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A Papaioannou

Publications and source records attributed to A Papaioannou.

At least 19 recordsLinked to original sources
PubMed2001

A study of metal distribution from lignite fuels using trees as biological monitors.

Concentrations of five metals (Cd, Cu, Mn, Fe, Zn) were determined in tree leaves collected from an area with large coal-fired plants in Ptolemais, Macedonia, Greece. The analyses were carried out with flame atomic absorption spectroscopy. Mean heavy metal content in the tree leaves is, in descending order, Fe>Mn>Zn>Cu>Cd. In Populus nigra and Salix babylonica the dense piled leaves and the widespread root system are the reasons for high heavy metal uptake. Conifer trees Pinus nigra and Juniperus arizona, which have a rough leaf surface, also had elevated concentrations. Leaves with a smooth surface were less contaminated. The presence of one metal within leaf cells may reduce the uptake or toxicity of other metals. Fruits accumulated less heavy metal than the corresponding leaves. The most damaged areas are those in the direct vicinity of the coal power plants, and the rate of damage caused in the environment is affected by the main wind direction. All sampling sites in Ptolemais basin are generally more or less polluted when compared with the control site.

Coal↗
PubMed2001

Economic implications of hip fracture: health service use, institutional care and cost in Canada.

As the burden of illness associated with hip fracture extends beyond the initial hospitalization, a longitudinal 1 year cohort study was used to analyze levels of health service use, institutional care and their associated costs, and to examine patient and residency factors contributing to overall 1 year cost. Patients in the study were aged 50 year and over, and had been admitted to an acute care facility for hip fracture in the Hamilton-Wentworth region of Canada from 1 April 1995 to 31 March 1996. Health care resources assessed included initial hospitalization, rehospitalization, rehabilitation, chronic care, home care, long-term care (LTC) and informal care. Regression analysis was used to determine the effects of age, gender, residence, survival and days of follow-up on 1 year cost. The mean 1 year cost of hip fracture for the 504 study patients was 26,527 Canadian dollars (95% Cl: $24,564-$28,490). One year costs were significantly different for patients who returned to the community ($21,385), versus those who were transferred to ($44,156), or readmitted to LTC facilities ($33,729) (p < 0.001). Initial hospitalization represented 58% of 1 year cost for community-dwelling patients, compared with 27% for LTC residents. Only 59.4% of community-dwelling patients resided in the community 1 year following hip fracture, and 5.6% of patients who survived their first fracture experienced a subsequent hip fracture. Linear regression indicated place of residence, age and survival were all important contributors to 1 year cost (p < 0.001). While the average 1 year cost of care was $26,527, the overall cost varied depending on a patient's place of residence, age, and survival to 1 year. Annual economic implications of hip fracture in Canada are $650 million and are expected to rise to $2.4 billion by 2041.

Aged↗
PubMed2001

Systemic lupus erythematosus presenting as subacute delirium in an 82-year-old woman.

OBJECTIVES: To describe an older patient with delirium attributed to systemic lupus erythematosus (SLE) and to review the literature on neuropsychiatric manifestations of SLE in older people. DESIGN: Case report and literature review. MEDLINE search using terms systemic lupus erythematosus, neurologic, psychiatric, neuropsychiatric, autoantibodies (anti-nuclear antibody (ANA), antiphospholipid, anticardiolipin, anti-double stranded deoxyribonucleic acid (anti-dsDNA), anti-Smith), and elderly. Additional articles obtained from hand-searched references and through experts. SETTING: Hospital (case report). PARTICIPANTS: Case report and literature cases. MEASUREMENTS: None. RESULTS: SLE is increasingly diagnosed in older adults. Onset is insidious and diagnosis is delayed because of a different clinical spectrum and immunological profile than in younger adults. Autoantibodies have an important role in the pathogenesis of neuropsychiatric manifestations, while vasculitis is less common. Aggressive immunosuppressive therapy is typically indicated, although recent case reports suggest that lower doses may suffice. The American College of Rheumatology 1982 revised criteria may be inadequate to diagnose neuropsychiatric lupus in older persons. CONCLUSION: Neuropsychiatric symptoms can be prominent in older people, presenting features of SLE. This case illustrates the lowest dose of corticosteroids shown to be effective in an older patient with delirium due to SLE.

Aged↗
PubMed2001

All patients with inflammatory bowel disease should have bone density assessment: pro.

Bone loss is a common problem for individuals with inflammatory bowel disease. Corticosteroids play an important role in the development of osteoporosis in these patients; however, active disease and longer disease duration also appear to increase the risk of osteoporosis. Given the current burden of osteoporosis, bone mineral density is recommended.

Adolescent↗
PubMed2001

Identifying research priorities on infections in older adults: proceedings of an interdisciplinary workshop.

BACKGROUND: Infections pose a substantial burden to the health of older adults. In this report, we describe the proceedings of a workshop to formulate and prioritize research questions about infections in older adults using an interdisciplinary approach. METHODS: Researchers from four sectors (basic science, clinical sciences, health services and epidemiology/determinants of health) and representatives from various Canadian local, provincial, and federal stakeholder groups were invited to a two-day workshop. Five multi-disciplinary groups and stakeholders from each of three healthcare settings (long term, acute care and community) discussed research priorities for each of the settings. Five to ten research questions were identified for each setting. RESULTS: The research questions proposed ranged from risk factors and outcomes for different infections to the effect of nutrition on infection and the role of alternative and complementary medicine in treating infections. Health service issues included barriers to immunization, prolongation of hospital length of stay by infection, use of care paths for managing infections, and decision-making in determining the site of care for individuals with infections. Clinical questions included risk factor assessment for infection, the effectiveness of preventative strategies, and technology evaluation. Epidemiologic issues included the challenge of achieving a better understanding of respiratory infections in the community and determining the prevalence of colonization with multi-resistant bacteria. CONCLUSIONS: The questions are of direct relevance to researchers in a wide variety of fields. Bringing together a multi-disciplinary group of researchers to frame and prioritize research questions about aging is feasible, participants valued the opinions of people working in other areas.

Journal Article↗
PubMed2001

Corticosteroid-Induced osteoporosis: detection and management.

Corticosteroid-induced osteoporosis is a major cause of morbidity and is the leading secondary cause of osteoporosis today. Unfortunately, despite this knowledge, patients receiving corticosteroid therapy are often not offered any preventative treatment. Recent research has focused attention on the critical role the osteoblast has played in the pathophysiology of corticosteroid-induced osteoporosis. In addition to an initial increase in bone resorption, there is evidence that corticosteroids induce osteoblast and osteocyte apoptosis and as a result are important contributors to bone loss. Interesting work has suggested that the bisphosphonates and calcitonin may help to prevent osteoblast apoptosis from occurring. Large scale randomised controlled trials have also been completed with a variety of therapeutic agents. Of the many different therapies, it is now clear that the bisphosphonates have the greatest evidence to support their use. Increases in bone mineral density when compared with a control group, not only at the spine but also at the hip, have been demonstrated. These studies have shown clinically significant reductions in vertebral fracture rates seen for the most part in postmenopausal women. Other therapies may well be effective, as evidenced by maintenance of bone mass in the spine; however, maintenance of bone mass in the hip and reductions in fracture rate have yet to be demonstrated for many of these therapies. Given our current knowledge and the evidence that is outlined in this review, it is hoped that patients who require therapy with corticosteroids for more than 3 months will be offered appropriate preventative treatment.

Adrenal Cortex Hormones↗
PubMed2000

Isolation of antibodies which neutralise the activity of early pregnancy factor.

Early pregnancy factor (EPF) is a secreted protein with growth regulatory and immunomodulatory properties. It functions as an autocrine growth factor for tumour cells and as an autocrine or paracrine growth factor for regenerating normal cells. Anti-EPF antibodies have demonstrable anti-tumour activity and, as a result, hybridomas which produce such antibodies are unstable. In this study, the phage display antibody techniques have been investigated as a means of producing recombinant anti-EPF antibodies. Mice were immunised with synthetic peptides which correspond to the N or C terminal regions of EPF, and their splenic tissue was used to make combinatorial antibody libraries. The Fab repertoire was displayed on the surface of phage and panned over recombinant EPF. Reactive Fabs were identified by ELISA and their binding was characterised by BIAcore analysis and functional studies. Three libraries with a size of greater than 5x10(7)cfu were constructed and a total of 26 unique Fabs with specific reactivity against EPF were identified. Three Fabs were purified and of these one demonstrated strong EPF neutralising activity, one had intermediate activity and the other was not neutralising. Phage display has provided the means of circumventing the problems of anti-EPF hybridoma development and has resulted in the production of antibodies with potential applications in the diagnosis of pregnancy and the diagnosis and therapy of cancer.

Amino Acid Sequence↗
PubMed2000

Continuous spinal anaesthesia/analgesia for the perioperative management of high-risk patients.

The intraoperative effects of continuous spinal anaesthesia, and the efficacy of postoperative continuous spinal analgesia in 48 elderly high risk patients undergoing major abdominal, vascular or orthopaedic surgery is reported. Intraoperative anaesthetic technique proved to be safe and provided satisfactory results in the immediate postoperative period. Furthermore, the postoperative analgesic regimen which involved intrathecal fentanyl and bupivacaine, and intravenous tenoxicam, provided effective analgesia for all patients. The intrathecal analgesic regimen was administered continuously through a PCA pump which had the facility to provide bolus doses when requested in predetermined lockout intervals. The mean doses of fentanyl and bupivacaine infused intrathecally for the first 24 h postoperatively were 14.5 +/- 1.5 microg h(-1) (mean +/- SD) and 0.72 +/- 0.08 mg h(-1) (mean +/- SD), respectively, while the requirements for analgesia decreased progressively overtime but lasted for 118 h. The technique provided effective analgesia with low pain scores that was reflected by the ease in performing physical exercises and the pleasant co-operation with the physiotherapist. Only minor complications related to anaesthesia/analgesia were encountered.

Aged↗
PubMed2000

A reply

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Journal Article↗
PubMed2000

Assessment of adherence to renal dosing guidelines in long-term care facilities.

OBJECTIVE: We determined whether dosing guidelines based on creatinine clearance (Ccr) for renally excreted drugs are being applied when prescribing to long-term care residents DESIGN: A cross sectional chart review for the month of May 1999. PARTICIPANTS: Long-term care residents more than 65 years of age from four long-term care facilities in Southern Ontario who were prescribed a medication from a list of renally excreted drugs commonly prescribed in long-term care facilities. RESULTS: Approximately one in three prescriptions (34.1%) were considered inappropriate for the calculated Ccr of the residents. Overall, 42.3% of the residents who were prescribed a drug under review received at least one inappropriate prescription based on creatinine clearance. Logistic regression found that age (odds ratio (OR) = 1.06 per year; 95% confidence interval (CI) 1.03-1.09, P = .001), weight (OR = 0.96 per kg; 95% CI 0.94-0.98, P < .001), the total number of prescribed medications (OR = 1.10; 95% CI 1.04-1.17, P = .001), and the number of physicians prescribing in the facility (OR 1.02; 95% CI, 1.003-1.044, P = .03) were predictive for receiving an inappropriate prescription based on Ccr. CONCLUSIONS: Renal function is often overlooked when prescribing renally excreted drugs to older long-term care residents. These findings emphasize the need for consideration of Ccr when prescribing such drugs in this population.

Aged↗
PubMed1999

Undiagnosed central anticholinergic syndrome may lead to dangerous complications.

This report describes two cases of central anticholinergic syndrome, the first after general anaesthesia and the other during a prolonged stay in the intensive care unit. The symptoms in both patients resolved soon after physostigmine administration. There was a delay in the diagnosis of central anticholinergic syndrome, which resulted in acute lung injury and unanticipated intensive care unit admission. It is suggested that in cases of abnormal mental recovery after anaesthesia or sedation, the diagnosis of central anticholinergic syndrome should be considered.

Adult↗
PubMed1999

Age-group differences in intrinsic motivation, goal orientations and perceptions of athletic competence, physical appearance and motivational climate in Greek physical education.

This study examined age-group differences in students' motivation, self-perceptions, task and ego orientations and perception of motivational climate in Greek physical education lessons. Six hundred and seventy-four students aged 10-17 years responded on self-reports which, in this study, had acceptable internal consistencies. The results showed that senior high school students scored lower on the scales assessing intrinsic motivation, perceived learning orientation in the lesson, task orientation and perceived athletic ability than junior high school and elementary school students. High school students had lower scores on the Perceived Physical Appearance scale and higher scores on the measure assessing perceptions of students' worries about mistakes than elementary school students. The results suggest that learning orientation should be strengthened in Greek physical education.

Achievement↗
PubMed1999

Minimal injury mastectomy in the surgical treatment of stage I and II breast cancer patients. A 20-year experience.

The main purpose of the present study is to enhance what we coined minimal injury mastectomy (MIM) as a reliable, efficient and acceptable procedure in the surgical treatment of breast cancer besides other therapeutic options currently used in the setting of adjuvant treatment (e.g. radiation therapy, chemotherapy or hormonal manipulations). We analysed retrospectively data of 142 patients with stage I and II breast cancer. Fifty-five of them had stage I, and the remaining 87 patients had stage II disease. Patients were submitted to minimal injury mastectomy, which is a broad segmental mastectomy, with limited or no axillary lymphadenectomy, thus minimizing locoregional trauma. Radiotherapy was given on a selective basis. Postoperative follow-up period ranged from one to 19.5 years (mean 103.5 months). Cosmetic results, shoulder function, texture of the breast and patient psychology were excellent in all the patients. In 55 stage I patients, six local recurrences occurred (12.72%), a mean 49.9 months after MIM, with ultimate local control of all patients and a remarkable survival after treatment of recurrences. In 87 stage II patients, six local (6.8%) and 16 systemic recurrences (18.7%) occurred, the latter after a mean period of 54.4 months postoperatively. It is concluded that with the minimal injury mastectomy, locoregional injury is minimized, preserving the regional immunological functions and by preventing lymphedema of the remaining breast, systemic resistance mechanisms are maintained and other adverse factors are avoided.

Adult↗
PubMed1998

Women's decisions about hormone replacement therapy after education and bone densitometry.

BACKGROUND: The decisions that postmenopausal women make about whether to start hormone replacement therapy may depend on the potential risks and benefits of such therapy as well as their risk for osteoporosis-related fractures. This study examined the decisions made by women at risk for osteoporosis-related fractures who were educated about hormone replacement therapy and who were given information about their bone mineral density. METHODS: The study employed a prospective cohort design. Thirty-seven post--menopausal women with risk factors for osteoporosis-related fractures were recruited from an orthopedic clinic at a teaching hospital in Hamilton, Ont. The women were given an education kit (consisting of an audio tape and a work-book) to clarify the benefits and risks of hormone replacement therapy. Two to 4 weeks later, densitometry of the hip and the lumbar spine was performed. A summary of the risks, the densitometry findings and decisions about hormone replacement therapy were given to the women's family physicians for follow-up. Outcome measures included decisions about hormone replacement therapy, as well as use of such therapy and other medications at 12 months. RESULTS: After the education component alone, 10 (27%) of the women requested hormone replacement therapy. After densitometry testing, 4 more requested hormone replacement therapy (for a total of 14 women [38%]). At 12 months, 2 (5%) of the women had been lost to follow-up. Of the remaining 35, 6 (17%) were receiving hormone replacement therapy, 7 (20%) were using bisphosphonates, and 24 (68%) were taking calcium supplements. INTERPRETATION: These preliminary findings suggest that the combination of education about hormone therapy and feedback about bone density is associated with an increase in the use of hormone replacement therapy and other preventive medications by women at risk for osteoporosis-related fractures. However, the observed increase was small and so the clinical significance must be confirmed and clarified.

Absorptiometry, Photon↗
PubMed1998

Adenosine A1 receptors modulate anxiety in CD1 mice.

The effect of the selective adenosine A1 receptor agonist 2-chloro-N6-cyclopentyladenosine (CCPA) was investigated in CD1 mice by the elevated plus-maze and the light/dark test, two models for measuring anxiety in rodents. CCPA, administered i.p., had an anxiolytic effect at 0.3 nmol/kg in the elevated plus-maze and at 1 nmol/kg in the light/dark test. Brain levels of 22 nM were found after administration of 100 nmol/kg CCPA, as measured by ex vivo binding experiments. These values are consistent with the occupancy of adenosine A1 but not A2 receptors by CCPA, and suggest that the anxiolytic-like action of CCPA may be mediated by centrally located adenosine A1 receptors. Both CPT, a selective adenosine A1 receptor antagonist, and IBMX, a non-selective adenosine antagonist, had an anxiogenic effect in the two tests. It is thus possible that purinergic neurons may be involved in the tonic modulation of affective state in mice.

Adenosine↗
PubMed1998

Students' perceptions of the physical education class environment for boys and girls and the perceived motivational climate.

Greek students (N = 310) responded to surveys concerning their perceptions of the physical education class environment. Based on factor and reliability analyses, 14 scale scores were computed. Two depicted perceptions of teacher-initiated mastery orientation and teacher-initiated performance orientation. Six scale scores reflected the teacher's negative behavior toward boy's, focus on boys' learning, encouragement toward boys, autonomy given to boys, adjustment of the lesson for boys, and motivation of boys. Six identical scale scores were calculated assessing the physical education class climate for girls. The perception of a teacher who behaves differently toward boys and girls was negatively related to the perception of a teacher who tried to help all students to improve. It is suggested that a mastery orientation increases students' motivation and maintains equality in physical education.

Adolescent↗
PubMed1997

Regulation and expression of human Fabs under the control of the Escherichia coli arabinose promoter, PBAD.

BACKGROUND: The L-arabinose operon from E. coli contains an inducible promoter PBAD which has been extensively studied for the control of gene expression. PBAD has a number of potential advantages over Plac, and has been used successfully to promote high level expression of recombinant proteins. OBJECTIVES: The aim of this study was to investigate PBAD as an alternative system to Plac for the bacterial expression of recombinant Fabs. STUDY DESIGN: The promoter PBAD from the E. coli arabinose operon araBAD and the gene encoding the regulator of this promoter, were cloned into the phagemid expression vector MCO1. Expression of human recombinant tetanus toxoid (TT) and c-erbB2 Fabs under the control of PBAD was compared at two induction temperatures with the same Fabs produced under the control of Plac. RESULTS: Expression of TT and c-erbB2 Fabs under the control of PBAD was comparable to Fab expression from Plac. However, highly expressed TT Fab under the control of PBAD was localised to the soluble periplasmic fraction whereas under the control of Plac, there was greater leakage of Fab into the culture supernatant. In addition, Fab expression from PBAD could be more tightly repressed than from Plac. CONCLUSION: PBAD is a useful and cheaply inducible alternative to the more commonly used Plac for the rapid expression of soluble recombinant human antibody fragments.

Arabinose↗