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Boziki M, Theotokis P, Kesidou E, Nella M, Bakirtzis C, Karafoulidou E, Tzitiridou-Chatzopoulou M, Doulberis M, Kazakos E, Deretzi G, Grigoriadis N, Kountouras J. Impact of Mast Cell Activation on Neurodegeneration: A Potential Role for Gut-Brain Axis and Helicobacter pylori Infection. Neurol Int 2024; 16:1750-1778. [PMID: 39728753 DOI: 10.3390/neurolint16060127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/08/2024] [Accepted: 12/03/2024] [Indexed: 12/28/2024] Open
Abstract
BACKGROUND The innate immune response aims to prevent pathogens from entering the organism and/or to facilitate pathogen clearance. Innate immune cells, such as macrophages, mast cells (MCs), natural killer cells and neutrophils, bear pattern recognition receptors and are thus able to recognize common molecular patterns, such as pathogen-associated molecular patterns (PAMPs), and damage-associated molecular patterns (DAMPs), the later occurring in the context of neuroinflammation. An inflammatory component in the pathology of otherwise "primary cerebrovascular and neurodegenerative" disease has recently been recognized and targeted as a means of therapeutic intervention. Activated MCs are multifunctional effector cells generated from hematopoietic stem cells that, together with dendritic cells, represent first-line immune defense mechanisms against pathogens and/or tissue destruction. METHODS This review aims to summarize evidence of MC implication in the pathogenesis of neurodegenerative diseases, namely, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, and multiple sclerosis. RESULTS In view of recent evidence that the gut-brain axis may be implicated in the pathogenesis of neurodegenerative diseases and the characterization of the neuroinflammatory component in the pathology of these diseases, this review also focuses on MCs as potential mediators in the gut-brain axis bi-directional communication and the possible role of Helicobacter pylori, a gastric pathogen known to alter the gut-brain axis homeostasis towards local and systemic pro-inflammatory responses. CONCLUSION As MCs and Helicobacter pylori infection may offer targets of intervention with potential therapeutic implications for neurodegenerative disease, more clinical and translational evidence is needed to elucidate this field.
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Ilia G, Paltoglou G, Chatzakis C, Christopoulos P, Tzitiridou-Chatzopoulou M, Mastorakos G. Increased prevalence of negative pregnancy and fetal outcomes in women with primary adrenal insufficiency. A systematic review and meta-analysis. Endocrine 2024; 86:1156-1170. [PMID: 39277840 DOI: 10.1007/s12020-024-04023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 08/27/2024] [Indexed: 09/17/2024]
Abstract
Maternal primary adrenal insufficiency (PAI) during pregnancy, due to either Addison disease (AD) or congenital adrenal hyperplasia (CAH), is rare. Only few studies have examined the subsequent important outcomes of maternal glucocorticoid and mineralocorticoid deficiencies during pregnancy upon the fetus and the neonate. Therefore, this systematic review and meta-analysis evaluated the impact of these deficiencies, with data from PubMed/Medline, Cochrane/CENTRAL, and Google Scholar. A total of 31 studies were included for qualitative analysis and 11 for quantitative analysis. Studies examining the prevalence of spontaneous abortion, preterm birth, the occurrence of small for gestational age (SGA) neonates, as well as the neonatal birth weight were included. The systematic review revealed a substantial number of spontaneous abortions, preterm births and SGA neonates in pregnant women with PAI. The meta-analysis showed a mean spontaneous abortion prevalence of 18%, 18% and 17% in women with PAI, AD or CAH, respectively. The mean preterm birth prevalence was 11% when women with AD or CAH were analyzed together, and 13% and 9% in women with AD or CAH, respectively, when these women were analyzed separately. The mean prevalence of SGA neonates was 8% when women with AD or CAH were analyzed together, and 5% and 10% in women with AD or CAH, respectively, when these women were analyzed separately. The mean fetal birth weight was within normalcy in all women with PAI, as well as in women with AD or CAH. In conclusion the executed systematic review of 31 studies followed by a meta-analysis of 11 studies in pregnant women with PAI has shown a greater prevalence of pregnancies with negative outcome (spontaneous abortion, preterm birth) and of negative fetal outcome (SGA) in women with either AD or CAH, as compared to control pregnant women.
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Tzitiridou-Chatzopoulou M, Zournatzidou G, Tsakiridis I, Tsakalidis C. Exploring the Nexus Between Fertility Rates and Geopolitical Risk with Intelligence Methods: A Multifaceted Analysis. Healthcare (Basel) 2024; 12:2205. [PMID: 39595404 PMCID: PMC11593425 DOI: 10.3390/healthcare12222205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/16/2024] [Accepted: 08/05/2024] [Indexed: 11/28/2024] Open
Abstract
Background/Objectives: This paper presents an analysis of birth rate statistics, specifically focusing on recorded births in Scotland. The main research objective focuses on investigating the influence of geopolitical concerns on birth rate forecasts. Specifically, we examine whether individuals may choose to postpone or abstain from having children during times of conflict or political turmoil due to concerns about personal safety, the welfare of their children, or uncertainty about the future caused by geopolitical risks. Additionally, this study examines how disruptions to healthcare services, such as limited access to prenatal care and maternal health facilities, can affect birth outcomes and lead to changes in birth rates. Methods: To approach the research objective both machine learning algorithms and classical statistical procedures. Also, as part of the current analysis, the Geopolitical Risk Index has been applied as an extra factor to predict the birth rate. Results: The results of our study demonstrate the effectiveness of machine learning in producing precise predictions in this field, while emphasizing the significant influence of geopolitical risk on comprehending the dynamics of birth rates in Scotland. Conclusions: This study examines the effectiveness of several machine learning regression models in accurately predicting the number of births in Scotland using data that is not included in the model training process. Findings show promising outcomes in predicting births, while geopolitical instability has been indicated as a substantial influence on birth rates and fertility rates.
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Kokkinari A, Antoniou E, Orovou E, Tzitiridou-Chatzopoulou M, Dagla M, Iatrakis G. Exclusive Breastfeeding Rates Among Roma and Non-Roma Mothers in Greece: A Single-Center Cross-Sectional Study from "Tzaneio" General Hospital of Piraeus. Clin Pract 2024; 14:2365-2375. [PMID: 39585013 PMCID: PMC11587093 DOI: 10.3390/clinpract14060185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 10/03/2024] [Accepted: 10/28/2024] [Indexed: 11/26/2024] Open
Abstract
BACKGROUND Exclusive breastfeeding is vital for the optimal development of infants, yet the practice of using infant formula has become increasingly prevalent. While many studies globally investigate factors affecting breastfeeding, there is a scarcity of research focusing on marginalized groups, particularly the Roma community. This study seeks to compare the breastfeeding rates of Roma and non-Roma mothers upon discharge from a maternity hospital in Greece. It also examines factors contributing to the decline in breastfeeding among Roma women, with particular emphasis on the role of midwifery support. The aim of this study is to promote the development of supportive policies and programs for breastfeeding among Roma mothers. METHODS A cross-sectional study was conducted from September 2019 to January 2022, involving 248 infants born at ≥37 weeks of gestation and their mothers, who were of Greek nationality. Both Roma and non-Roma participants received consistent, high-quality care from the same midwife researcher, who personally attended to them. All participants initiated breastfeeding immediately after their newborns' births and practiced rooming-in by keeping their babies in the room with them during their hospital stay. Data were collected through questionnaires to determine the rates of exclusive breastfeeding among the two groups. RESULTS The study found that a smaller proportion of Roma mothers exclusively breastfed their infants compared to non-Roma mothers, despite receiving similar levels of support from healthcare professionals. CONCLUSIONS The provision of midwifery support did not significantly enhance exclusive breastfeeding rates among Roma mothers. This suggests the need for more comprehensive and multi-faceted interventions. Further research is required to confirm these findings and to design effective programs aimed at increasing exclusive breastfeeding rates, thereby improving health outcomes for Roma children and mothers.
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Doulberis M, Papaefthymiou A, Kazakos E, Tzitiridou-Chatzopoulou M, Polyzos SA, Kountouras J. The 1st EoETALY consensus on the diagnosis and management of eosinophilic esophagitis and the missing link: Helicobacter pylori infection. Dig Liver Dis 2024; 56:1946-1947. [PMID: 39060184 DOI: 10.1016/j.dld.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
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Tzitiridou-Chatzopoulou M, Zournatzidou G, Orovou E, Lavasidis L, Tsiotsias A, Eskitzis P, Papoutsis D. Intermittent Preventive Treatment of Malaria in Pregnancy and the Impact on Neonates in African Countries as Assessed by Entropy Weight and TOPSIS Methods. J Clin Med 2024; 13:6231. [PMID: 39458181 PMCID: PMC11508258 DOI: 10.3390/jcm13206231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 10/15/2024] [Accepted: 10/16/2024] [Indexed: 10/28/2024] Open
Abstract
Background/Objectives: In regions of Africa with a high prevalence of malaria, pregnant women in their first or second trimester should be administered intermittent preventive treatment in pregnancy (IPTp). However, infants may contract malaria despite the IPTp therapy that their mothers have received. The objective of the present investigation was to assess the symptoms and various treatments for neonatal malaria. Methods: Entropy weight and TOPSIS were used to achieve the study goal. The TOPSIS multi-attribute decision-making system was used to assess newborn malaria symptoms and select the optimal treatment, even for mothers receiving IPTp medication during pregnancy. The entropy weight approach calculated TOPSIS attribute weights. The present research used UNICEF data for 14 African nations in 2023. Results: The results indicated that neonates whose mothers received IPTp therapy ultimately contracted malaria, with diarrhea being the primary symptom. It is important to note that health providers administer a combination of zinc and oral rehydration solution (ORS) to infants as the most effective treatment for malaria symptoms, thereby abandoning the first-line treatment for malaria, artemisinin-based combination therapy (ACT). Conclusions: The most effective treatment for neonatal malaria is a combination of zinc and ORS, although less than half of children in Africa have access to ORS. Therefore, the findings of this study may encourage African countries to prioritize co-pack therapy in their procurement and supply, healthcare provider training, and expenditures. This therapy will also help alleviate the symptoms of malaria in neonates.
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Tzitiridou-Chatzopoulou M, Zournatzidou G. Bibliometric Analysis on of the Impact of Screening to Minimize Maternal Mental Health on Neonatal Outcomes: A Systematic Review. J Clin Med 2024; 13:6013. [PMID: 39408074 PMCID: PMC11477711 DOI: 10.3390/jcm13196013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 10/01/2024] [Accepted: 10/06/2024] [Indexed: 10/20/2024] Open
Abstract
(1) Background: Prenatal depression, maternal anxiety, puerperal psychosis, and suicidal thoughts affect child welfare and development and maternal health and mortality. Women in low-income countries suffer maternal mental health issues in 25% of cases during pregnancy and 20% of cases thereafter. However, MMH screening, diagnosis, and reporting are lacking. The primary goals of the present study are twofold, as follows: firstly, to evaluate the importance of screening maternal mental health to alleviate perinatal depression and maternal anxiety, and, secondly, to analyze research patterns and propose novel approaches and procedures to bridge the current research gap and aid practitioners in enhancing the quality of care offered to women exhibiting symptoms of perinatal depression. (2) Methods: We conducted a bibliometric analysis to analyze the research topic, using the bibliometric tools Biblioshiny and VOSviewer, as well as the R statistical programming language. To accomplish our goal, we obtained a total of 243 documents from the Scopus and PubMed databases and conducted an analysis utilizing network, co-occurrence, and multiple correlation approaches. (3) Results: Most of the publications in the field were published between the years 2021 and 2024. The results of this study highlight the significance of shifting from conventional screening methods to digital ones for healthcare professionals to effectively manage the symptoms of maternal mental health associated with postpartum depression. Furthermore, the results of the present study suggest that digital screening can prevent maternal physical morbidity, contribute to psychosocial functioning, and enhance infant physical and cognitive health. (4) Conclusions: The research indicates that it is crucial to adopt and include a computerized screening practice to efficiently and immediately detect and clarify the signs of prenatal to neonatal depression. The introduction of digital screening has led to a decrease in scoring errors, an improvement in screening effectiveness, a decrease in administration times, the creation of clinical and patient reports, and the initiation of referrals for anxiety and depression therapy.
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Laliotis N, Chrysanthou C, Konstandinidis P, Tzitiridou-Chatzopoulou M. Surgical Treatment of Central Type Mirror Foot Associated with Eight Toes: A Case Report. J Orthop Case Rep 2024; 14:107-112. [PMID: 39381287 PMCID: PMC11458243 DOI: 10.13107/jocr.2024.v14.i10.4828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 08/19/2024] [Indexed: 10/10/2024] Open
Abstract
Introduction Mirror foot is an extremely rare type of foot malformation and is characterized by the duplication of toes and metatarsals around a centrally located hallux toe. It can be part of a generalized congenital dysplasia or an isolated one. The central type is the less frequent form of the mirror foot. Case Report We present an isolated type of central mirror foot with eight toes, seven metatarsals, and four cuneiforms. The isolated toe was medially located. The child presented no other deformities. Surgical management was performed at the age of 1 year, consisting of central-ray removal, using a dorsal and plantar incision. The approximation of the remaining metatarsals was reinforced using a suture that enwrapped the bones. We achieved an appropriate reduction in the width of the foot. A year after the procedure, the foot had a normal shape. Conclusion Our manuscript presents the case of a central mirror foot that was treated surgically with adequate restoration of the proximity of the remaining rays.
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Kountouras J, Vardaka E, Zavos C, Chatzopoulos D, Tzitiridou-Chatzopoulou M, Tzilves D, Zournatzidou G, Kyrailidou F, Mouratidou MC. Letter: Potential impact of Helicobacter pylori infection on oesophageal disorders in chronic liver disease. Aliment Pharmacol Ther 2024; 60:1139-1140. [PMID: 39223754 DOI: 10.1111/apt.18220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
LINKED CONTENTThis article is linked to Idalsoaga et al papers. To view these articles, visit https://doi.org/10.1111/apt.18193 and https://doi.org/10.1111/apt.18246
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Kountouras J, Zavos C, Vardaka E, Kyrailidi F, Mouratidou MC, Tzitiridou-Chatzopoulou M, Orovou E, Touloumtzi M, Papanikolaou IS, Kazakos E. Helicobacter pylori and metabolic syndrome-related adipokines in nonalcoholic fatty liver disease pathophysiology. J Gastroenterol Hepatol 2024; 39:1957-1959. [PMID: 38725326 DOI: 10.1111/jgh.16621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/06/2024] [Accepted: 05/03/2024] [Indexed: 10/01/2024]
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Kountouras J, Polyzos SA, Kazakos E, Zavos C, Grigoriadis N, Papanikolaou IS, Vardaka E, Tzilves D, Chatzopoulos D, Tzitiridou-Chatzopoulou M, Touloumtzi M, Doulberis M, Papaefthymiou A. Letter: Role of Helicobacter pylori and metabolic syndrome-related insulin resistance and lipotoxicity in the pathogenesis of MAFLD and MASH. Aliment Pharmacol Ther 2024. [PMID: 39076103 DOI: 10.1111/apt.18124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
LINKED CONTENTThis article is linked to Lin et al papers. To view these articles, visit https://doi.org/10.1111/apt.17930 and https://doi.org/10.1111/apt.18182.
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Tzitiridou-Chatzopoulou M, Zournatzidou G, Orovou E, Lithoxopoulou M, Drogouti E, Sklavos G, Antoniou E, Tsakalidis C. Evaluating Malnutrition Practices and Mother's Education on Children Failure to Thrive Symptoms Using Entropy-Weight and TOPSIS Method. CHILDREN (BASEL, SWITZERLAND) 2024; 11:903. [PMID: 39201838 PMCID: PMC11353107 DOI: 10.3390/children11080903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES Failure to thrive (FTT) is mostly caused by insufficient consumption of nutrient-rich food, recurrent infections like diarrhea and intestinal worms, substandard caregiving practices, and limited availability of health and other vital services. Furthermore, there was a correlation between the educational level of mothers and the occurrence of FTT in children aged 6-12 months. Thus, the objective of the current research is twofold: (i) to investigate other factors related to FTT and (ii) to evaluate the impact of them on FTT in Sub-Saharan African countries and their urban areas. METHODS We used weight entropy and TOPSIS methods to approach the research question. In particular, the entropy-weight method is effective for precisely evaluating the relative significance of the selected criteria for TOPSIS computation. Thus, data were retrieved from the database of UNICEF for the year 2019 for nine Sub-Saharan countries, and based on the methods used, five criteria have been selected for consideration. Those of mothers in higher education were identified as having a higher weight, which means that this can affect positively the ability of mothers to mitigate the situation of FTT and protect their children. RESULTS The findings of the study highlight the factors of maternal education at a higher level and unhealthy habits as those with the greatest weight and impact on the FTT. Moreover, the results indicate that the association between maternal education, and especially higher education, and FTT is stronger in Ethiopia. Despite the limited amount of research on the specified relationship in Sub-Saharan countries, this study is among the initial ones to examine it. CONCLUSIONS The current study can aid policymakers in devising appropriate policies and implementing effective measures to tackle FTT in Sub-Saharan Africa, like enhancing the number of mothers in these countries to be integrated into the educational system to help both themselves and their children mitigate or avoid the symptoms of FTT.
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Palaska E, Antoniou E, Tzitiridou-Chatzopoulou M, Eskitzis P, Orovou E. Correlation between Breastfeeding, Maternal Body Mass Index, and Childhood Obesity. EPIDEMIOLOGIA 2024; 5:411-420. [PMID: 39051210 PMCID: PMC11270408 DOI: 10.3390/epidemiologia5030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/09/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
Breast milk is a unique and highly beneficial source of nutrition for infants. It contains a wide range of nutrients that are specifically tailored to meet the specific needs of a growing infant. On the other hand, obesity is a major health issue that affects people around the world. The aim of this study is to investigate the relationship between breastfeeding and child BMI and the role of maternal BMI, which may influence this relationship. This study revealed that a longer duration of exclusive breastfeeding was associated with a decrease in the prevalence of overweight children. Additionally, the research found that children born to overweight or obese women had a higher probability of being overweight or obese themselves. Considering that mothers with a higher pre-pregnancy body weight are more likely to have children with a higher BMI, it is important that they receive information about the advantages of breastfeeding for a minimum of 6 months for both themselves and their children. Additionally, they should be offered ongoing support, to encourage them to start breastfeeding and continue with it beyond this period.
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Kountouras J, Boziki MK, Tzitiridou-Chatzopoulou M, Zavos C, Kazakos E. A potential effect of active Helicobacter pylori infection on the risk of multiple sclerosis. Neurol Sci 2024; 45:3543-3544. [PMID: 38409472 DOI: 10.1007/s10072-024-07424-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
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Tzitiridou-Chatzopoulou M, Zournatzidou G, Kourakos M. Predicting Future Birth Rates with the Use of an Adaptive Machine Learning Algorithm: A Forecasting Experiment for Scotland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:841. [PMID: 39063418 PMCID: PMC11276648 DOI: 10.3390/ijerph21070841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024]
Abstract
The total fertility rate is influenced over an extended period of time by shifts in population socioeconomic characteristics and attitudes and values. However, it may be impacted by macroeconomic trends in the short term, although these effects are likely to be minimal when fertility is low. With the objective of forecasting monthly deliveries, this study concentrates on the analysis of registered births in Scotland. Through this approach, we examine the significance of precisely forecasting fertility trends, which can subsequently aid in the anticipation of demand in diverse sectors by allowing policymakers to anticipate changes in population dynamics and customize policies to tackle emerging demographic challenges. Consequently, this has implications for fiscal stability, national economic accounts and the environment. In conducting our analysis, we incorporated non-linear machine learning methods alongside traditional statistical approaches to forecast monthly births in an out-of-sample exercise that occurs one step in advance. The outcomes underscore the efficacy of machine learning in generating precise predictions within this particular domain. In sum, this research will comprehensively demonstrate a cutting-edge model of machine learning that utilizes several attributes to assist in clinical decision-making, predict potential complications during pregnancy and choose the appropriate delivery method, as well as help in medical diagnosis and treatment.
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Skanika K, Tzitiridou-Chatzopoulou M, Papadopoulou O, Xalkia A, Dimaki D, Koukou Z, OROVOUb E, Savvidis G, Hristara-Papadopoulou A. Effect of Physiotherapy on Preterm Neonates and its Results on Five-Year-Old Children, According to GMFM - GMPM Evaluation Scales. MAEDICA 2024; 19:273-282. [PMID: 39188833 PMCID: PMC11345075 DOI: 10.26574/maedica.2024.19.2.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVE The purpose of this study is to emphasize the necessity and possibilities of early intervention and physiotherapy rehabilitation of premature infants, as they are reflected in five-year olds according to the gross motor function measure (GMFM) and gross motor performance measure (GMPM) evaluation scales for gross function and quality of movement. In addition, the present study examined the importance of using assessment tools for children who have received or not therapeutic intervention, through which both the child's abilities and appropriateness of the help received by him/her are evaluated based on individual needs. MATERIAL AND METHODS Our specific exploratory process was carried out through a literature review as well as a process of primary research, in order to obtain and collect all necessary information and data which would finally lead us to the nearest and best conclusions. Our goal was to collect 20 complete and graded GMFM and 20 GMPM assessment tests, so that our research was based on a satisfactory sample of participants. In the next year, the scores received by participants were recorded and analyzed using the statistical software program SPSS (Superior Performance Software System). The analysis was performed through descriptive and inductive statistical analysis in the SPSS statistical program. Specifically, the SPSS version 20.0 and specifically the one-way ANOVA variance analysis and the Tukey's parametric test were used for the statistical analysis of the results. RESULTS The use of physiotherapy care was found to be important for premature infants, as the level of statistical significance was set at p <0.05, while the data were reported as average. The final overall scores of the evaluations (on average) were higher in the group who received early intervention and specialized physiotherapy intervention from the first day after birth. CONCLUSIONS The effect of physiotherapy on premature infants is positive in five-year-old children, who have completed almost all their developmental stages at that age. These benefits become apparent not only in a better handling of kinetic patterns and sequences but also in the ability to execute kinetic models, conquer developmental motor stages and perform them with quality in terms of alignment, sequence, synergy of movements, separation and stability.
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Vouchara A, Chorti A, Tzikos G, Menni A, Ntouma S, Giza S, Tzitiridou-Chatzopoulou M, Bakkar S, Galli-Tsinopoulou A, Michalopoulos A, Papavramidis TS. Thyroidectomy in children and adolescents: a systematic review. Gland Surg 2024; 13:697-712. [PMID: 38845829 PMCID: PMC11150202 DOI: 10.21037/gs-24-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/28/2024] [Indexed: 06/09/2024]
Abstract
Background Thyroid surgery in pediatric population is not as common as that in adults, although they share the same indications, techniques and complications. This review aims to evaluate the surgical management of thyroid disease in patients under 18 years old. Methods We conducted a bibliographic search in the international literature. Data from the identified studies such as demographics, indication for surgery, type of procedure, complications and length of hospital stay were recorded. A retrospective review study of all patients under 18 years old who underwent thyroidectomy was performed. Results We included 37 retrospective studies and a total of 12,728 patients. Thyroidectomy was more common in female patients and the mean age was approximately 14 years old. The leading indication for surgery was benign thyroid pathology. Due to the surgical treatments' safety and effectiveness in young patients, total and subtotal thyroidectomy, whether for malignancies or benign diseases, is becoming more popular today. The most often occurring complication of pediatric thyroid surgery is hypoparathyroidism. Despite the high likelihood of recurrence of pediatric malignancies, overall survival rates of pediatric thyroid cancer are excellent. Conclusions Thyroidectomy performed by high-volume thyroid surgeons in children and adolescents is considered an efficient and safe method of treatment of thyroid disease.
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Tzitiridou-Chatzopoulou M, Orovou E, Zournatzidou G. Digital Training for Nurses and Midwives to Improve Treatment for Women with Postpartum Depression and Protect Neonates: A Dynamic Bibliometric Review Analysis. Healthcare (Basel) 2024; 12:1015. [PMID: 38786425 PMCID: PMC11120917 DOI: 10.3390/healthcare12101015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
The high prevalence of postpartum depression makes it necessary for midwives and nurses to implement prenatal interventions for expectant mothers. The current study aims to investigate and highlight the importance of the digital training of nurses in order to help women mitigate the symptoms of postpartum depression and protect infants. To approach this, we conducted a bibliometric analysis to address the study's main objective. Articles were retrieved from the Scopus database for the timeframe 2000-2023. Data analysis was conducted using the statistical programming language R (version R-4.4.) and the bibliometric software VOSviewer (version 1.6.20) and Biblioshiny (version 4.1.4), focused on year, journal, and country. For this investigation, we selected a total of 31 MeSH keywords and sub-headings that exhibited significant frequencies. We consistently used six significant clusters of MeSH keywords. We obtained a total of 585 articles from the Scopus database that were major contributors to the field of PPD, as evidenced by their extensive publication of research articles and their influential role in the domain. The studies included a thorough analysis of depression research, the use of scales for diagnosing and screening PPD, psychological studies related to PPD, and the exploration of causes, mechanisms, outcomes, and genetic factors. Our study's results demonstrate a steady and significant increase in the availability of information on PPD. Importantly, the novelty of the current study lies in highlighting the need for a transition in the ways in which nurses and midwives are trained to mitigate postpartum disease by integrating emerging technologies into their practices. The knowledge provided here has the potential to serve as a foundation for future advancements in obstetric psychology, both presently and in the future.
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Tzitiridou-Chatzopoulou M, Kountouras J, Zournatzidou G. The Potential Impact of the Gut Microbiota on Neonatal Brain Development and Adverse Health Outcomes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:552. [PMID: 38790548 PMCID: PMC11119242 DOI: 10.3390/children11050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut-brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period from birth to three years old may yield the greatest benefits. Investigating the substantial link between the gut and brain during this crucial developmental phase raises fundamental issues about the role of microorganisms in human health and brain development. This underscores the importance of focusing on the prevention rather than the treatment of neurodevelopmental and neuropsychiatric disorders. The present review examines the gut microbiota from birth to age 3, with a particular focus on its potential relationship with neurodevelopment. This review emphasizes the immunological mechanisms underlying this relationship. Additionally, the study investigates the impact of the microbiome on cognitive development and neurobehavioral issues such as anxiety and autism. Importantly, it highlights the need to integrate mechanistic studies of animal models with epidemiological research across diverse cultures to better understand the role of a healthy microbiome in early life and the implications of dysbiosis. Furthermore, this review summarizes factors contributing to the transmission of gut microbiome-targeted therapies and their effects on neurodevelopment. Recent studies on environmental toxins known to impact neurodevelopment are also reviewed, exploring whether the microbiota may mitigate or modulate these effects.
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Kountouras J, Boziki M, Kazakos E, Theotokis P, Kesidou E, Nella M, Bakirtzis C, Karafoulidou E, Vardaka E, Mouratidou MC, Kyrailidi F, Tzitiridou-Chatzopoulou M, Orovou E, Giartza-Taxidou E, Deretzi G, Grigoriadis N, Doulberis M. Impact of Helicobacter pylori and metabolic syndrome on mast cell activation-related pathophysiology and neurodegeneration. Neurochem Int 2024; 175:105724. [PMID: 38508416 DOI: 10.1016/j.neuint.2024.105724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/03/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
Both Helicobacter pylori (H. pylori) infection and metabolic syndrome (MetS) are highly prevalent worldwide. The emergence of relevant research suggesting a pathogenic linkage between H. pylori infection and MetS-related cardio-cerebrovascular diseases and neurodegenerative disorders, particularly through mechanisms involving brain pericyte deficiency, hyperhomocysteinemia, hyperfibrinogenemia, elevated lipoprotein-a, galectin-3 overexpression, atrial fibrillation, and gut dysbiosis, has raised stimulating questions regarding their pathophysiology and its translational implications for clinicians. An additional stimulating aspect refers to H. pylori and MetS-related activation of innate immune cells, mast cells (MC), which is an important, often early, event in systemic inflammatory pathologies and related brain disorders. Synoptically, MC degranulation may play a role in the pathogenesis of H. pylori and MetS-related obesity, adipokine effects, dyslipidemia, diabetes mellitus, insulin resistance, arterial hypertension, vascular dysfunction and arterial stiffness, an early indicator of atherosclerosis associated with cardio-cerebrovascular and neurodegenerative disorders. Meningeal MC can be activated by triggers including stress and toxins resulting in vascular changes and neurodegeneration. Likewise, H.pylori and MetS-related MC activation is linked with: (a) vasculitis and thromboembolic events that increase the risk of cardio-cerebrovascular and neurodegenerative disorders, and (b) gut dysbiosis-associated neurodegeneration, whereas modulation of gut microbiota and MC activation may promote neuroprotection. This narrative review investigates the intricate relationship between H. pylori infection, MetS, MC activation, and their collective impact on pathophysiological processes linked to neurodegeneration. Through a comprehensive search of current literature, we elucidate the mechanisms through which H. pylori and MetS contribute to MC activation, subsequently triggering cascades of inflammatory responses. This highlights the role of MC as key mediators in the pathogenesis of cardio-cerebrovascular and neurodegenerative disorders, emphasizing their involvement in neuroinflammation, vascular dysfunction and, ultimately, neuronal damage. Although further research is warranted, we provide a novel perspective on the pathophysiology and management of brain disorders by exploring potential therapeutic strategies targeting H. pylori eradication, MetS management, and modulation of MC to mitigate neurodegeneration risk while promoting neuroprotection.
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Kountouras J, Kazakos E, Vardaka E, Mouratidou MC, Kyrailidi F, Tzitiridou-Chatzopoulou M, Orovou E, Papanikolaou IS, Doulberis M, Zavos C. Comment on: Association between Helicobacter pylori infection and incident risk of dementia: The AMI cohort. J Am Geriatr Soc 2024; 72:1557-1559. [PMID: 38682310 DOI: 10.1111/jgs.18929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/02/2024] [Accepted: 03/08/2024] [Indexed: 05/01/2024]
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Tzitiridou-Chatzopoulou M, Kazakos E, Orovou E, Andronikidi PE, Kyrailidi F, Mouratidou MC, Iatrakis G, Kountouras J. The Role of Helicobacter pylori and Metabolic Syndrome-Related Mast Cell Activation Pathologies and Their Potential Impact on Pregnancy and Neonatal Outcomes. J Clin Med 2024; 13:2360. [PMID: 38673633 PMCID: PMC11050948 DOI: 10.3390/jcm13082360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Helicobacter pylori infection, a significant global burden beyond the gastrointestinal tract, has long been implicated in various systemic pathologies. Rising evidence suggests that the bacterium's intricate relationship with the immune system and its potential to induce chronic inflammation impact diverse pathophysiological processes in pregnant women that may in turn affect the incidence of several adverse pregnancy and neonate outcomes. Helicobacter pylori infection, which has been linked to metabolic syndrome and other disorders by provoking pericyte dysfunction, hyperhomocysteinemia, galectin-3, atrial fibrillation, gut dysbiosis, and mast cell activation pathologies, may also contribute to adverse pregnancy and neonatal outcomes. Together with increasing our biological understanding of the individual and collective involvement of Helicobacter pylori infection-related metabolic syndrome and concurrent activation of mast cells in maternal, fetus, and neonatal health outcomes, the present narrative review may foster related research endeavors to offer novel therapeutic approaches and informed clinical practice interventions to mitigate relevant risks of this critical topic among pregnant women and their offspring.
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Doulberis M, Papaefthymiou A, Polyzos SA, Boziki M, Kazakos E, Tzitiridou-Chatzopoulou M, Vardaka E, Hammrich C, Kulaksiz H, Riva D, Kiosses C, Linas I, Touloumtzi M, Stogianni A, Kountouras J. Impact of Helicobacter pylori and metabolic syndrome-related mast cell activation on cardiovascular diseases. FRONTIERS IN GASTROENTEROLOGY 2024; 3. [DOI: 10.3389/fgstr.2024.1331330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Abstract
Helicobacter pylori, a widely renowned bacterium, has recently gained attention owing to its potential impact on extragastric health. The emergence of research linking H. pylori infection with metabolic syndrome (MetS)-related cardiovascular diseases (CVDs) has raised intriguing questions about the pathogenic linkage and its translational implications for clinicians. MetS encompasses a collection of metabolic abnormalities that considerably elevate the risk of CVDs and cerebrovascular diseases. Emerging evidence supports a potential pathogenetic role of H. pylori for MetS-related disorders through mechanisms implicating chronic smoldering inflammation, insulin resistance (IR), and modulation of immune responses. One intriguing aspect of this possible connection is the role of mast cells (MCs), a subset of immune cells representing innate immune system effector cells. They play a fundamental role in innate immune responses and the modulation of adaptive immunity. Activated MCs are commonly found in patients with MetS-related CVD. Recent studies have also suggested that H. pylori infection may activate MCs, triggering the release of pro-inflammatory mediators that contribute to IR and atherosclerosis. Understanding these intricate interactions at the cellular level provides new insights into the development of therapeutic strategies targeting both H. pylori infection and MetS-related MCs activation. This review investigates the current state of research regarding the potential impact of H. pylori infection and MetS-related MCs activation on the pathophysiology of CVD, thereby opening up new avenues for related research and paving the way for innovative approaches to prevention and treatment in clinical practice
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Partalidou S, Patoulias D, Deuteraiou K, Avgerou P, Kitas G, Tzitiridou-Chatzopoulou M, Dimitroulas T. Risk of Major Adverse Cardiovascular Events and Venous Thromboembolism with JAK Inhibitors versus TNF Inhibitors in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis. Mediterr J Rheumatol 2024; 35:10-19. [PMID: 38756933 PMCID: PMC11094442 DOI: 10.31138/mjr.171023.rof] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 05/18/2024] Open
Abstract
Objective The aim of this study was to compare the risk of major cardiovascular events (MACE) and venous thromboembolic events (VTE) between tumour necrosis factor (TNF) and Janus kinase (JAK) inhibitors in patients with rheumatoid arthritis (RA). Methods We researched PubMed, Scopus, Cochrane Library, and clinicaltrials.gov until December of 2023 for randomised controlled trials (RCTs) and observational studies. The outcomes studied were MACE (stroke, heart attack, myocardial infarction, sudden cardiac death) and VTE (deep vein thrombosis, pulmonary embolism). We pooled data using random effects model. Risk for the reported outcomes was expressed as odds ratio (OR) with a 95% confidential interval (CI). We performed a subgroup analysis based on study design. Results We identified 23 studies, 20 of which compared the odds for MACE and 14 the odds for VTE between JAK and TNF inhibitors in RA patients. Ten studies were RCTs and the rest were observational. Regarding MACE risk we pooled data from a total of 215,278 patients (52,243 were treated with JAK inhibitors, while the rest 163,035 were under TNF inhibitors). Compared with TNF inhibitors, the OR for JAK inhibitors in regards with MACE risk was 0.87 (0.64-1.17, p<0.01). Regarding VTE, a total of 176,951 patients were analysed (41,375 JAK inhibitors users and 135,576 TNF inhibitors users). The OR for VTE for JAK inhibitors compared with TNF inhibitors was 1.28 (0.89-1.84, p<0.01). Conclusion According to our results, there is no statistically significant difference for MACE or VTE in RA patients who receive either JAK or TNF inhibitors.
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Skouvaklidou E, Deligeorgakis D, Skalkou A, Skepastianos V, Tsafis K, Papadimitriou E, Pagkopoulou E, Avgerou P, Mytilinaiou MG, Tzitiridou-Chatzopoulou M, Kougkas N, Adamichou C. Focus on Filgotinib in Rheumatoid Arthritis: A Trial-Based Review. Mediterr J Rheumatol 2024; 35:1-9. [PMID: 38756936 PMCID: PMC11094443 DOI: 10.31138/mjr.281123.fof] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 05/18/2024] Open
Abstract
Janus kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway is involved in pathophysiologic cascade of a notable number of rheumatic diseases. The development of JAK inhibitors has expanded treatment choices in rheumatoid arthritis (RA) with a sustained class-effect efficacy. Filgotinib is a novel selective inhibitor of JAK1 isoform licensed for use in RA and ulcerative colitis. In this review we aim to present an analysis of filgotinib's efficacy and drug-specific safety warnings. Patients with RA with or without concomitant conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs) (naïve or experienced) and those who have failed biologic Disease-Modifying Antirheumatic Drugs (bDMARDs) were examined in randomised clinical trials. Filgotinib was also tested against placebo, methotrexate, or adalimumab. Long-term extension trials provide insights for up to four years of continuous filgotinib administration. Beneficial effects are depicted in both disease activity parameters and quality of life indexes in moderate or severe RA with a longitudinal efficacy. In head-to-head comparison with adalimumab, filgotinib 200 mg was non-inferior. Adverse effects alerts are marked by the elevated risk of infectious adverse effects with the exception of herpes zoster infection, which has a low incidence.
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