinical manifestations of significantly altered hemostasis were recorded. Data of TEM interpretation of hemostasis in SGA neonates are not available. What is New: • TEM seems to interpret coagulation mechanism of preterm and full-term SGA neonates and confirm previous relevant literature findings regarding hemostasis in these neonates.
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Affiliation(s)
- Rozeta Sokou
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece.
| | | | - Charikleia Stefanaki
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece
| | - Andreas G Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Parastatidou
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece
| | - Katerina Lampropoulou
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece
| | - George Katsaras
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece
| | - Evagelia Tavoulari
- Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Piraeus, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaeio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kyriakou
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Gounaris
- Neonatal Intensive Care Unit, University Hospital of Larissa, Larissa, Greece
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, Milan, Italy
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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17
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Stefanaki C. The Gut Microbiome Beyond the Bacteriome—The Neglected Role of Virome and Mycobiome in Health and Disease. Microbiome and Metabolome in Diagnosis, Therapy, and other Strategic Applications 2019. [DOI: 10.1016/b978-0-12-815249-2.00003-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Bacopoulou F, Foskolos E, Stefanaki C, Tsitsami E, Vousoura E. Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents. Eat Weight Disord 2018; 23:621-8. [PMID: 29189978 DOI: 10.1007/s40519-017-0466-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/21/2017] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship. METHODS Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires. RESULTS Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05). CONCLUSION Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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19
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Stefanaki C, Bacopoulou F, Michos A. The impact of probiotics' administration on glycemic control, body composition, gut microbiome, mitochondria, and other hormonal signals in adolescents with prediabetes - A randomized, controlled trial study protocol. Contemp Clin Trials Commun 2018; 11:55-62. [PMID: 30003169 DOI: 10.1016/j.conctc.2018.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/20/2018] [Accepted: 06/01/2018] [Indexed: 12/28/2022] Open
Abstract
Background Recent studies have demonstrated that a significant proportion of adolescents exhibit abdominal obesity in early–middle adolescence, and impaired glucose metabolism. Dysregulation of glucose metabolism is aggravated by the existing osteosarcopenia not only in obese but also in overweight youth. Biochemical inflammation, derived from glucose metabolism dysregulation, in combination with increased stress levels lead to the accumulation of reactive oxygen species, also known as ROS, which seem to afflict the integrity of the gastrointestinal wall, gut mucosa, and commensal, intestinal gut microflora. The current scientific protocol aims to assess the administration of probiotics in prediabetic adolescents in relation with their glycemic control, body composition, and intestinal microbiome. Methods/Design This is a study protocol of a two-armed RCT, that recruits adolescents with prediabetes, who will receive either a 4-month, life-style intervention, or a life-style intervention along with a probiotic supplement. The primary outcome is the differences in gut microbiome synthesis, body composition analysis parameters, and concentrations of hormones, before and after the intervention. Discussion This study aims to halt the progression of obesity and diabetes and aspires to contribute new evidence for upgraded treatment of obesity and diabetes. Trial registration Australian New Zealand Clinical Trial Registry (ACTRN12615000470594).
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20
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Stefanaki C, Pervanidou P, Boschiero D, Chrousos GP. Chronic stress and body composition disorders: implications for health and disease. Hormones (Athens) 2018; 17:33-43. [PMID: 29858868 DOI: 10.1007/s42000-018-0023-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/15/2018] [Indexed: 02/06/2023]
Abstract
Recent studies have suggested that body composition is key to health and disease. First, fat tissue is a complex, essential, and highly active metabolic and endocrine organ that responds to afferent signals from traditional hormone systems and the central nervous system but also expresses and secretes factors with important endocrine, metabolic, and immune functions. Second, skeletal muscle mass is an important predictor of health in adult life, while severe mass loss has been associated with the frailty of old age. Studies have shown that skeletal muscle is also an important endocrine organ that secretes factors with autocrine, paracrine, or endocrine actions, which have been associated with inflammatory processes. Third, the bone is also a systemic endocrine regulator playing a pivotal role in health and disease. Finally, proper hydration in humans has been neglected as a health factor, especially in adults. Chronic stress and stress hormone hypersecretion alone or associated with distinct disorders, such as anxiety, depression, obesity, metabolic syndrome, autoimmune disorders, type 2 diabetes mellitus, and polycystic ovary syndrome (PCOS), have been associated with psychological and somatic manifestations, typically, increased fat mass, osteosarcopenia/frailty, cellular dehydration, and chronic systemic inflammation. This review aims to provide new insights into the newly developed concept of stress-related osteosarcopenic obesity and its prevention.
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Affiliation(s)
- Charikleia Stefanaki
- Choremeion Research Laboratory, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Thivon and Levadeias streets, Goudi, 11527, Athens, Greece.
- Unit of Translational and Clinical Research in Endocrinology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Panagiota Pervanidou
- Choremeion Research Laboratory, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Thivon and Levadeias streets, Goudi, 11527, Athens, Greece
| | | | - George P Chrousos
- Choremeion Research Laboratory, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Thivon and Levadeias streets, Goudi, 11527, Athens, Greece
- Unit of Translational and Clinical Research in Endocrinology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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21
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Al-Daghri NM, Batzel JJ, Burgmann H, Carbone F, Charmandari E, Chrousos GP, Distelmaier K, Cvirn G, Dullaart RPF, Dumitrascu DL, Esteve-Pastor MA, Gervasini G, Goliasch G, Goswami N, Gruppen EG, Hernández-Mijares A, Kalantaridou SN, Krause R, Latini R, Makrigiannakis A, Marín F, Masson S, Montecucco F, Ndrepepa G, Nicolaides NC, Novelli D, Orasan OH, Qorbani M, Ratzinger F, Roessler A, Sabico S, Sciatti E, Stefanaki C, Stoner L, Tabatabaei-Malazy O, Tatar E, Toz H, Uslu A, Victor VM, Vizzardi E. Research update for articles published in EJCI in 2015. Eur J Clin Invest 2017; 47:775-788. [PMID: 28960328 DOI: 10.1111/eci.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Nasser M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Jerry J Batzel
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Heinz Burgmann
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Federico Carbone
- First Clinical of Internal Medicine Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- Choremeion Research Laboratory, 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Klaus Distelmaier
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Gerhard Cvirn
- Physiology, Medical University of Graz, Graz, Austria.,Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Robin P F Dullaart
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Dan L Dumitrascu
- 2nd Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - María A Esteve-Pastor
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBER-CV, Murcia, Spain
| | - Guillermo Gervasini
- Department of Medical and Surgical Therapeutics, Medical School, University of Extremadura, Badajoz, Spain
| | - Georg Goliasch
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Nandu Goswami
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Eke G Gruppen
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Antonio Hernández-Mijares
- Service of Endocrinology, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Sophia N Kalantaridou
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,CBmed GmbH - Center for Biomarker Research in Medicine, Graz, Austria
| | - Roberto Latini
- Department of Cardiovascular Research, IRCCS - Istituto Mario Negri, Milano, Italy
| | - Antonis Makrigiannakis
- Department of Obstetrics and Gynecology, Medical School, University of Crete, Heraklion, Greece
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBER-CV, Murcia, Spain
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS - Istituto Mario Negri, Milano, Italy
| | - Fabrizio Montecucco
- First Clinical of Internal Medicine Department of Internal Medicine, University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, Genova, Italy.,Centre of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | | | - Nicolas C Nicolaides
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Deborah Novelli
- Department of Cardiovascular Research, IRCCS - Istituto Mario Negri, Milano, Italy
| | - Olga H Orasan
- 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical sciences, Karaj, Iran.,Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran university of Medical sciences, Tehran, Iran
| | - Franz Ratzinger
- Division of Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Andreas Roessler
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Shaun Sabico
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Edoardo Sciatti
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University and Spedali Civili of Brescia, Brescia, Italy
| | - Charikleia Stefanaki
- Choremeion Research Laboratory, 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lee Stoner
- School of Sport and Exercise, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ozra Tabatabaei-Malazy
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran university of Medical sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran
| | - Erhan Tatar
- Department of Nephrology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Huseyin Toz
- Department of Nephrology, Ege University School of Medicine, Izmir, Turkey
| | - Adam Uslu
- Department of General Surgery and Transplantation, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Victor M Victor
- Service of Endocrinology, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Physiology, University of Valencia, Valencia, Spain
| | - Enrico Vizzardi
- Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University and Spedali Civili of Brescia, Brescia, Italy
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Stefanaki C, Peppa M, Mastorakos G, Chrousos GP. Examining the gut bacteriome, virome, and mycobiome in glucose metabolism disorders: Are we on the right track? Metabolism 2017; 73:52-66. [PMID: 28732571 DOI: 10.1016/j.metabol.2017.04.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/21/2017] [Accepted: 04/28/2017] [Indexed: 12/19/2022]
Abstract
Human gut microbiome is defined as the gene complement of the gut microbial community, measured via laboratory metagenomic techniques. It includes bacteriome, virome and mycobiome, which represent, respectively, the assemblages of bacteria, viruses and fungi, living in the human gut. Gut microbiota function as a living "organ" that interacts with the gastro-intestinal environment, provides nutrients and vitamins to the organism and transduces hormonal messages, essentially influencing the main metabolic pathways, including drug metabolism. A clear association between gut, and glucose metabolism disorders has recently emerged. Medications acting on glucose absorption in the gut, or enhancing gut hormone activity are already extensively employed in the therapy of diabetes. Moreover, the gut is characterized by immune, and autonomous neuronal features, which play a critical role in maintaining glucose metabolism homeostasis. Gut microbes respond to neuroendocrine, and immune biochemical messages, affecting the health, and behavior of the host. There is vast heterogeneity in the studies included in this review, hence a meta-analysis, or a systematic review were not applicable. In this article, we attempt to reveal the interplay between human gut microbiota physiology, and hyperglycemic states, synthesizing, and interpreting findings from human studies.
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Affiliation(s)
- Charikleia Stefanaki
- 1st Department of Pediatrics, Choremeio Research Laboratory, Athens University Medical School, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Melpomeni Peppa
- Endocrine Unit, 2nd Department of Internal Medicine Propaedeutic, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - George Mastorakos
- Department of Endocrinology, Metabolism and Diabetes, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- 1st Department of Pediatrics, Choremeio Research Laboratory, Athens University Medical School, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Peppa M, Stefanaki C, Papaefstathiou A, Boschiero D, Dimitriadis G, Chrousos GP. Bioimpedance analysis vs. DEXA as a screening tool for osteosarcopenia in lean, overweight and obese Caucasian postmenopausal females. Hormones (Athens) 2017; 16:181-193. [PMID: 28742506 DOI: 10.14310/horm.2002.1732] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/12/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND-OBJECTIVES We aimed at evaluating the efficiency of a newly developed, advanced Bioimpedance Analysis (BIA-ACC®) device as a screening tool for determining the degree of obesity and osteosarcopenia in postmenopausal women with normal or decreased bone density determined by Dual-Energy X-Ray absorptiometry (DEXA) in a representative sample of Greek postmenopausal women. METHODS This is a single-gate cross-sectional study of body composition measured by BIA-ACC® and DEXA. Postmenopausal females with BMI ranging from 18.5 to 40 kg/m2 were subjected to two consecutive measurements of DEXA and BIA-ACC® within 5-10 minutes of each other. We used Pearson's co-efficient to examine linear correlations, the intraclass correlation co-efficient (ICC) to test reliability, Bland-Atman plots to assess bias and Deming regressions to establish the agreement in parameters measured by BIA-ACC® and DEXA. Last, we used ANOVA, with Bonferroni correction and Dunnett T3 post hoc tests, for assessing the differences between quantitative and Pearson's x2 between qualitative variables. SAMPLE AND RESULTS Our sample consisted of 84 overweight/obese postmenopausal women, aged 39-83 years, of whom 22 had normal bone density, 38 had osteopenia and 24 had osteoporosis based on DEXA measurements, using quota sampling. ICCs and Deming regressions showed strong agreement between BIA-ACC® and DEXA and demonstrated minimal proportional differences of no apparent clinical significance. Bland-Altman plots indicated minimal biases. Fat, skeletal and bone mass measured by BIA-ACC® and DEXA were increased in the non-osteopenic/non-osteoporotic women compared with those of the osteopenic and osteoporotic groups. CONCLUSIONS BIA-ACC® is a rapid, bloodless and useful screening tool for determining body composition adiposity and presence of osteo-sarcopenic features in postmenopausal women. Women with osteopenia and osteoporosis evaluated by DEXA had decreased fat, skeletal and bone mass compared with normal bone density women, suggesting concordance in the change of these three organ masses in postmenopausal women.
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Affiliation(s)
- Melpomeni Peppa
- Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Medicine and Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
| | - Charikleia Stefanaki
- First Department of Pediatrics and Choremeion Research Laboratory, National and Kapodistrian University of Athens, Thivon & Levadeias Str., Goudi, Athens, 11527, Greece.
- Unit of Translational and Clinical Research in Endocrinology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Athanasios Papaefstathiou
- Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Medicine and Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
| | | | - George Dimitriadis
- Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Medicine and Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
| | - George P Chrousos
- First Department of Pediatrics and Choremeion Research Laboratory, National and Kapodistrian University of Athens, Thivon & Levadeias Str., Goudi, Athens, 11527, Greece
- Unit of Translational and Clinical Research in Endocrinology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Kyrou I, Christou A, Panagiotakos D, Stefanaki C, Skenderi K, Katsana K, Tsigos C. Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: a randomized, placebo-controlled, double-blind, crossover pilot study. Hormones (Athens) 2017; 16:171-180. [PMID: 28742505 DOI: 10.14310/horm.2002.1738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 06/19/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The Humulus lupulus L. plant (hops) is used as a herbal medicinal product for anxiety/mood disorders. Our aim was to study the effects of a hops dry extract on self-reported depression, anxiety and stress levels in young adults. DESIGN Apparently healthy young adults from our university completed the Depression Anxiety Stress Scale-21 (DASS-21) and those reporting at least mild depression, anxiety and stress were invited to complete the study intervention. This followed a randomized (1:1), placebo-controlled, double-blind, crossover design with two 4-week intervention periods (Melcalin hops or placebo; two 0.2 gr capsules once daily) separated by a 2-week wash-out. Anthropometric measurements, DASS-21 assessments and measurements of morning cortisol plasma levels were performed at the beginning and the end of the 4-week treatment periods. RESULTS 36 participants (Females/Males: 31/5; age: 24.7±0.5 years) completed the study intervention (attrition: 6/42). No significant changes in body weight and composition or morning circulating cortisol were noted with the hops or placebo. Significantly decreased DASS-21 anxiety, depression and stress scores were documented with hops (9.2±7.3 vs. 5.1±5.9, 11.9±7.9 vs. 9.2±7.4, and 19.1±8.1 vs. 11.6±8.1; all p values <0.05), which were significantly greater compared to those caused by the placebo (all p values <0.05). CONCLUSION In otherwise healthy young adults reporting at least mild depression, anxietyand stress symptoms, daily supplementation with a hops dry extract can significantly improve all these symptoms over a 4-week period. These beneficial effects agree with the indication of hops for anxiety/mood disorders and restlessness, as approved by the German Commission E.
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Affiliation(s)
- Ioannis Kyrou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece
- Aston Medical Research Institute, Aston Medical School, Aston University, B4 7ET, Birmingham, UK
- Translational & Experimental Medicine, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK
- WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, CV2 2DX, Coventry, UK
| | - Aimilia Christou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece
| | - Charikleia Stefanaki
- Choremeion Research Laboratory, 1st Department of Pediatrics, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Skenderi
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece
| | - Konstantina Katsana
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece
| | - Constantine Tsigos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Str., 17671, Athens, Greece.
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Stefanaki C, Peppa M, Boschiero D, Chrousos GP. Healthy overweight/obese youth: early osteosarcopenic obesity features. Eur J Clin Invest 2016; 46:767-78. [PMID: 27434725 DOI: 10.1111/eci.12659] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/17/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Osteosarcopenic obesity was recently described as a variant phenotype of obesity, mainly observed in old age. This nested case-control study was performed to detect the differences in body composition between young, healthy overweight/obese and healthy lean populations of both genders. Our null hypothesis was that except for the fat mass, there would be absence of body composition differences, namely skeletal muscle and bone masses, between the groups. METHODS We used an advanced bio-impedance device to determine the body composition and measured circulating CRP (hsCRP) and diurnal salivary cortisol concentrations, as indices of inflammation and chronic stress, respectively. Overall, 2551 subjects aged 18-21 years participated in the study. RESULTS The healthy lean group included 1072 participants [900 males (84%) and 172 females (16%)], and the healthy overweight/obese group included 1479 participants [74 males (5%) and 1405 females (95%)]. Healthy overweight/obese participants presented with an increased fat mass (P < 0·001), as expected, but lower muscle (P < 0·001) and bone (P < 0·001) masses than lean controls. These findings were accompanied by increased extracellular water compartments, circulating hsCRP levels and evening salivary cortisol concentrations in the healthy overweight/obese group. CONCLUSIONS Our study suggests that 'osteosarcopenic' elements exist even in very young populations. These may represent a 'precursor' or forme fruste of the osteosarcopenic obesity phenotype in young healthy overweight/obese subjects, who may progressively develop osteosarcopenia in its full form at an older age. Our study highlights the significance of body composition analysis in medical practice, improving prevention and alleviating later health-related economic burden.
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Affiliation(s)
- Charikleia Stefanaki
- 1st Department of Pediatrics and Choremeion Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | - Melpomeni Peppa
- Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Propaedeutic Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - George P Chrousos
- 1st Department of Pediatrics and Choremeion Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece.,Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Bacopoulou F, Karakitsos P, Kottaridi C, Stefanaki C, Deligeoroglou E, Theodoridou K, Chrousos GP, Michos A. Genital HPV in Children and Adolescents: Does Sexual Activity Make a Difference? J Pediatr Adolesc Gynecol 2016; 29:228-33. [PMID: 26342734 DOI: 10.1016/j.jpag.2015.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/02/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
Abstract
STUDY OBJECTIVE To compare the prevalence of human papillomavirus (HPV) genital infection among prepubertal children, sexually active and not sexually active adolescents, and assess potential risk factors for transmission. DESIGN Prospective study. SETTING Outpatient adolescent health clinic. PARTICIPANTS Ninety-five girls aged 2-21 years; 38 sexually active adolescents (group A), 28 not sexually active adolescents (group B), and 29 prepubertal children (group C). INTERVENTIONS Participants' vaginal or cervical specimens were tested for HPV with the CLART HPV 2 assay (Clinical Array Technology, Genomica, Madrid, Spain) and for cytological abnormalities with liquid-based cytology. MAIN OUTCOME MEASURES Differences in prevalence of low- and high-risk HPV infections among the 3 groups. RESULTS Genital HPV was detected in 37.9% (36/95) of all participants; 47.4% (18/38) of group A, 28.6% (8/28) of group B, and 34.5% (10/29)of group C (P = .27). Multiple HPV infection was detected in 26.3% (10/38), 10.7% (3/28), and 13.8% (4/29) of groups A, B, and C, respectively (P = .21). High-risk genotypes were detected in 47.4% (18/38), 28.6% (8/28), and 24.1% (7/29) of groups A, B, and C, respectively (P = .10). Main high-risk genotypes were HPV 16 (27%, 10/37), HPV 31 (21.6%, 8/37 ), HPV 35 (13.5%, 5/37), HPV 53 (13.5%, 5/37), and low-risk HPV 6 (18.9%, 7/37). Sexual activity was associated with increased risk for genital high-risk HPV infection (odds ratio = 3.41; 95% confidence interval, 1.19-9.78); specifically with HPV 33 and HPV 51. Forty percent of sexually active adolescents with normal cervical cytology were infected with high-risk HPV types. Family history of skin HPV was positively associated with genital HPV in the sexually active group (odds ratio = 2.01; 95% confidence interval, 1.17-3.46). CONCLUSION Timeline and target population for HPV vaccination might need to be reappraised, in view of significant nonsexual transmission of genital HPV so early in childhood.
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Affiliation(s)
- Flora Bacopoulou
- Center for Adolescent Medicine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Adolescent Health Care, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.
| | - Petros Karakitsos
- Department of Cytopathology, Attikon University Hospital, Athens, Greece
| | | | - Charikleia Stefanaki
- Center for Adolescent Medicine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Adolescent Health Care, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Efthymios Deligeoroglou
- Center for Adolescent Medicine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Adolescent Health Care, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Kalliopi Theodoridou
- Center for Adolescent Medicine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Adolescent Health Care, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - George P Chrousos
- Center for Adolescent Medicine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Adolescent Health Care, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Athanasios Michos
- Division of Infectious Diseases, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
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Abstract
I ntermediate hyperglycemia, or prediabetes, is increasing worldwide, affecting people of all ages, including adolescents. Hormonal, physiological, psychological, and lifestyle changes in adolescence have been associated with disruptions in glucose homeostasis, such as decreased insulin sensitivity, insulin resistance, or the combination of both. As a rule, glucose homeostasis is ameliorated, in normal subjects, when puberty is completed. However, in susceptible individuals, like obese adolescents, or adolescents with a strong genetic background, there is a progression to type 2 diabetes onset. Thus, susceptible adolescents should be screened for prediabetes, using fasting plasma glucose, and glycated hemoglobin (HbA1c), and oral glucose tolerance testing. Prediabetic adolescents should be counseled for a healthy lifestyle including healthy dietary habits, increased physical activity, and/or stress management. Other pathological conditions should be adequately treated. Early recognition of prediabetes in adolescence will prevent type 2 diabetes onset, decreasing the diabetes-associated health burden in adult life. This review aims to revise the associations and elucidate on the gaps between prediabetes and adolescence, via a comprehensive review of the current medical literature.
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Livadas S, Dastamani A, Stefanaki C, Mantzou E, Painesi A, Papanikolaou E, Chrousos G. A low glycaemic index, low glycaemic load snack based on stevia and fortified with vitamin D, improves metabolic/hormonal profile, and compliance in normal subjects and prediabetics; results from a 4 months, controlled trial. EJEA 2015. [DOI: 10.1530/endoabs.37.ep616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tsigos C, Stefanaki C, Lambrou GI, Boschiero D, Chrousos GP. Stress and inflammatory biomarkers and symptoms are associated with bioimpedance measures. Eur J Clin Invest 2015; 45:126-34. [PMID: 25431352 DOI: 10.1111/eci.12388] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/25/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND This large cross-sectional, multi-centre study evaluated the association of body composition measurements by a novel dual frequency bioimpedance device (BIA-ACC) with chronic stress/inflammation biomarkers and the presence of medically unexplained symptoms (MUS). MATERIALS AND METHODS Participants were adult Caucasians of both sexes and included 10,416 lean subjects with no MUS (Group A), 58,710 lean subjects with MUS (Group B) and 30,445 overweight/obese subjects with no MUS and excessive fat mass (FM) (Group C). RESULTS Total body extracellular water (ECW) was higher, while intracellular water (ICW) was lower in Group B than both other groups (P < 0.01). Group A had significantly lower FM and higher skeletal mass (SK) and phase angle (PA) than Group B and lower circulating high sensitivity (hs) CRP levels than both other groups. hsCRP was higher in Group C than Group A though (P < 0.01). Salivary cortisol in Group B was lower in the morning and higher in the evening than both other groups (P < 0.001), indicating circadian rhythm obliteration or reversal in this group. ECW correlated positively with serum hsCRP and 8 p.m. salivary cortisol, but negatively with 8 a.m. salivary cortisol, while PA correlated positively with 8 a.m. and negatively with 8 p.m. salivary cortisol and serum hsCRP. Both 8 a.m. and 8 p.m. salivary cortisol and serum hsCRP were associated with the presence of MUS and BIA-ACC measurements, including ECW, ICW, FM, SK and PA. CONCLUSIONS MUS is an index of chronic stress and inflammation and BIA-ACC may provide a useful, bloodless and rapid tool in the clinical setting, distinguishing patients with chronic stress/inflammation from healthy subjects and monitoring their response to treatment.
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Affiliation(s)
- Constantine Tsigos
- School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
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Stefanaki C, Bacopoulou F, Livadas S, Kandaraki A, Karachalios A, Chrousos GP, Diamanti-Kandarakis E. Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress 2015; 18:57-66. [PMID: 25287137 DOI: 10.3109/10253890.2014.974030] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder with a significant psychological burden throughout the life course of affected women. Thus, use of mindful awareness may be beneficial as an adjunct to conventional medical management of women with PCOS. A randomized, controlled trial was conducted at the Evgenideion Hospital of the Athens University Medical School to explore the impact of an 8-week mindfulness stress management program on measures of depression, anxiety and stress as well as on the quality of life in reproductive age women with PCOS. The study was approved by the Research Ethics Committee. Twenty-three and 15 women with PCOS were randomly allocated to the intervention or control group, respectively. All participants were administered DASS21, PSS-14, PCOSQ, Daily Life and General Life Satisfaction Questionnaires and provided three-timed daily samples of salivary cortisol, before and after the intervention. Intervention group participants were provided with the Credibility/Expectancy Questionnaire at the day of enrolment, to check for possible placebo effect on the outcome. Post-intervention, between-group results revealed statistically significant reductions in stress, depressive and anxiety symptoms, as well as in salivary cortisol concentrations, along with an increase in Life Satisfaction and Quality of Life scores in the intervention group only. There was no significant "placebo" effect on the outcome measures. Mindfulness techniques seem promising in ameliorating stress, anxiety, depression and the quality of life in women with PCOS and could be used as an adjunct method to the conventional management of these women.
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Affiliation(s)
- Charikleia Stefanaki
- Division of Endocrinology, Metabolism and Diabetes, Evgenideion Hospital, Athens University Medical School , Athens , Greece
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Tsiouli E, Alexopoulos EC, Stefanaki C, Darviri C, Chrousos GP. Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes: Systematic review. Can Fam Physician 2013; 59:143-149. [PMID: 23418238 PMCID: PMC3576940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. DATA SOURCES PubMed and Scopus were searched for relevant studies published since 1990 using the following key words: diabetes type 1, glycemic control, family stress, family conflict, and family function. STUDY SELECTION In total, 1478 papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement. SYNTHESIS In most studies family stress was negatively correlated with patients' glycemic control. Family function was strongly related to patients' glycemic control, while family conflict was adversely associated with glycemic control. Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. CONCLUSION Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control.
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Affiliation(s)
- Elina Tsiouli
- Biomedical Research Foundation, Academy of Athens, Soranou Ephessiou Str, 4, GR-115-27, Athens, Greece
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Stamatakos M, Karaiskos I, Pateras I, Alexiou I, Stefanaki C, Kontzoglou K. Gastrocolic fistulae; From Haller till nowadays. Int J Surg 2012; 10:129-33. [PMID: 22361308 DOI: 10.1016/j.ijsu.2012.02.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 11/25/2022]
Abstract
Gastrocolic Fistula is, in the majority of cases the pathological communication between stomach and transverse colon, because cases involved with the small intestine, pancreas and skin have been also documented, even though are rare. It occurs mostly in adults, but they can be present to infants, as well, as a result of congenital abnormalities or iatrogenic procedures (i.e. migration of PEG tube that placed before). In the Western Countries, the most common cause is the adenocarcinoma of the colon, while in Japan, adenocarcinoma of the stomach is the most frequent cause. It seldom appears, as a complication of a benign peptic ulcer, in Crohn's disease and as a result of significant intake of steroids or NSAIDs. The typical symptoms of a gastrocolic fistula are abdominal pain, nausea-vomiting, diarrhea and weight loss. Radiology has been used for the detection of the fistulae all these years but the golden standard remained the barium enema. Barium meal and CT findings play a smaller role in the diagnosis. Although the management of gastrocolic fistulae has historically been surgical, medical treatment has recently been recommended as the first line when a malignancy can be excluded.
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Stamatakos M, Stefanaki C, Xiromeritis K, Pavlerou N, Kontzoglou K. Breast cancer in reproductive age. The new plaque or just myth? Surg Oncol 2011; 20:e169-74. [PMID: 21680175 DOI: 10.1016/j.suronc.2011.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 05/19/2011] [Accepted: 05/21/2011] [Indexed: 11/25/2022]
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Stamatakos M, Stefanaki C, Stasinou T, Papantoni E, Alexiou I, Kontzoglou K. Intracystic Papillary Carcinoma of the Breast in Males. In Search of the Optimal Treatment for this Rare Disease. ACTA ACUST UNITED AC 2011; 6:399-403. [PMID: 22619652 DOI: 10.1159/000331386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Intracystic papillary carcinoma (IPC) of the breast in men is an extremely infrequent disease, and it appears to have a good prognosis. Because of this, histological findings are of great importance in the decision-making process regarding treatment. Clinical examination, radiological and histological assessments are required for early detection. Adequate surgical excision with negative margins is mandatory. However, the role of sentinel node biopsy has not been evaluated in male IPC. It appears that sentinel node biopsy may be an excellent alternative to radical axillary dissection in patients with IPC and associated ductal carcinoma in situ or invasive carcinoma. Nevertheless, due to the rarity of IPC and its confusing histopathological classification and staging, there are still no clear guidelines as far as IPC treatment is concerned.
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Affiliation(s)
- Michael Stamatakos
- 4th Department of Surgery, University of Athens, Laiko General Hospital, Athens, Greece
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Michael S, Charikleia S, Konstantinos K. Lymphedema and breast cancer: a review of the literature. Breast Cancer 2011; 18:174-80. [DOI: 10.1007/s12282-010-0246-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2010] [Accepted: 10/30/2010] [Indexed: 10/18/2022]
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Stamatakos M, Paraskeva P, Stefanaki C, Katsaronis P, Lazaris A, Safioleas K, Kontzoglou K. Medullary thyroid carcinoma: The third most common thyroid cancer reviewed. Oncol Lett 2010; 2:49-53. [PMID: 22870127 DOI: 10.3892/ol.2010.223] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Accepted: 11/02/2010] [Indexed: 01/15/2023] Open
Abstract
Medullary thyroid cancer is a type of thyroid cancer of neuroendocrine origin. It occurs in hereditary and sporadic forms, and its aggressive behavior is associated with the clinical presentation and type of RET mutation. Total thyroidectomy remains the ideal choice of treatment. Early diagnosis and treatment are the fundamental for a 100% cure rate. In this study, we present our experience of 3 cases, along with a complete review of the literature derived from a Pubmed Database search.
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Affiliation(s)
- Michael Stamatakos
- Fourth Department of Surgery, School of Medicine, Athens University, Attikon Hospital, Athens, Greece
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Stamatakos M, Stefanaki C, Kontzoglou K, Masouridi S, Sakorafas G, Safioleas M. Recapitulation of ras oncogene mutations in breast cancer. ACTA ACUST UNITED AC 2010; 33:540-4. [PMID: 20926903 DOI: 10.1159/000319697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Several human breast cancer cell lines have been shown to contain mutational activation of Ras oncogenes. The goal of this review is to clarify the physiology and biochemical pathways of Ras family oncogenes in order to understand thoroughly the mechanisms behind Ras gene mutations. Ras genes are involved in the early stages of mammary oncogenesis through augmented expression of the normal p21 protein. Recognition of the mechanisms resulting in aberrant expression of Ras, as well as unveiling the influence of the Ras family gene activation in the Ras signaling pathway, should have a major impact on clarifying the oncogenetic process, possibly offering candidate therapy and prevention strategies.
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Affiliation(s)
- Michael Stamatakos
- 4th Department of Surgery, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
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Abstract
Walled-off pancreatic necrosis (WOPN), formerly known as pancreatic abscess is a late complication of acute pancreatitis. It can be lethal, even though it is rare. This critical review provides an overview of the continually expanding knowledge about WOPN, by review of current data from references identified in Medline and PubMed, to September 2009, using key words, such as WOPN, infected pseudocyst, severe pancreatitis, pancreatic abscess, acute necrotizing pancreatitis (ANP), pancreas, inflammation and alcoholism. WOPN comprises a later and local complication of ANP, occurring more than 4 wk after the initial attack, usually following development of pseudocysts and other pancreatic fluid collections. The mortality rate associated with WOPN is generally less than that of infected pancreatic necrosis. Surgical intervention had been the mainstay of treatment for infected peripancreatic fluid collection and abscesses for decades. Increasingly, percutaneous catheter drainage and endoscopic retrograde cholangiopancreatography have been used, and encouraging results have recently been reported in the medical literature, rendering these techniques invaluable in the treatment of WOPN. Applying the recommended therapeutic strategy, which comprises early treatment with antibiotics combined with restricted surgical intervention, fewer patients with ANP undergo surgery and interventions are ideally performed later in the course of the disease, when necrosis has become well demarcated.
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Tasoulis MK, Livaditi O, Stamatakos M, Stefanaki C, Paneris P, Prigouris P, Flevari A, Goutas N, Vlachodimitropoulos D, Villiotou V, Douzinas EE. High concentrations of reactive oxygen species in the BAL fluid are correlated with lung injury in rabbits after hemorrhagic shock and resuscitation. TOHOKU J EXP MED 2010; 219:193-9. [PMID: 19851047 DOI: 10.1620/tjem.219.193] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Increased levels of cytokines or reactive oxygen species (ROS) in the bronchoalveolar lavage (BAL) fluid are associated with acute lung injury after ischemia/reperfusion. We investigated the correlation of these markers with the degree of lung injury in a rabbit model of hemorrhagic shock. Rabbits, maintained by mechanical ventilation, were left untreated (control) or subjected to hemorrhagic shock by withdrawing blood (n = 12 for each group). Shock animals were re-infused their shed blood for resuscitation. At the end of the experiment, BAL fluid was recovered, in which parameters of oxidative stress and cytokines were measured. Macrophages and malondialdehyde levels were increased (p = 0.043 and p = 0.003, respectively), and total antioxidant capacity (TAC) was decreased in the shock animals compared with control (p = 0.009). Production of ROS was significantly enhanced in shock animals compared with controls (p < 0.001). BAL fluid levels of tumor necrosis factor-alpha, interleukin (IL)-1beta and IL-6 were higher in shock rabbits by more than twofold (p < 0.001 for each). Shock animals also showed higher histopathological scores that represent severe tissue damage than controls (p = 0.022). Numbers of macrophages and levels of ROS and TAC were correlated with the degree of lung injury (p = 0.006, p = 0.02, and p = 0.04, respectively), but not cytokines. Therefore, resuscitation from hemorrhagic shock results in acute lung injury, with enhanced pulmonary oxidative and inflammatory responses. In conclusion, ROS in the BAL fluid are good markers that predict lung injury following hemorrhagic shock and resuscitation.
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Abstract
Lymphatic mapping and sentinel lymphadenectomy have become an important tool for axillary lymph node staging in women with early-stage breast cancer. Many issues such as indications, usefulness, or best method of performing a sentinel node biopsy need to be addressed. Multiple studies now confirm that sentinel lymphadenectomy accurately stages the axilla and is associated with less morbidity than axillary dissection. Blue dye, radiocolloid, or both can be used to identify the sentinel node, and several injection techniques may be used successfully. Many patient factors previously thought to affect accuracy of the procedure have now been shown to be of limited significance. This paper's main purpose is to present the pros and cons of the sentinel lymph node biopsy, and to elucidate all questions regarding to the matter by reviewing the current medical literature.
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Affiliation(s)
- Michael Stamatakos
- 4th Department of Surgery, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
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Stamatakos M, Douzinas E, Stefanaki C, Safioleas P, Polyzou E, Levidou G, Safioleas M. Gastrointestinal stromal tumor. World J Surg Oncol 2009. [DOI: https:/doi.org/10.1186/1477-7819-7-61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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Stamatakos M, Douzinas E, Stefanaki C, Safioleas P, Polyzou E, Levidou G, Safioleas M. Gastrointestinal stromal tumor. World J Surg Oncol 2009; 7:61. [PMID: 19646278 PMCID: PMC2749031 DOI: 10.1186/1477-7819-7-61] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 08/01/2009] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND GISTs are a subset of mesenchymal tumors and represent the most common mesenchymal neoplasms of GI tract. However, GIST is a recently recognized tumor entity and the literature on these stromal tumors has rapidly expanded. METHODS An extensive review of the literature was carried out in both online medical journals and through Athens University Medical library. An extensive literature search for papers published up to 2009 was performed, using as key words, GIST, Cajal's cells, treatment, Imatinib, KIT, review of each study were conducted, and data were abstracted. RESULTS GIST has recently been suggested that is originated from the multipotential mesenchymal stem cells. It is estimated that the incidence of GIST is approximately 10-20 per million people, per year. CONCLUSION The clinical presentation of GIST is variable but the most usual symptoms include the presence of a mass or bleeding. Surgical resection of the local disease is the mainstay therapy. However, therapeutic agents, such as Imatinib have now been approved for the treatment of advanced GISTs and others, such as everolimus, rapamycin, heat shock protein 90 and IGF are in trial stage demonstrate promising results for the management of GISTs.
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Affiliation(s)
- Michael Stamatakos
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece
| | - Emmanouel Douzinas
- 3rd Department of Critical Care, Athens University, Eugenidion Hospital, Athens, Greece
| | - Charikleia Stefanaki
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece
| | - Panagiotis Safioleas
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece
| | - Electra Polyzou
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece
| | - Georgia Levidou
- Department of Pathology, School of Medicine, University of Athens, Greece
| | - Michael Safioleas
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece
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Stamatakos M, Stefanaki C, Tsaknaki S, Safioleas P, Iannescu R, Safioleas M. Primary adenocarcinoma of the appendix: an update. Chirurgia (Bucur) 2009; 104:389-392. [PMID: 19886044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Adenocarcinoid arising in the vermiform appendix is a rarity. The diagnosis of appendiceal adenocarcinoma has never been made preoperatively and is frequently an incidental finding at the time of operation for unrelated conditions. Because of the rarity of the disease, its natural history is poorly understood. Benefits from adjuvant radiation, chemotherapy, or a combination have not been reported. Most studies emphasize survival outcome based on surgical technique. There are few data and, consequently, much debate on the appropriate management of these lesions. The aim of this article is to review this entity and to assess and report new data, through a study of the literature.
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Affiliation(s)
- M Stamatakos
- 4th Surgical Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece.
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Stamatakos M, Stefanaki C, Mastrokalos D, Arampatzi H, Safioleas P, Chatziconstantinou C, Xiromeritis C, Safioleas M. Mesenteric ischemia: still a deadly puzzle for the medical community. TOHOKU J EXP MED 2009; 216:197-204. [PMID: 18987453 DOI: 10.1620/tjem.216.197] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The main goal of this article is to update etiology, epidemiology, diagnosis, treatment and outcome of the various causes of mesenteric ischemia in order to elucidate its labyrinthine clinical riddle, by reviewing the current English medical literature. Mesenteric ischemia is a quite uncommon disorder, observed in the emergency department. It is a life-threatening vascular emergency that requires early diagnosis and intervention to restore mesenteric blood flow and to prevent bowel necrosis and patient death. Consequently, it is a vital diagnosis to make because of its high mortality rate and its thorny complications. The underlying causes vary, and the prognosis depends on the specific findings during clinical examination. Vague and nonspecific clinical findings and limitations of diagnostic studies make the diagnosis a significant challenge. The prognosis of acute mesenteric ischemia of any type is grave. The complications following this medical jigsaw puzzle are also severe. Patients in whom the diagnosis is missed until infarction occurs have a mortality rate of 90%. Even with good treatment, up to 50-80% of patients die. Survivors of extensive bowel resection face lifelong disability. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of treatment modalities, the entity remains a diagnostic challenge for clinicians. Delay in diagnosis contributes to a high mortality rate. Early diagnosis and adequate treatment can improve the clinical outcome. Even if diagnostic modalities have improved since the first successful attempts to confront effectively this clinical entity, mesenteric ischemia still remains a lethal diagnostic enigma for the medical community.
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Affiliation(s)
- Michael Stamatakos
- Second Department of Propaedeutic Surgery, Medical School, University of Athens, Laiko General Hospital, Athens, Greece.
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Stamatakos M, Sargedi C, Stefanaki C, Safioleas C, Matthaiopoulou I, Safioleas M. Anthelminthic treatment: an adjuvant therapeutic strategy against Echinococcus granulosus. Parasitol Int 2009; 58:115-20. [PMID: 19272345 DOI: 10.1016/j.parint.2009.01.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 12/30/2008] [Accepted: 01/07/2009] [Indexed: 11/17/2022]
Abstract
The main goal of the paper is to clarify anthelminthic treatment as an alternative hydatic cyst therapy, its indications and contraindications. Chemotherapy constitutes a non-invasive treatment and is less limited by the patient's status than surgery or PAIR. Many investigators have employed benzoimidazole carbonates for the management of human hydatid disease. Both, albendazole and mebendazole have, a favourable effect in patients suffering from multiorgan and multicystic disease, in inoperable primary liver or lung echinococcosis, and they can also prevent secondary echinococcosis. Chemotherapy is contraindicated for large cysts that are at risk to rupture and for inactive or calcified cysts. The main adverse events are related to changes in liver enzyme levels. The best efficacy is observed with liver, lung, and peritoneal cysts. Certain various factors influence the therapeutic results of medical treatment. The vast majority of the recurring cysts show good susceptibility to re-treatment.
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Affiliation(s)
- M Stamatakos
- 2nd Propaedeutic Department of Surgery, Medical School, University of Athens, Laiko General Hospital, Athens, Greece.
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Stamatakos M, Kontzoglou K, Stefanaki Ch, Tsaknaki S, Iannescu R, Manta A, Safioleas M. Wilkie syndrome. What is this? Chirurgia (Bucur) 2009; 104:11-5. [PMID: 19388563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Superior mesenteric artery syndrome is extremely rare and is characterized by postprandial epigastric pain, nausea, vomiting and loss of appetite, with subsequent weight loss, which aggravates the condition of the patients. The syndrome is caused by compression of the third part of the duodenum in the angle between the aorta and the superior mesenteric artery. This review updates etiology, epidemiology, diagnosis, treatment and outcome of the superior mesenteric artery syndrome. Superior mesenteric artery syndrome is clearly defined and frequently associated with a wide range of predisposing conditions and surgical procedures.
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Stamatakos M, Douzinas E, Stefanaki C, Petropoulou C, Arampatzi H, Safioleas C, Giannopoulos G, Chatziconstantinou C, Xiromeritis C, Safioleas M. Ischemic Colitis: Surging Waves of Update. TOHOKU J EXP MED 2009; 218:83-92. [PMID: 19478463 DOI: 10.1620/tjem.218.83] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Michael Stamatakos
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
| | - Emmanuel Douzinas
- Third Department of Critical Care, Medical School, Athens University, Eugenidion Hospital
| | - Charikleia Stefanaki
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
| | - Constantina Petropoulou
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
| | - Helen Arampatzi
- First Department of Obstetrics and Gynecology, Athens University Medical School, Alexandra Hospital
| | - Constantinos Safioleas
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
| | - George Giannopoulos
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
| | | | | | - Michael Safioleas
- Fourth Department of Surgery, Medical School, University of Athens, ATTIKON General Hospital
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