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Kokkinidis DG, Schizas D, Pargaonkar S, Karamanis D, Mylonas KS, Hasemaki N, Palaiodimos L, Varrias D, Tzavellas G, Siasos G, Klonaris C, Kharawala A, Chlorogiannis DD, Georgopoulos S, Bakoyiannis C. Differences between Lower Extremity Arterial Occlusion vs. Stenosis and Predictors of Successful Endovascular Interventions. Medicina (Kaunas) 2023; 59:2029. [PMID: 38004078 PMCID: PMC10673017 DOI: 10.3390/medicina59112029] [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] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: In patients with peripheral artery disease, there is insufficient understanding of characteristics that predict successful revascularization of the lower extremity (LE) chronic total occlusions (CTOs) and baseline differences in demographic, clinical, and angiographic characteristics in patients with LE CTO vs. non-CTO. We aim to explore these differences and predictors of successful revascularization among CTO patients. Materials and Methods: Two vascular centers enrolled LE-CTO patients who underwent endovascular revascularization. Data on demographics, clinical, angiographic, and interventional characteristics were collected. LE non-CTO arterial stenosis patients were compared. A total of 256 patients with LE revascularization procedures were studied; among them, 120 had CTOs and 136 had LE stenosis but no CTOs. Results: Aspirin use (Odds ratio, OR: 3.43; CI 1.32-8.88; p = 0.011) was a positive predictor whereas a history of malignancy (OR: 0.27; CI 0.09-0.80; p = 0.018) was a negative predictor of successful crossing in the CTO group. The CTO group had a higher history of myocardial infarction (29.2 vs. 18.3%, p = 0.05), end-stage renal disease (19.2 vs. 9.6%, p = 0.03), and chronic limb-threatening ischemia as the reason for revascularization (64.2 vs. 22.8%, p < 0.001). They were more likely to have advanced TransAtlantic Inter-Society Consensus (TASC) stages, multi-vessel revascularization procedures, longer lesions, and urgent treatment. Conclusions: The use of aspirin is a positive predictor whereas a history of malignancy is a negative predictor for successful crossing in CTO lesions. Additionally, LE-CTO patients have a higher incidence of comorbidities, which is expected given their higher disease burden. Successful endovascular re-vascularization can be associated with baseline clinical variables.
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Affiliation(s)
- Damianos G Kokkinidis
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Dimitrios Schizas
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sumant Pargaonkar
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 18534 Piraeus, Greece
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA
| | - Konstantinos S Mylonas
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Natasha Hasemaki
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Varrias
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Georgios Tzavellas
- Department of Vascular Surgery, Ball Memorial Hospital, Muncie, IN 47303, USA
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Klonaris
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Amrin Kharawala
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Sotirios Georgopoulos
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Kharawala A, Seo J, Barzallo D, Romero GH, Demirhan YE, Duarte GJ, Vegivinti CTR, Hache-Marliere M, Balasubramanian P, Santos HT, Nagraj S, Alhuarrat MAD, Karamanis D, Varrias D, Palaiodimos L. Assessment of the Utilization of Validated Diagnostic Predictive Tools and D-Dimer in the Evaluation of Pulmonary Embolism: A Single-Center Retrospective Cohort Study from a Public Hospital in New York City. J Clin Med 2023; 12:jcm12113629. [PMID: 37297824 DOI: 10.3390/jcm12113629] [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: 04/03/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION A significant increase in the use of computed tomography with pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE) has been observed in the past twenty years. We aimed to investigate whether the validated diagnostic predictive tools and D-dimers were adequately utilized in a large public hospital in New York City. METHODS We conducted a retrospective review of patients who underwent CTPA for the specific indication of ruling out PE over a period of one year. Two independent reviewers, blinded to each other and to the CTPA and D-dimer results, estimated the clinical probability (CP) of PE using Well's score, the YEARS algorithm, and the revised Geneva score. Patients were classified based on the presence or absence of PE in the CTPA. RESULTS A total of 917 patients were included in the analysis (median age: 57 years, female: 59%). The clinical probability of PE was considered low by both independent reviewers in 563 (61.4%), 487 (55%), and 184 (20.1%) patients based on Well's score, the YEARS algorithm, and the revised Geneva score, respectively. D-dimer testing was conducted in less than half of the patients who were deemed to have low CP for PE by both independent reviewers. Using a D-dimer cut-off of <500 ng/mL or the age-adjusted cut-off in patients with a low CP of PE would have missed only a small number of mainly subsegmental PE. All three tools, when combined with D-dimer < 500 ng/mL or <age-adjusted cut-off, yielded a NPV of > 95%. CONCLUSION All three validated diagnostic predictive tools were found to have significant diagnostic value in ruling out PE when combined with a D-dimer cut-off of <500 ng/mL or the age-adjusted cut-off. Excessive use of CTPA was likely secondary to suboptimal use of diagnostic predictive tools.
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Affiliation(s)
- Amrin Kharawala
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jiyoung Seo
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Diego Barzallo
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gabriel Hernandez Romero
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Yunus Emre Demirhan
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gustavo J Duarte
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Charan Thej Reddy Vegivinti
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Manuel Hache-Marliere
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Prasanth Balasubramanian
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Heitor Tavares Santos
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Sanjana Nagraj
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Majd Al Deen Alhuarrat
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 18534 Attica, Greece
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA
| | - Dimitrios Varrias
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Leonidas Palaiodimos
- Department of Medicine, New York City Health + Hospitals/Jacobi, Bronx, NY 10461, USA
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
- School of Medicine, City University of New York, New York, NY 10031, USA
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Syrimi N, Sourri F, Giannakopoulou MC, Karamanis D, Pantousas A, Georgota P, Rokka E, Vladeni Z, Tsiantoula E, Soukara E, Lavda N, Gkaragkanis D, Zisaki A, Vakalidis P, Goula V, Loupou E, Palaiodimos L, Hatzigeorgiou D. Humoral and Cellular Response and Associated Variables Nine Months following BNT162b2 Vaccination in Healthcare Workers. J Clin Med 2023; 12:jcm12093172. [PMID: 37176612 PMCID: PMC10179201 DOI: 10.3390/jcm12093172] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
In this study, we aimed to illustrate the trajectory of humoral and cellular immunity nine months after primary vaccination with the BNT162b2 mRNA vaccine among 189 healthcare workers (HCWs). Additionally, we endeavored to identify correlations between immunity parameters and a number of common variables and comorbidities. A total of 189 healthcare workers (HCWs), vaccinated against COVID-19, were finally included in the study. All of the subjects had received two doses of the BNT162b2 vaccine; had undergone antibody tests one, four and nine months post-vaccination; and had completed a medical questionnaire. Further samples taken at nine months were tested for cellular immunity. No participants had evidence of COVID-19 infection pre- or post-vaccination. An anti-S1 receptor binding domain (RBD) antibody assay was used to assess humoral response, and cellular immunity was estimated with an INF-γ release assay (IGRA). Statistical analysis was performed using STATA. We report a statistically significant antibody drop over time. Being above the age of 40 or a smoker reduces the rise of antibodies by 37% and 28%, respectively. More than half of the participants did not demonstrate T-cell activation at nine months. Female gender and antibody levels at four months predispose detection of cellular immunity at nine months post-immunization. This study furthers the qualitative, quantitative, and temporal understanding of the immune response to the BNT162b2 mRNA vaccine and the effect of correlated factors.
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Affiliation(s)
- Natalia Syrimi
- Paediatric Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Flora Sourri
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Maria-Christina Giannakopoulou
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, 65 Bergen St., Newark, NJ 07107, USA
- Department of Economics, University of Piraeus, Karaoli and Dimitriou 80, 18534 Piraeus, Greece
| | - Asterios Pantousas
- Department of Electrical and Computer Engineering, Democritus University of Thrace, 69100 Komotini, Greece
| | - Persefoni Georgota
- Immunology Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Eleni Rokka
- Oncology Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Zoe Vladeni
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Euaggelia Tsiantoula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evangelia Soukara
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Nikoletta Lavda
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Dimitrios Gkaragkanis
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Aikaterini Zisaki
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Panagiotis Vakalidis
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Vasiliki Goula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evdokia Loupou
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Hatzigeorgiou
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
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Liaqat W, Palaiodimos L, Li W, Karamanis D, Tahir A, Tzoumas A, Nagraj S, Tiwari N, Grushko M, Kokkinidis D, Gashi E, Leider J, Coyle C, Faillace RT. Correction: Epidemiologic and clinical characteristics of infective endocarditis: a single-center retrospective study in the Bronx, New York. Infection 2023:10.1007/s15010-023-02004-z. [PMID: 37072605 DOI: 10.1007/s15010-023-02004-z] [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] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Affiliation(s)
- Wasla Liaqat
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA.
- Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Weijia Li
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dimitrios Karamanis
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ, USA
- Department of Economics, University of Peiraeus, Attica, Greece
| | - Arooj Tahir
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andreas Tzoumas
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sanjana Nagraj
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nidhish Tiwari
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michael Grushko
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Damianos Kokkinidis
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Eleonora Gashi
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jason Leider
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christina Coyle
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert T Faillace
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
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Mehta A, Kharawala A, Nagraj S, Apple SJ, Barzallo D, Al Deen Alhuarrat M, Moya CJB, Vikash S, Zoumpourlis P, Xesfingi S, Varrias D, Demirhan YE, Palaiodimos L, Karamanis D. Invasive Mechanical Ventilation and Death Was More Likely in Patients with Lower LDL Cholesterol Levels during COVID-19 Hospitalization: A Retrospective Propensity-Matched Cohort Study. JoR 2023. [DOI: 10.3390/jor3020005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Hyperlipidemia has been associated with worse outcomes in patients with Coronavirus disease 2019 (COVID-19). However, lower LDL-C (low-density lipoprotein cholesterol) levels have been associated with increased COVID-19 severity and mortality. We conducted a retrospective observational study of patients with COVID-19 admitted to New York City Health and Hospitals from 1 March 2020 to 31 October 2020, comparing pre-COVID-19 LDL-C levels or LDL-C levels obtained during COVID-19 hospitalization, with the need for invasive mechanical ventilation and death. Propensity score matching was performed using logistic regression models, and standardized mean differences were calculated. A total of 3020 patients (median age 61 years; 36% women) were included. In the matched cohort, on multivariate logistic regression analysis, LDL was inversely associated with in-hospital death (OR: 0.99, 95% CI: 0.986–0.999, p = 0.036). As a categorical variable, LDL > 70 mg/dL was associated with 47% lower likelihood of invasive mechanical ventilation (OR: 0.53, 95% CI: 0.29–0.95, p = 0.034). No significant association between pre-COVID-19 LDL and death or invasive mechanical ventilation was found (OR: 1.00, 95% CI 0.99–1.01, p = 0.833). Low LDL-C level measured during COVID-19 was associated with a higher likelihood of invasive mechanical ventilation and in-hospital death. A similar association was not found between pre-COVID-19 LDL-C and these outcomes. LDL-C levels obtained during COVID-19 are likely not reflective of the baseline lipid profile.
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Affiliation(s)
- Adhya Mehta
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Amrin Kharawala
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sanjana Nagraj
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Samuel J. Apple
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Diego Barzallo
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Majd Al Deen Alhuarrat
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Cesar Joel Benites Moya
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sindhu Vikash
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Panagiotis Zoumpourlis
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sophia Xesfingi
- National Documentation Center, Zefirou 56, 17564 Paleo Faliro, Greece
| | - Dimitrios Varrias
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Yunus Emre Demirhan
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Leonidas Palaiodimos
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
- CUNY School of Medicine, New York, NY 10031, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 18534 Piraeus, Greece
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA
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6
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Karokis D, Karamanis D, Xesfingi S, Antonopoulos I, Politi E, Bounas A, Lykoura C, Voulgari P. Anxiety, Distress, and Depression in Elderly Rheumatoid Arthritis Patients. Mediterr J Rheumatol 2022; 33:394-406. [PMID: 37034365 PMCID: PMC10075367 DOI: 10.31138/mjr.33.4.394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/22/2022] [Accepted: 07/04/2022] [Indexed: 01/22/2023] Open
Abstract
Rheumatoid arthritis (RA) and affective disorders (anxiety/depression) constitute important pathologies in the elderly population, and their coexistence creates synergistically increased problems in functional ability and quality of life of the patients. Purpose Evaluation of anxiety, distress, and depression in elderly (≥65 years old) patients with RA. Patients – methods 114 patients from the cities of Patras, Arta and Ioannina (all located in Western Greece) were included. Demographics and medical information regarding RA were recorded, including disease duration, medication, previous treatments, disease activity measures, comorbidities etc. Patients answered the State-Trait Anxiety Inventory (STAI), General Health Questionnaire-28 (GHQ28) and Health Assessment Questionnaire -Disability Index (HAQ-DI) questionnaires, for evaluation of anxiety, general health and functional ability, respectively. Statistical analysis was made by using STATA. Results 88 women (78.07%) and 25 men (21.93%) with median age 70 years and median disease duration 10 years were studied. Female patients, with longer disease duration and higher disease activity, had statistically significant higher levels of anxiety, worse general health and decreased functional ability. A strongly significant association was found between the levels of anxiety and distress, with disease activity and functional inability. Conclusions Levels of anxiety and distress are strongly associated with disease activity and functional inability in elderly patients with RA. Women with longer disease have higher levels of anxiety and distress. Controlling disease activity is of upmost importance for improvement of anxiety and distress and functional ability. Larger studies are needed for evaluation of anxiety and distress in elderly patients with RA.
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Affiliation(s)
| | - Dimitrios Karamanis
- Adjunct Lecturer, School of Social Sciences, Hellenic Open University, Patras, Greece,
| | - Sofia Xesfingi
- Adjunct Lecturer, School of Social Sciences, Hellenic Open University, Patras, Greece,
| | | | | | | | - Chrysa Lykoura
- Trainee in Rheumatology, University Hospital Patras, Greece,
| | - Paraskevi Voulgari
- Professor of Rheumatology, Department of Rheumatology, School of Health, Sciences, Faculty of Medicine, University of Ioannina, Greece
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7
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Liaqat W, Palaiodimos L, Li W, Karamanis D, Tahir A, Tzoumas A, Nagraj S, Tiwari N, Grushko M, Kokkinidis D, Gashi E, Leider J, Coyle C, Faillace RT. Epidemiologic and clinical characteristics of infective endocarditis: a single-center retrospective study in the Bronx, New York. Infection 2022; 50:1349-1361. [PMID: 35614176 DOI: 10.1007/s15010-022-01846-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/24/2021] [Accepted: 05/01/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is paucity of data on the epidemiological, microbiological, and clinical characteristics of patients admitted with infective endocarditis (IE) in the Bronx, New York. PATIENT AND METHODS We conducted a retrospective study at Jacobi Medical Center, a tertiary care hospital in the Bronx. All adult patients who were hospitalized with a primary diagnosis of new-onset IE between January 1st, 2010 and September 30th, 2020 were included. The primary outcome was in-hospital mortality. A logistic regression model was used to identify baseline variables associated with in-hospital mortality. RESULTS 182 patients were included in this analysis (female sex: 38.5%, median age: 54 years). 46 patients (25.3%) reported intravenous drug use. 153 patients (84.1%) had positive blood cultures. Staphylococcus aureus (S. aureus) was the most common isolated pathogen (45.1% of monomicrobial IE). Nearly half of the cases secondary to S. aureus were methicillin resistant Staphylococcus aureus (MRSA) (34/69). 164 patients (90.1%) were diagnosed with native valve IE. The mitral valve was involved in 32.4% of patients followed by the aortic valve (19.8%). The in-hospital mortality was 18.1%. The mortality was higher in the cohort 2010-2015 compared to the cohort 2016-2020 (22.1% vs 14.6%). Increasing age, MRSA IE, and active malignancy were the only variables found to have significant association with in-hospital death. CONCLUSION S. aureus was the most common causative agent and MRSA accounted for about half of the S. aureus IE cases. The incidence of IE in patients with intravenous drug use increased over time, while the median age decreased. The in-hospital death rate was higher in 2010-2015 compared to 2016-2020.
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Affiliation(s)
- Wasla Liaqat
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA.
- Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Weijia Li
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dimitrios Karamanis
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ, USA
- Department of Economics, University of Peiraeus, Attica, Greece
| | - Arooj Tahir
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andreas Tzoumas
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sanjana Nagraj
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nidhish Tiwari
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michael Grushko
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Damianos Kokkinidis
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Eleonora Gashi
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jason Leider
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christina Coyle
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert T Faillace
- Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY, 10461, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
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Nagraj S, Varrias D, Hernandez Romero G, Santos HT, Karamanis D, Sagris D, Korompoki E, Milionis H, Palaiodimos L, Ntaios G. Incidence of Stroke in Randomized Trials of COVID-19 Therapeutics: A Systematic Review and Meta-Analysis. Stroke 2022; 53:3410-3418. [PMID: 36000394 DOI: 10.1161/strokeaha.122.040233] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND COVID-19 has been frequently associated with an increased risk of thrombotic complications. There have also been reports of an increased likelihood of stroke, although its true incidence in patients with COVID-19 is currently unknown. METHODS Electronic databases PubMed and Scopus were searched from inception up to July 30, 2021 to identify randomized controlled studies in patients with confirmed COVID-19 undergoing one or more interventions. Studies were screened for eligibility using a predefined inclusion criterion and selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A random-effects model meta-analysis was conducted, and heterogeneity was assessed using I-squared test. RESULTS Out of 3960 potentially eligible articles, 77 randomized studies (38 732 patients) were included. Mean age of the study population was 55±9.3 years. Females constituted 38% of the study population and mean duration of follow-up after study enrollment was 23±12.9 days. Cumulative incidence of stroke in the overall study population was 0.001 (95% CI, 0.001-0.002) with a total of 65 events in 38 732 patients, corresponding to an absolute incidence of 0.168%. Incidence of stroke in the inpatient population was 0.001 (95% CI, 0.001-0.002; 65 events in 37 069 patients), corresponding to an absolute incidence of 0.175%. No strokes were observed in the outpatient setting. CONCLUSIONS The overall incidence of stroke in patients with COVID-19 appears to be lower than that reported in previous observational reports.
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Affiliation(s)
- Sanjana Nagraj
- Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY (S.N., D.V., G.H.R., H.T.S., L.P.)
| | - Dimitrios Varrias
- Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY (S.N., D.V., G.H.R., H.T.S., L.P.)
| | - Gabriel Hernandez Romero
- Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY (S.N., D.V., G.H.R., H.T.S., L.P.)
| | - Heitor T Santos
- Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY (S.N., D.V., G.H.R., H.T.S., L.P.)
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, Greece (D.K.).,Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ (D.K.)
| | - Dimitrios Sagris
- School of Health Sciences, University of Thessaly, Larissa, Greece (D.S.)
| | - Eleni Korompoki
- National and Kapodistrian University of Athens, Alexandra General Hospital, Greece & Imperial College London, Exhibition Rd, South Kensington, London SW7 2BX, United Kingdom (E.K.)
| | | | - Leonidas Palaiodimos
- Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY (S.N., D.V., G.H.R., H.T.S., L.P.)
| | - George Ntaios
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece (G.N.)
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Lim H, Palaiodimos L, Berto CG, Tedunjaiye O, Malik P, Nagraj S, Choi H, Hti Lar Seng NS, Kladas M, Kharawala A, Karamanis D, Varma N, Anjali A. Remdesivir in the Treatment of COVID-19: A Propensity Score-Matched Analysis from a Public Hospital in New York City Assessing Renal and Hepatic Safety. J Clin Med 2022; 11:jcm11113132. [PMID: 35683518 PMCID: PMC9181125 DOI: 10.3390/jcm11113132] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/15/2022] Open
Abstract
While the relative efficacy of remdesivir as a therapeutic agent in selected patients with COVID-19 has been established, safety concerns have been raised regarding potential nephrotoxicity and hepatotoxicity. Our main objective was to investigate the kidney- and liver-related safety outcomes in patients with COVID-19 treated with remdesivir in a public hospital in New York. A propensity score-matched retrospective study was conducted in hospitalized patients with COVID-19 from 1 June 2020 to 10 March 2021. A total of 927 patients were included in this study (remdesivir: 427, non-remdesivir: 500; women: 51.8%; median age 61 years; median BMI: 28.5 kg/m2). Matching without replacement yielded a cohort of 248 patients (124 in each group). In the matched cohort, the remdesivir group had a significantly lower rate of acute kidney injury (AKI) (12.1% vs. 21.8%, p = 0.042), a lower rate of acute liver injury (ALI) on the verge of statistical significance (7.3% vs. 14.5%, p = 0.067), and non-significantly lower death rate (13.7% vs. 16.1%, p = 0.593) compared to the non-remdesivir group. Multivariable analyses revealed that patients treated with remdesivir were found to be associated with a significantly lower likelihood for AKI (OR: 0.40; 95% CI: 0.24−0.67, p < 0.001), no association was found for ALI (OR: 0.68; 95% CI: 0.35−1.30, p = 0.241), while a trend towards an association of patients treated with remdesivir with a lower likelihood for in-hospital death was observed (OR: 0.57; 95% CI: 0.32−1.01, p = 0.053). In conclusion, no safety concerns with regards to renal and liver outcomes were raised in patients with COVID-19 treated with remdesivir. Instead, there were signals of possible nephroprotection and improved in-hospital mortality.
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Affiliation(s)
- Hyomin Lim
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Leonidas Palaiodimos
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Division of Hospital Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA
- CUNY School of Medicine, New York, NY 10031, USA
- Correspondence:
| | - Cesar G. Berto
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Oluwatitomi Tedunjaiye
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Paras Malik
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Sanjana Nagraj
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Hansol Choi
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Nang San Hti Lar Seng
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Michail Kladas
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, North Central Bronx Hospital, NYC Health + Hospitals, New York, NY 10467, USA
| | - Amrin Kharawala
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
| | - Dimitrios Karamanis
- Department of Medicine, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA;
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07102, USA
- Department of Economics, University of Piraeus, 18534 Piraeus, Greece
| | - Nidhi Varma
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Division of Nephrology, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA
| | - Acharya Anjali
- Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA; (H.L.); (C.G.B.); (O.T.); (P.M.); (S.N.); (H.C.); (N.S.H.L.S.); (M.K.); (A.K.); (N.V.); (A.A.)
- Division of Nephrology, Jacobi Medical Center, NYC Health + Hospitals, New York, NY 10461, USA
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Palaiodimos L, Ali R, Teo HO, Parthasarathy S, Karamanis D, Chamorro-Pareja N, Kokkinidis DG, Kaur S, Kladas M, Sperling J, Chang M, Hupart K, Cha-Fong C, Srinivasan S, Kishore P, Davis N, Faillace RT. Obesity, Inflammation, and Mortality in COVID-19: An Observational Study from the Public Health Care System of New York City. J Clin Med 2022; 11:jcm11030622. [PMID: 35160073 PMCID: PMC8836690 DOI: 10.3390/jcm11030622] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 01/08/2023] Open
Abstract
Severe obesity increases the risk for negative outcomes in patients with coronavirus disease 2019 (COVID-19). Our objectives were to investigate the effect of BMI on in-hospital outcomes in our New York City Health and Hospitals’ ethnically diverse population, further explore this effect by age, sex, race/ethnicity, and timing of admission, and, given the relationship between COVID-19 and hyperinflammation, assess the concentrations of markers of systemic inflammation in different BMI groups. A retrospective study was conducted in hospitalized patients with COVID-19 in the public health care system of New York City from 1 March 2020 to 31 October 2020. A total of 8833 patients were included in this analysis (women: 3593, median age: 62 years). The median body mass index (BMI) was 27.9 kg/m2. Both overweight and obesity were independently associated with in-hospital death. The association of overweight and obesity with death appeared to be stronger in men, younger patients, and individuals of Hispanic ethnicity. We did not observe higher concentrations of inflammatory markers in patients with obesity as compared to those without obesity. In conclusion, overweight and obesity were independently associated with in-hospital death. Obesity was not associated with higher concentrations of inflammatory markers.
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Affiliation(s)
- Leonidas Palaiodimos
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: (L.P.); (S.P.)
| | - Ryad Ali
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Hugo O. Teo
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Sahana Parthasarathy
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: (L.P.); (S.P.)
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Natalia Chamorro-Pareja
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Damianos G. Kokkinidis
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Sharanjit Kaur
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Michail Kladas
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jeremy Sperling
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Michael Chang
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Kenneth Hupart
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Colin Cha-Fong
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Shankar Srinivasan
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Preeti Kishore
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nichola Davis
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Robert T. Faillace
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Chetboun M, Raverdy V, Labreuche J, Simonnet A, Wallet F, Caussy C, Antonelli M, Artigas A, Goma G, Meziani F, Helms J, Mylonakis E, Levy MM, Kalligeros M, Latronico N, Piva S, Cerf C, Neuville M, Klouche K, Larcher R, Tamion F, Occhiali E, Snacken M, Preiser J, Kontar L, Riviere A, Silva S, Sarton B, Krouchi R, Dubar V, Palaiodimos L, Karamanis D, Perche J, L'Her E, Busetto L, Dicker D, Lev S, Duhamel A, Jourdain M, Pattou F. BMI and pneumonia outcomes in critically ill covid-19 patients: An international multicenter study. Obesity (Silver Spring) 2021; 29:1477-1486. [PMID: 33966355 PMCID: PMC8242742 DOI: 10.1002/oby.23223] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID-19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, and current smoking status) in critically ill patients with COVID-19. METHODS Patients admitted to intensive care units for COVID-19 in 21 centers (in Europe, Israel, and the United States) were enrolled in this study between February 19, 2020, and May 19, 2020. Primary and secondary outcomes were the need for invasive mechanical ventilation (IMV) and 28-day mortality, respectively. RESULTS A total of 1,461 patients were enrolled; the median (interquartile range) age was 64 years (40.9-72.0); 73.2% of patients were male; the median BMI was 28.1 kg/m2 (25.4-32.3); a total of 1,080 patients (73.9%) required IMV; and the 28-day mortality estimate was 36.1% (95% CI: 33.0-39.5). An adjusted mixed logistic regression model showed a significant linear relationship between BMI and IMV: odds ratio = 1.27 (95% CI: 1.12-1.45) per 5 kg/m2 . An adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was increased only in obesity class III (≥40; hazard ratio = 1.68 [95% CI: 1.06-2.64]). CONCLUSIONS In critically ill COVID-19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and a nonlinear association between BMI and mortality risk were observed.
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Palaiodimos L, Chamorro-Pareja N, Karamanis D, Li W, Zavras PD, Chang KM, Mathias P, Kokkinidis DG. Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients. Hormones (Athens) 2021; 20:305-314. [PMID: 33123973 PMCID: PMC7595056 DOI: 10.1007/s42000-020-00246-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Infectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. The aim of this study was to systematically review and conduct a meta-analysis of the available observational studies reporting the effect of diabetes on mortality among hospitalized patients with COVID-19. METHODS The Medline, Embase, Google Scholar, and medRxiv databases were reviewed for identification of eligible studies. A random effects model meta-analysis was used, and I2 was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed. RESULTS A total of 18,506 patients were included in this meta-analysis (3713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared with patients without diabetes (OR 1.65; 95% CI 1.35-1.96; I2 77.4%). The heterogeneity was high. A study-level meta-regression analysis was performed for all the important covariates, and no significant interactions were found between the covariates and the outcome of mortality. CONCLUSION This meta-analysis shows that that the likelihood of death seems to be higher in diabetic patients hospitalized with COVID-19 compared with non-diabetic patients. Further studies are needed to assess whether this association is independent or not, as well as to investigate the role of adequate glycemic control prior to infection with COVID-19.
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Affiliation(s)
- Leonidas Palaiodimos
- Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, NW Building, 8th Floor, 111 East 210th Str., Bronx, NY, 10467, USA.
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA.
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA.
| | - Natalia Chamorro-Pareja
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 72 Ellis Str., Piraeus, 18546, Attica, Greece
| | - Weijia Li
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Phaedon D Zavras
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Kai Ming Chang
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
- Division of Infectious Disease, Northwell Health, New Hyde Park, NY, USA
| | - Priyanka Mathias
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
- Division of Endocrinology, Montefiore Medical Center, 111 East 210th Str., Bronx, NY, 10467, USA
| | - Damianos G Kokkinidis
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
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Angelidi AM, Belanger MJ, Lorinsky MK, Karamanis D, Chamorro-Pareja N, Ognibene J, Palaiodimos L, Mantzoros CS. Vitamin D Status Is Associated With In-Hospital Mortality and Mechanical Ventilation: A Cohort of COVID-19 Hospitalized Patients. Mayo Clin Proc 2021; 96:875-886. [PMID: 33714594 PMCID: PMC7834253 DOI: 10.1016/j.mayocp.2021.01.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the possible associations of serum 25-hydroxyvitamin D [25(OH)D] concentration with coronavirus disease 2019 (COVID-19) in-hospital mortality and need for invasive mechanical ventilation. PATIENTS AND METHODS A retrospective, observational, cohort study was conducted at 2 tertiary academic medical centers in Boston and New York. Eligible participants were hospitalized adult patients with laboratory-confirmed COVID-19 between February 1, 2020, and May 15, 2020. Demographic and clinical characteristics, comorbidities, medications, and disease-related outcomes were extracted from electronic medical records. RESULTS The final analysis included 144 patients with confirmed COVID-19 (median age, 66 years; 64 [44.4%] male). Overall mortality was 18%, whereas patients with 25(OH)D levels of 30 ng/mL (to convert to nmol/L, multiply by 2.496) and higher had lower rates of mortality compared with those with 25(OH)D levels below 30 ng/mL (9.2% vs 25.3%; P=.02). In the adjusted multivariable analyses, 25(OH)D as a continuous variable was independently significantly associated with lower in-hospital mortality (odds ratio, 0.94; 95% CI, 0.90 to 0.98; P=.007) and need for invasive mechanical ventilation (odds ratio, 0.96; 95% CI, 0.93 to 0.99; P=.01). Similar data were obtained when 25(OH)D was studied as a continuous variable after logarithm transformation and as a dichotomous (<30 ng/mL vs ≥30 ng/mL) or ordinal variable (quintiles) in the multivariable analyses. CONCLUSION Among patients admitted with laboratory-confirmed COVID-19, 25(OH)D levels were inversely associated with in-hospital mortality and the need for invasive mechanical ventilation. Further observational studies are needed to confirm these findings, and randomized clinical trials must be conducted to assess the role of vitamin D administration in improving the morbidity and mortality of COVID-19.
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Affiliation(s)
- Angeliki M Angelidi
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Matthew J Belanger
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Michael K Lorinsky
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | | | - Natalia Chamorro-Pareja
- Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | | | - Leonidas Palaiodimos
- Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY; Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA.
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Chamorro-Pareja N, Karamanis D, Zavras PD, Li W, Mathias P, Kokkinidis D, Palaiodimos L. 377. Diabetes as a prognostic factor for mortality in Coronavirus Disease 19 (COVID-19): a systematic review and meta-analysis comprising 18,506 patients. Open Forum Infect Dis 2020. [PMCID: PMC7776559 DOI: 10.1093/ofid/ofaa439.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Diabetes Mellitus is one of the leading causes of morbidity and mortality in the world. Infectious diseases are more common and associated with worse outcomes among diabetics. Diabetes is considered a predictor of morbidity in patients with COVID-19. Methods Medline, Embase, Google Scholar, and medRxiv were systematically reviewed up to May 10th, 2020 for observational studies on diabetic adult populations hospitalized for COVID-19 and that assessed possible correlation between diabetes and mortality. A meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Heterogeneity among trials for each outcome was assessed with the I-squared test. Values < 25% indicated low, 25 to 70% moderate, and > 70% high heterogeneity. Egger test and funnel plots were used to assess for publication bias. Results Fourteen observational studies (12 retrospective and 2 prospective) met the prespecified criteria for inclusion in the analysis, including 18,506 patients (43% women): 3,713 diabetics (DM group) and 14,793 non-diabetics (no-DM group). The mean or median age was above 60 years in 12 studies. DM group had a higher risk of death compared to the no-DM group, heterogeneity was significant (OR: 1.65; 95% CI: 1.35–1.96; I2 77.4%). Sensitivity analysis for US studies only also revealed a higher chance of death among the DM group (OR: 1.34; 95% CI: 1.04–1.85; I2 73.7%). Conclusion In conclusion, death was 65% more likely among diabetic inpatients compared to non-diabetics. Further studies are needed to assess whether this association is independent or not, and to investigate to role of glucose control prior or during the disease. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | | | | | - Weijia Li
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Priyanka Mathias
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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Palaiodimos L, Herman HS, Wood E, Karamanis D, Martinez-Rodriguez C, Sanchez-Lopez A, Ruderman E, Jang M, Fischer D, Huang H, Gadde U, Leider J. Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic. J Sex Med 2020; 17:1509-1519. [DOI: 10.1016/j.jsxm.2020.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/31/2020] [Accepted: 05/03/2020] [Indexed: 01/22/2023]
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Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, Southern WN, Mantzoros CS. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism 2020; 108:154262. [PMID: 32422233 PMCID: PMC7228874 DOI: 10.1016/j.metabol.2020.154262] [Citation(s) in RCA: 548] [Impact Index Per Article: 137.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS New York is the current epicenter of Coronavirus disease 2019 (COVID-19) pandemic. The underrepresented minorities, where the prevalence of obesity is higher, appear to be affected disproportionately. Our objectives were to assess the characteristics and early outcomes of patients hospitalized with COVID-19 in the Bronx and investigate whether obesity is associated with worse outcomes independently from age, gender and other comorbidities. METHODS This retrospective study included the first 200 patients admitted to a tertiary medical center with COVID-19. The electronic medical records were reviewed at least three weeks after admission. The primary endpoint was in-hospital mortality. RESULTS 200 patients were included (female sex: 102, African American: 102). The median BMI was 30 kg/m2. The median age was 64 years. Hypertension (76%), hyperlipidemia (46.2%), and diabetes (39.5%) were the three most common comorbidities. Fever (86%), cough (76.5%), and dyspnea (68%) were the three most common symptoms. 24% died during hospitalization (BMI < 25 kg/m2: 31.6%, BMI 25-34 kg/m2: 17.2%, BMI ≥ 35 kg/m2: 34.8%, p = 0.03). Increasing age (analyzed in quartiles), male sex, BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2), heart failure, CAD, and CKD or ESRD were found to have a significant univariate association with mortality. The multivariate analysis demonstrated that BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2, OR: 3.78; 95% CI: 1.45-9.83; p = 0.006), male sex (OR: 2.74; 95% CI: 1.25-5.98; p = 0.011) and increasing age (analyzed in quartiles, OR: 1.73; 95% CI: 1.13-2.63; p = 0.011) were independently associated with higher in-hospital mortality. Similarly, age, male sex, BMI ≥ 35 kg/m2 and current or prior smoking were significant predictors for increasing oxygenation requirements in the multivariate analysis, while male sex, age and BMI ≥ 35 kg/m2 were significant predictors in the multivariate analysis for the outcome of intubation. CONCLUSIONS In this cohort of hospitalized patients with COVID-19 in a minority-predominant population, severe obesity, increasing age, and male sex were independently associated with higher in-hospital mortality and in general worse in-hospital outcomes.
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Affiliation(s)
- Leonidas Palaiodimos
- Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Damianos G Kokkinidis
- Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Weijia Li
- Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | - Shitij Arora
- Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA
| | - William N Southern
- Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christos S Mantzoros
- Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
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Kokkinidis DG, Palaiodimos L, Mastoris I, Karamanis D, Faillace RT. The best DEFENSE for high-risk patent foramen ovale: An updated meta-analysis of six randomized trials. Arch Cardiovasc Dis 2018; 112:150-152. [PMID: 30594572 DOI: 10.1016/j.acvd.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/12/2018] [Accepted: 06/18/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Damianos G Kokkinidis
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 10461 NY, USA
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 10461 NY, USA.
| | - Ioannis Mastoris
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 10461 NY, USA
| | | | - Robert T Faillace
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 10461 NY, USA
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Dupont E, Otuka N, Cabellos O, Aberle O, Aerts G, Altstadt S, Alvarez H, Alvarez-Velarde F, Andriamonje S, Andrzejewski J, Audouin L, Bacak M, Badurek G, Balibrea J, Barbagallo M, Barros S, Baumann P, Bécares V, Bečvář F, Beinrucker C, Belloni F, Berthier B, Berthoumieux E, Billowes J, Boccone V, Bosnar D, Brown A, Brugger M, Caamaño M, Calviani M, Calviño F, Cano-Ott D, Capote R, Cardella R, Carrapiço C, Casanovas A, Castelluccio D, Cennini P, Cerutti F, Chen Y, Chiaveri E, Chin M, Colonna N, Cortés G, Cortés-Giraldo M, Cosentino L, Couture A, Cox J, Damone L, David S, Deo K, Diakaki M, Dillmann I, Domingo-Pardo C, Dressler R, Dridi W, Duran I, Eleftheriadis C, Embid-Segura M, Fernández-Domínguez B, Ferrant L, Ferrari A, Ferreira P, Finocchiaro P, Fraval K, Frost R, Fujii K, Furman W, Ganesan S, Garcia A, Gawlik A, Gheorghe I, Gilardoni S, Giubrone G, Glodariu T, Göbel K, Gomez-Hornillos M, Goncalves I, Gonzalez-Romero E, Goverdovski A, Gramegna F, Griesmayer E, Guerrero C, Gunsing F, Gurusamy P, Haight R, Harada H, Heftrich T, Heil M, Heinitz S, Hernández-Prieto A, Heyse J, Igashira M, Isaev S, Jenkins D, Jericha E, Kadi Y, Kaeppeler F, Kalamara A, Karadimos D, Karamanis D, Katabuchi T, Kavrigin P, Kerveno M, Ketlerov V, Khryachkov V, Kimura A, Kivel N, Kokkoris M, Konovalov V, Krtička M, Kroll J, Kurtulgil D, Lampoudis C, Langer C, Leal-Cidoncha E, Lederer C, Leeb H, Naour CL, Lerendegui-Marco J, Leong L, Licata M, Meo SL, Lonsdale S, Losito R, Lozano M, Macina D, Manousos A, Marganiec J, Martinez T, Marrone S, Masi A, Massimi C, Mastinu P, Mastromarco M, Matteucci F, Maugeri E, Mazzone A, Mendoza E, Mengoni A, Milazzo P, Mingrone F, Mirea M, Mondelaers W, Montesano S, Moreau C, Mosconi M, Musumarra A, Negret A, Nolte R, O’Brien S, Oprea A, Palomo-Pinto F, Pancin J, Paradela C, Patronis N, Pavlik A, Pavlopoulos P, Perkowski J, Perrot L, Pigni M, Plag R, Plompen A, Plukis L, Poch A, Porras I, Praena J, Pretel C, Quesada J, Radeck D, Rajeev K, Rauscher T, Reifarth R, Riego A, Robles M, Roman F, Rout P, Rudolf G, Rubbia C, Rullhusen P, Ryan J, Sabaté-Gilarte M, Salgado J, Santos C, Sarchiapone L, Sarmento R, Saxena A, Schillebeeckx P, Schmidt S, Schumann D, Sedyshev P, Smith A, Sosnin N, Stamatopoulos A, Stephan C, Suryanarayana S, Tagliente G, Tain J, Tarifeño-Saldivia A, Tarrío D, Tassan-Got L, Tavora L, Terlizzi R, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Versaci R, Vermeulen M, Villamarin D, Vicente M, Vlachoudis V, Vlastou R, Voss F, Wallner A, Walter S, Ware T, Warren S, Weigand M, Weiß C, Wolf C, Wiesher M, Wisshak K, Woods P, Wright T, Žugec P. Dissemination of data measured at the CERN n_TOF facility. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201714607002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karamanis D, Petit M, Andriamonje S, Barreau G, Bercion M, Billebaud A, Blank B, Czajkowski S, Moral RD, Giovinazzo J, Lacoste V, Marchand C, Perrot L, Pravikoff M, Thomas JC. Neutron Radiative Capture Cross Section of232Th in the Energy Range from 0.06 to 2 MeV. NUCL SCI ENG 2017. [DOI: 10.13182/nse01-a2238] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - M. Petit
- CEN Bordeaux-Gradignan, 33175 Gradignan, France
| | | | - G. Barreau
- CEN Bordeaux-Gradignan, 33175 Gradignan, France
| | - M. Bercion
- CEN Bordeaux-Gradignan, 33175 Gradignan, France
| | | | - B. Blank
- CEN Bordeaux-Gradignan, 33175 Gradignan, France
| | | | | | | | | | - C. Marchand
- CEN Bordeaux-Gradignan, 33175 Gradignan, France
| | - L. Perrot
- ISN Grenoble, 38026 Grenoble, France
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Affiliation(s)
- Fani Akritidou
- Department of Ophthalmology, General Hospital of Kavala, Greece
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Diakaki M, Audouin L, Berthoumieux E, Calviani M, Colonna N, Dupont E, Duran I, Gunsing F, Leal-Cidoncha E, Le Naour C, Leong L, Mastromarco M, Paradela C, Tarrio D, Tassan-Got L, Aerts G, Altstadt S, Alvarez H, Alvarez-Velarde F, Andriamonje S, Andrzejewski J, Badurek G, Barbagallo M, Baumann P, Becares V, Becvar F, Belloni F, Berthier B, Billowes J, Boccone V, Bosnar D, Brugger M, Calvino F, Cano-Ott D, Capote R, Carrapiço C, Cennini P, Cerutti F, Chiaveri E, Chin M, Cortes G, Cortes-Giraldo M, Cosentino L, Couture A, Cox J, David S, Dillmann I, Domingo-Pardo C, Dressler R, Dridi W, Eleftheriadis C, Embid-Segura M, Ferrant L, Ferrari A, Finocchiaro P, Fraval K, Fujii K, Furman W, Ganesan S, Garcia A, Giubrone G, Gomez-Hornillos M, Goncalves I, Gonzalez-Romero E, Goverdovski A, Gramegna F, Griesmayer E, Guerrero C, Gurusamy P, Haight R, Heil M, Heinitz S, Igashira M, Isaev S, Jenkins D, Jericha E, Kadi Y, Kaeppeler F, Karadimos D, Karamanis D, Kerveno M, Ketlerov V, Kivel N, Kokkoris M, Konovalov V, Krticka M, Kroll J, Lampoudis C, Langer C, Lederer C, Leeb H, Lo Meo S, Losito R, Lozano M, Manousos A, Marganiec J, Martinez T, Marrone S, Massimi C, Mastinu P, Mendoza E, Mengoni A, Milazzo P, Mingrone F, Mirea M, Mondelaers W, Moreau C, Mosconi M, Musumarra A, O’Brien S, Pancin J, Patronis N, Pavlik A, Pavlopoulos P, Perkowski J, Perrot L, Pigni M, Plag R, Plompen A, Plukis L, Poch A, Pretel C, Praena J, Quesada J, Rauscher T, Reifarth R, Riego A, Roman F, Rudolf G, Rubbia C, Rullhusen P, Salgado J, Santos C, Sarchiapone L, Sarmento R, Saxena A, Schillebeeckx P, Schmidt S, Schumann D, Stephan C, Tagliente G, Tain J, Tavora L, Terlizzi R, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Versaci R, Vermeulen M, Villamarin D, Vincente M, Vlachoudis V, Vlastou R, Voss F, Wallner A, Walter S, Ware T, Weigand M, Weiß C, Wiesher M, Wisshak K, Wright T, Zugec P. Towards the high-accuracy determination of the238U fission cross section at the threshold region at CERN – n_TOF. EPJ Web of Conferences 2016. [DOI: 10.1051/epjconf/201611102002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stamoulis K, Karamanis D, Ioannides K. Assessment of tritium levels in rivers and precipitation in north-western Greece before the ITER operation. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2010.12.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tarrío D, Tassan-Got L, Audouin L, Berthier B, Duran I, Ferrant L, Isaev S, Le Naour C, Paradela C, Stephan C, Trubert D, Abbondanno U, Aerts G, Álvarez H, Álvarez-Velarde F, Andriamonje S, Andrzejewski J, Assimakopoulos P, Badurek G, Baumann P, Becvár F, Berthoumieux E, Calviño F, Calviani M, Cano-Ott D, Capote R, Carrapiço C, Cennini P, Chepel V, Chiaveri E, Colonna N, Cortes G, Couture A, Cox J, Dahlfors M, David S, Dillmann I, Domingo-Pardo C, Dridi W, Eleftheriadis C, Embid-Segura M, Ferrari A, Ferreira-Marques R, Fujii K, Furman W, Gonçalves I, González-Romero E, Gramegna F, Guerrero C, Gunsig F, Haas B, Haight R, Heil M, Herrera-Martinez A, Igashira M, Jericha E, Kadi Y, Käppeler F, Karadimos D, Karamanis D, Kerveno M, Koehler P, Kossionides E, Krticka M, Lampoudis C, Leeb H, Lindote A, Lopes I, Lozano M, Lukic S, Marganiec J, Marrone S, Martínez T, Massimi C, Mastinu P, Mengoni A, Milazzo P, Moreau C, Mosconi M, Neves F, Oberhummer H, O’Brien S, Oshima M, Pancin J, Papachristodoulou C, Papadopoulos C, Patronis N, Pavlik A, Pavlopoulos P, Perrot L, Pigni M, Plag R, Plompen A, Plukis A, Poch A, Praena J, Pretel C, Quesada J, Rauscher T, Reifarth R, Rubbia C, Rudolf G, Rullhusen P, Salgado J, Santos C, Sarchiapone L, Savvidis I, Tagliente G, Tain J, Tavora L, Terlizzi R, Vannini G, Vaz P, Ventura A, Villamarin D, Vicente M, Vlachoudis V, Vlastou R, Voss F, Walter S, Wiescher M, Wisshak K. Measurements of high-energy neutron-induced fission ofnatPb and209Bi. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100807009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Colonna N, Abbondanno U, Aerts G, Álvarez H, Álvarez-Velarde F, Andriamonje S, Andrzejewski J, Assimakopoulos P, Audouin L, Badurek G, Baumann P, Becvar F, Berthoumieux E, Calviani M, Calviño F, Cano-Ott D, Capote R, Carrillo de Albornoz A, Cennini P, Chepel V, Chiaveri E, Cortes G, Couture A, Cox J, Dahlfors M, David S, Dillman I, Dolfini R, Domingo-Pardo C, Dridi W, Duran I, Eleftheriadis C, Ferrant L, Ferrari A, Ferreira-Marques R, Frais-Koelbl H, Fujii K, Furman W, Goncalves I, González-Romero E, Goverdovski A, Gramegna F, Griesmayer E, Guerrero C, Gunsing F, Haas B, Haight R, Heil M, Herrera-Martinez A, Igashira M, Isaev S, Jericha E, Käppeler F, Kadi Y, Karadimos D, Karamanis D, Kerveno M, Ketlerov V, Koehler P, Konovalov V, Kossionides E, Krticka M, Lampoudis C, Leeb H, Lindote A, Lopes I, Lozano M, Lukic S, Marganiec J, Marques L, Marrone S, Martínez T, Massimi C, Mastinu P, Mengoni A, Milazzo P, Moreau C, Mosconi M, Neves F, Oberhummer H, O’Brien S, Oshima M, Pancin J, Papachristodoulou C, Papadopoulos C, Paradela C, Patronis N, Pavlik A, Pavlopoulos P, Perrot L, Pigni M, Plag R, Plompen A, Plukis A, Poch A, Pretel C, Quesada J, Rauscher T, Reifarth R, Rosetti M, Rubbia C, Rudolf G, Rullhusen P, Salgado J, Sarchiapone L, Savvidis I, Stephan C, Tagliente G, Tain J, Tassan-Got L, Tavora L, Terlizzi R, Vannini G, Vaz P, Ventura A, Villamarin D, Vicente M, Vlachoudis V, Vlastou R, Voss F, Walter S, Wendler H, Wiescher M, Wisshak K. Neutron cross-sections for next generation reactors: New data from n_TOF. Appl Radiat Isot 2010; 68:643-6. [DOI: 10.1016/j.apradiso.2010.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stamoulis KC, Ioannides KG, Karamanis D. Deconvolution of liquid scintillation alpha spectra of mixtures of uranium and radium isotopes. Anal Chim Acta 2010; 657:108-15. [PMID: 20005321 DOI: 10.1016/j.aca.2009.10.034] [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] [Received: 06/22/2009] [Revised: 10/15/2009] [Accepted: 10/18/2009] [Indexed: 12/01/2022]
Abstract
A method for the determination of uranium and radium isotopes in water samples is proposed. Liquid scintillation techniques were used for collecting alpha spectra, which were then analyzed by fitting the alpha peaks with overlapping Gaussians. The analysis can quantify the observed isotopes with accuracy depending on the activity of each isotope. In order to simulate the peaks with Gaussian normal distribution functions, the centroid of each peak as well as the full width at half maximum (FWHM) are required, as they depend on the quenching of the sample. For this purpose, samples with known activities of 226Ra and its decay products and also of the uranium isotopes 238U and 234U, at various quenching levels, were used to establish the correlation of the peaks' shift with the quench effect. In addition, the correlation of the FWHM with the centroid of a peak was determined, using the same procedure. Following the above analysis technique, an average of 97+/-2% of detection efficiency and a lower limit of detection of 8.2 mBq kg(-1) for alpha isotopes were achieved.
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Affiliation(s)
- K C Stamoulis
- Archaeometry Center, University of Ioannina, Ioannina, 45110, Greece.
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Jurado B, Kessedjian G, Petit M, Aïche M, Barreau G, Bidaud A, Boyer S, Carjan N, Czajkowski S, Dassie D, Grosjean C, Guiral A, Haas B, Karamanis D, Mathieu L, Misicu S, Rizea C, Santiamon F, Audouin L, Capellan N, Tassan-Got L, Wilson J, Andriamonje S, Berthoumieux E, Bouchez E, Gunsing F, Hürstel A, Lecoz Y, Lucas R, Theisen C, Sérot O, Bauge E, Billebaud A, Perrot L, Ahmad I, Greene J, Janssens R. Neutron-induced fission cross sections of short-lived actinides with the surrogate reaction method. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100206004] [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: 11/14/2022] Open
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Karamanis D, Assimakopoulos PA. Efficiency of aluminum-pillared montmorillonite on the removal of cesium and copper from aqueous solutions. Water Res 2007; 41:1897-906. [PMID: 17374545 DOI: 10.1016/j.watres.2007.01.053] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Revised: 01/30/2007] [Accepted: 01/30/2007] [Indexed: 05/14/2023]
Abstract
Aluminum-pillared-layered montmorillonites (PILMs) were tested for their potential application in the removal of copper or cesium from aqueous solutions. By varying the initial conditions, several PILMs were prepared and characterized by means of X-ray fluorescence (XRF), proton induced gamma-ray emission (PIGE), X-ray diffraction (XRD) and sorption isotherms. Uptake of metals was studied by means of XRF spectrometry for copper sorption or gamma-ray spectrometry for cesium, using 137Cs as radiotracer. The sorption kinetics and capacity of PILMs were determined in relation to the effects of factors such as the initial metal concentration, initial pH of the solution and the presence of competitive cations. Kinetic studies showed that an equilibrium time of few minutes was needed for the adsorption of metal ions on PILMs. A pseudo-first-order equation was used to describe the sorption process for either copper or cesium. The most effective pH range for the removal of copper and cesium was found to be 4.0-6.0 and 3.0-8.0, respectively. Cesium sorption isotherms were best represented by a two-site Langmuir model while copper isotherms followed the Freundlich or the two-site Langmuir model. Cesium sorption experiments with inorganic or organic competitive cations as blocking agents revealed that the high selective sites of PILMs for cesium sorption (1-2% of total) are surface and edge sites in addition to interlayer exchange sites. In copper sorption, the two sites were determined as interlayer sites of PILMs after restoring their cation exchange capacity and sites associated with the pillar oxides.
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Affiliation(s)
- D Karamanis
- Department of Physics, The University of Ioannina, 45110 Ioannina, Greece.
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Karamanis D, Ioannides KG, Stamoulis KC. Determination of 226Ra in aqueous solutions via sorption on thin films and α-spectrometry. Anal Chim Acta 2006; 573-574:319-27. [PMID: 17723540 DOI: 10.1016/j.aca.2006.03.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Revised: 03/03/2006] [Accepted: 03/08/2006] [Indexed: 10/24/2022]
Abstract
An improved spectrometric method to determine the 226Ra activity in aqueous solutions is described. The method involves two stages, a preconcentration stage of 226Ra sorption onto a thin manganese layer and a measurement stage using alpha-spectrometry. Manganese oxide thin films were prepared and characterized with X-ray diffraction (XRD) and X-ray fluorescence (XRF) analyses. The thin films were found to follow the XRD patterns and chemical formula of the K-birnessite layered exchanger. The preconcentration of radium was studied relative to the initial radium concentration, pH and salt concentrations. The preconcentration kinetics was studied as a function of manganese surface, solution volume and salt concentration. Extensive Monte Carlo calculations were performed to optimise the detection of alpha-particles. In this way, the thin film preparation procedure as well as the radium sorption and the measurement conditions were optimised and detection limits lower than 0.5 mBq L(-1) were obtained for 2d of procedure completion. The method was validated with IAEA standards and it was applied for the determination of 226Ra in bottled waters and also wastewaters from the major thermoelectric plant in Greece. Moreover, the 226Ra distribution coefficients (K(d)) of two differently prepared powder manganese oxides, a crystalline silicotitanate and an aluminium-pillared montmorillonite were determined by gamma-spectrometry. 226Ra sorption experiments on silicotitanate thin films were performed and improvements in resolution and reduction of exposure time were observed.
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Affiliation(s)
- D Karamanis
- Physics Department, The University of Ioannina, 45110 Ioannina, Greece.
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Ioannides K, Papachristodoulou C, Stamoulis K, Karamanis D, Pavlides S, Chatzipetros A, Karakala E. Soil gas radon: a tool for exploring active fault zones. Appl Radiat Isot 2003; 59:205-13. [PMID: 12941512 DOI: 10.1016/s0969-8043(03)00164-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The profile of soil gas radon was monitored in five active fault sites in northern and northwestern Greece. Measurements were carried out during summer months, using CR-39 solid state nuclear track detectors (SSNTDs). The spatial distribution of radon along lines traversing the fault zones revealed anomalies, clearly connected to the local tectonic structure. Specifically, increased radon signals evolved on the radon background level, in the vicinity of the faults' axes and the signal-to-background ratio ranged from 2 to 13. The consistency of this pattern confirms that the radon technique is powerful in the detection and mapping of active fault zones.
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Affiliation(s)
- K Ioannides
- Nuclear Physics Laboratory, The University of Ioannina, 451 10 Ioannina, Greece.
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Assimakopoulos PA, Ioannides KG, Karamanis D, Lagoyannis A, Pakou AA, Koutsotolis K, Nikolaou E, Arkhipov A, Arkhipov N, Gaschak S. Ratios of transfer coefficients for radiocesium transport in ruminants. Health Phys 1995; 69:410-414. [PMID: 7635741 DOI: 10.1097/00004032-199509000-00016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A corollary of the multiple-compartment model for the transport of trace elements through animals was tested for cows, goats, and sheep. According to this corollary, for a given body "compartment" k of the animal (soft tissue, lung, liver, etc.), the ratio a(k) = f(k)/f(blood) of the transfer coefficients f, should exhibit similar values for physiologically similar animals. In order to verify this prediction, two experiments were performed at the Agricultural Research Station of Ioannina and at the facilities of Ria Pripyat in Pripyat, Ukraine. Eight animals in the first experiment and eighteen in the second were housed in individual pens and were artificially contaminated with a constant daily dose of radiocesium until equilibrium was reached. The animals were then sacrificed and transfer coefficients f(k) to twelve body "compartments" k were measured. These data were used to calculate the ratios a(k). The results were in accordance with predictions of the model and average values of a(k) were extracted for ruminants. It is concluded that these values may be employed for the prediction of animal contamination in any body compartment through the measurement of blood samples.
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