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Biomedical subjects

I Ilias

Publications and source records attributed to I Ilias.

At least 19 recordsLinked to original sources
PubMed2006

Alpha 2-adrenergic receptors decrease DNA replication and cell proliferation and induce neurite outgrowth in transfected rat pheochromocytoma cells.

Alpha 2-adrenergic receptors (alpha(2)-ARs) have a widespread distribution in the central nervous system (CNS) and affect a number of biochemical and behavioral functions, including stimulation of prefrontal cortex (PFC) and cognitive function. In addition to its role as a classical neurotransmitter, norepinephrine (NE) has been recently shown to exert an important influence on the plasticity in areas of the brain where neurogenesis persists in the adult, notably the subgranular zone (SGZ) within the dentate gyrus of the hippocampus and the olfactory bulb (OB). In regulating adult neurogenesis, the noradrenergic system is functionally integrated with chronic stress and depression. Chronic stress, depression, or depletion of NE in vivo suppress, and antidepressant treatments induce hippocampal neurogenesis by down- or upregulating, respectively, cell proliferation. In the present study we show that alpha(2)-AR subtypes promote the differentiation rather than cell proliferation of PC12 cells. It is conceivable that alpha(2)-ARs might contribute neurotrophic actions in vivo synergistically or in permutation with other neurotrophic factors.

Adrenergic alpha-Agonists↗
PubMed2005

Diagnosis and management of tumors of the adrenal medulla.

The adrenal medulla consists of chromaffin cells, the site of catecholamine biosynthesis. Pheochromocytomas are chromaffin-cell tumors; 80-85 % arise from the adrenal medulla and 15-20 % arise from extra-adrenal chromaffin tissues (paragangliomas). Neuroblastomas are primitive tumors that derive from the same blastic precursor as in pheochromocytomas, and are distributed along the sympathetic nervous system. Pheochromocytomas account for 6.5 % of incidentally discovered adrenal tumors; they are found in 50 % of patients with multiple endocrine neoplasia 2A (MEN 2A) and 5-25 % of patients with von Hippel-Lindau (VHL) syndrome. Neuroblastomas are the most common solid extra-cranial tumors in children, and account for 7-10 % of all tumors. The diagnosis of pheochromocytoma should first be established biochemically by measuring plasma free metanephrines (the measurement of urinary fractionated metanephrines is the second choice). Measurements of homovanillic acid (HVA), norepinephrine and vanilmandelic acid (VMA) in urine are a necessity in patients with suspected neuroblastoma. Anatomical (radiological) imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is necessary for both pheochromocytomas and neuroblastomas. Functional (nuclear medicine) methods are useful for both tumors. Scintigraphy with [123I]-metaiodobenzylguanidine is the specific functional imaging test of first choice; if this is not available, scintigraphy with [131I]-MIBG is the second choice. Other newer specific modalities that have been used for evaluating pheochromocytomas include positron emission tomography (PET) with [18F]-F-fluorodopamine (F-DA) and [18F]-F-dihydroxyphenylalanine (DOPA). These should be used when MIBG scintigraphy is negative. Primary treatment for both types of tumor is surgical; chemotherapy is used for inoperable disease. After successful surgery, survival of patients with benign, sporadic pheochromocytomas is believed to be equal to that of the general population. Depending on the extent of disease and age, patients with neuroblastomas have cure rates of 15-90 %.

Adrenal Gland Neoplasms↗
PubMed2005

Biochemical diagnosis, localization and management of pheochromocytoma: focus on multiple endocrine neoplasia type 2 in relation to other hereditary syndromes and sporadic forms of the tumour.

Approximately 50% of patients with multiple endocrine neoplasia (MEN) 2A or 2B develop pheochromocytoma. These tumours are almost exclusively benign and localized in the adrenal glands. About one-third are bilateral at initial diagnosis. Amongst patients with pheochromocytoma, those with MEN 2A have subtler symptoms compared to those with sporadic disease. Since pheochromocytomas in patients with MEN 2 often secrete catecholamines episodically (but metabolize them continuously to metanephrines), the first choice for biochemical diagnosis is the measurement of free metanephrines in plasma, with urinary fractionated metanephrines being the second choice. In patients with pheochromocytomas that produce exclusively normetanephrine, MEN 2 can be excluded. In patients with biochemically proven MEN 2-related pheochromocytoma, anatomical imaging of the adrenals (with either computerized tomography or magnetic resonance) should be obtained next. Functional imaging with specific ligands (e.g. scintigraphy with [(123)I]-metaiodobenzylguanidine or, if available, positron emission tomography with [(18)F]-fluorodopamine, [(18)F]-dihydroxyphenylalanine, [(11)C]-adrenaline or [(11)C]-hydroxyephedrine) may then be particularly useful in patients with distorted anatomy from previous surgery, in cases of equivocal biochemical data despite high clinical suspicion for a tumour, to rule out multifocal disease, or where there is suspicion of metastatic disease (e.g. tumours larger than 5 cm). Laparoscopic surgery is the treatment of choice and subtotal (cortical-sparing) adrenalectomy is the procedure of choice in bilateral pheochromocytomas.

Adrenal Gland Neoplasms↗
PubMed2004

Current views on imaging of adrenal tumors.

Anatomical imaging modalities (such as computed tomography [CT] or magnetic resonance imaging [MRI]) and functional imaging modalities (that is, nuclear medicine) are used in the evaluation of adrenal glands. The use of CT (unenhanced, followed by contrast-enhanced) evaluation is the cornerstone of imaging of adrenal tumors. Attenuation values of less than 10 Hounsfield units at unenhanced CT are practically diagnostic for adenomas, while attenuation values of greater than 10 HU are not diagnostic of metastatic disease since non-metastatic disease is also a possibility. When lesions cannot be characterized adequately with CT, MRI evaluation (with T1 and T2-weighted sequences and chemical shift and fat-suppression refinements) is sought. Functional nuclear medicine imaging can be of utility in the evaluation of adrenal masses, more particularly for lesions not adequately characterized with CT and MRI. Nuclear medicine techniques are based on physiological and pathophysiological processes (cellular metabolism, tissue perfusion and local synthesis, uptake, storage of hormones and their receptors). Functional imaging aids initial preoperative staging, diagnostic evaluation of suspicious lesions, identification of metastatic or recurrent tumors, refining prognosis, and deciding on and predicting responses to therapy. [ (131)I]-6-iodomethyl norcholesterol scintigraphy can differentiate adenomas from carcinomas. Pheochromocytomas appear as areas of abnormal/increased [ (131)I]- and [ (123)I]-meta-iodobenzylguanidine uptake. Our experience has shown that [ (18)F]-fluorodopamine is an excellent agent for localizing adrenal and extra-adrenal pheochromocytomas.

Adrenal Gland Neoplasms↗
PubMed2003

The emerging role of peripheral corticotropin-releasing hormone (CRH).

Corticotropin-releasing hormone (CRH) is distributed in the brain and spinal cord and it has also been found in the myometrium, the endometrium, the placenta and diverse inflammatory sites. Traditionally, hypothalamic CRH has been considered to act indirectly in an anti-inflammatory fashion, since the end product of the hypothalamic-pituitary-adrenal axis is cortisol, a well-known anti-inflammatory compound. However, CRH produced at peripheral inflammatory sites may participate in an auto-/paracrine stimulation of inflammation. CRH in inflammatory sites seems to be involved in the activation of the Fas/Fas ligand system. Furthermore, locally produced embryonic and endometrial CRH plays a role in both the aseptic inflammatory process of implantation and the anti-rejection process that protects the fetus from the maternal immune system. There are two types of G protein-coupled CRH receptors, type 1 and 2. Pyrrolopyrimidine compounds, such as antalarmin, have been developed as CRH receptor antagonists. The systemic administration of antalarmin blocks pituitary CRH receptors and the CRH-induced secretion of adrenocorticotropin. Additonally, antalarmin has been shown to reduce the inflammatory-like reaction of the endometrium to the invading blastocyst, with a possible therapeutic potential as a non-steroidal inhibitor of pregnancy at its early stages.

Alternative Splicing↗
PubMed2003

Impaired hypothalamic endocrine function in neuroacanthocytosis.

Two sisters aged 28 and 26, suffering from neuroacanthocytosis (NA), had hypothyroidism and showed a flat growth hormone (GH) response to the insulin tolerance test. GH-releasing hormone (GHRH) administration resulted in a normal GH response in the older sister and a partial GH response in the younger sister. A pathological process--attributable to NA--can be suggested, leading to impaired hypothalamic function, but sparing the pituitary.

Adult↗
PubMed2002

An XY female with Müllerian duct development and persistent Wolffian duct structures.

Disorders of sexual differentiation are usually diagnosed at an early age. We hereby describe a case of a 29-year-old phenotypic woman who during the evaluation of amenorrhea was found to have a 46, XY karyotype. Further evaluation (including laparoscopy) suggested that she presented a variant of gonadal dysgenesis, with the particularity of having well-developed müllerian structures and testicular remnants alongside a steroid-producing gonadoblastoma.

Adult↗
PubMed2002

Successful treatment with carbimazole of a hyperthyroid pregnancy with hepatic impairment after propylthiouracil administration: a case report.

We report the case of a 27-year-old woman with hyperthyroidism during pregnancy. Antithyroid treatment with propylthiouracil (PTU) resulted in elevated hepatic enzymes and after the 12th week of pregnancy treatment was changed to carbimazole (CBZ). The remaining pregnancy, delivery and follow-up period were uneventful for the mother and her offspring. Antithyroid treatment during pregnancy should allow the use not only of PTU but also of CBZ and methimazole.

Adult↗
PubMed2001

Scintigraphic evaluation of primary congenital hypothyroidism: results of the Greek screening program.

The Greek screening program for primary congenital hypothyroidism was initiated in 1979. By early 2000, thyrotropin measurements had been performed in 1,976,719 newborns, using dried blood spots obtained by heel prick. Among these children, 584 were diagnosed with congenital hypothyroidism (incidence: 1/3,384 births) and were given L-thyroxine (L-T4) replacement therapy. In order to further evaluate and classify the children as having either an aplastic (AT) or an ectopic thyroid gland (ET) or as showing thyroidal dyshormonogenesis (DN, with a nomotopic gland), scintigraphic studies were performed at the age of 2-3 years. In 413 children of this age group (including 24 subsequently diagnosed as having had transient hypothyroidism, in whom L-T4 therapy was not resumed), thyroid hormones were measured and scintigraphic studies were done after withdrawal of L-T4 replacement treatment for 3 weeks. Given the long duration of the study, we used various scintigraphic modalities. In 96 children (group A), scintigraphy was performed using technetium-99m pertechnetate (99mTcO4-; 18.5 MBq given i.v.) and a rectilinear scanner. Seventy-three children (group B) were studied with 99mTcO4- (18.5 MBq given i.v.) and a gamma camera equipped with a pinhole collimator. In these groups, atropine was administered 30 min prior to the study (0.02 mg/kg i.v. or i.m.) in order to reduce the secretion of saliva from the salivary glands. Finally, in the remaining 220 children (group C) iodine-123 sodium iodide (123I-Na) (0.74-1.85 MBq i.v.) and the same gamma camera were used. Between-group comparisons of scintigraphic findings were done with the chi square test. In 191 children from group C, thyroglobulin (Tg) was measured and in 49 children ultrasound (US) was performed (categorising the gland as AT or ET/DN). Comparison of these modalities was done with the kappa statistic. In group A, 61.5% of children had AT, 26.0% had ET and 12.5% had DN; in group B, 28.8% of children had AT, 52.0% had ET and 19.2% had DN; in group C, 23.2% of children had AT, 63.2% had ET and 13.6% had DN. Statistically significant differences in group A versus groups B and C were noted for AT and ET. The implementation of newer scintigraphic modalities, and especially the use of 123I-Na, indicates that the commonest finding in congenital hypothyroidism is ET. Scintigraphy was more concordant with Tg measurements (though at a moderate level) than with US. The latter was even less concordant with Tg values. These results show that the most appropriate approach for the evaluation and classification of congenital hypothyroidism is 123I-Na scanning.

Child, Preschool↗
PubMed2001

Nursing staff anxiety versus smoking habits.

The aim of this study was to assess smoking habits versus anxiety levels of 114 female nurses. The Spielberger State-Trait Anxiety Inventory Scale (STAI, Questions 21-40) was used. Current smokers (n=52) had the highest levels of anxiety (STAI score: mean+/-SD, 43.04+/-8.48) compared to non-smokers (n=30), and ex-smokers (n=32) (38.94+/-6.45 and 36.56+/-6.62, respectively; P<0.02). Differences in STAI scores were greater between non-smokers and ex-smokers (P<0.01), while the STAI scores of current smokers were positively correlated with their per day quota of cigarettes (Pearson's: +0.65; P<0.002). We concluded that even in people who are well-acquainted with the ill-effects of nicotine abuse, smoking habits persist and are correlated with levels of anxiety. Apparently the (perceived) stress-relieving effects of nicotine outweigh anxiety of nursing staff. Preventive programs, if based exclusively on information on the effects of smoking on health, seem to be ineffective. Alternatively, techniques aimed at the relief of anxiety may yield better results.

Adult↗
PubMed2001

Burnout versus depression and sense of coherence: study of Greek nursing staff.

We assessed the relationships between burn out, depression and sense of coherence (SOC) using the Maslach Burnout Inventory, Beck's depression inventory and Antonovsky's SOC questionnaire in a large sample of 17 male and 62 female Greek nurses. Analysis showed that SOC in nursing staff was correlated with burnout (BO) and depression, while the latter was correlated to a lesser degree with BO. The relationship of BO with depression seems to be the result of the relationship between depression and SOC. Thus, we could hypothesize that the degree of SOC renders persons either vulnerable or resistant to both depression and BO, though further studies are warranted. In the hospital setting, the intervention by specialized personnel in order to assist nursing staff with BO may be an appealing option. Further, prevention programs aimed at helping individuals prone to BO could also be envisaged.

Adult↗
PubMed2001

Effects of severity of chronic obstructive pulmonary disease on thyroid function.

To investigate thyroid function in chronic obstructive pulmonary disease (COPD), 46 consecutive patients (35 men) with stable, mild-to-severe disease, having a mean (SD) age of 67 +/- 7 years were studied. All subjects underwent pulmonary function tests (PFTs), arterial blood gas determination, and measurement of serum total thyroxine (TT4), total triiodothyronine (TT3), resin T3 uptake (RT3U), reverse triiodothyronine (rT3), and thyroid-stimulating hormone (TSH) levels. The free thyroxine and free triiodothyronine indexes (FT4I = RT3U/30TT4 and FT3I = RT3U/30TT3, respectively) along with the TT3/TT4 ratio were calculated; the latter was used as a marker of peripheral conversion of thyroxine into triiodothyronine. Interleukin (IL)-6 was also measured to evaluate its potential associations with thyroidal hormone levels. On the basis of forced expiratory volume in 1 second (FEV1), patients were divided in 2 groups: group 1, (FEV1 > or = 50% of predicted, n = 26), with mild-to-moderate COPD and group 2 (FEV1 < 50% of predicted, n = 20) having severe disease. All subjects had normal serum thyroid hormone levels; for the entire COPD population, mean values were 7.80 +/- 1.60 microg/dL for TT4, 1.12 +/- 0.20 ng/mL for TT3, 29.0 +/- 1.88 for RT3U, 7.54 +/- 1.34 for FT4I, 1.07 +/- 0.16 for FT3I, 18.71 +/- 5.89 ng/dL for rT3, and 1.15 +/- 0.6 microU/mL for TSH. Mean TT3/TT4 ratio was 0.14 +/- 0.03. In group 1, TT3, TT4, and TT3/TT4 ratio did not correlate with age, FEV1, PaO2, or inhaled corticosteroids. Similarly, in group 2, TT3 and TT4 were unrelated to the above-mentioned variables; however, there was a strong positive correlation between TT3/TT4 ratio and PaO2 (r =.61, P =.004). IL-6 was within normal limits in all subjects, and it did not correlate with any thyroid hormone either in group 1 or in group 2. It is concluded that in stable COPD, severity of disease through hypoxemia is important in determining the peripheral metabolism of thyroid hormones. Whether this constitutes an adaptation is not known.

Aged↗
PubMed2001

Hypercalcaemia in Greek patients with tuberculosis before the initiation of anti-tuberculosis treatment.

Hypercalcaemia has been known to occur in association with granulomatous diseases. The aim of this study was to ascertain the incidence of hypercalcaemia and determine the prevalence of symptoms associated with it in Greek patients with newly-diagnosed tuberculosis (TB), before the initiation of anti-tuberculosis treatment. We prospectively evaluated all patients with newly-diagnosed TB presenting, either as inpatients or as outpatients, to our hospital, during a 3-year period. We evaluated 88 patients with TB (50 males and 38 females), aged between 23 and 89 years (mean age+/-SD: 46.4+/-19 years), and 65 age- and sex-matched controls with chronic obstructive pulmonary disease (36 males and 29 females), aged between 28 and 88 years (mean age+/-SD: 47.2+/-18 years). Among TB patients, 56 had pulmonary TB, 20 had pleural TB without evidence of pulmonary parenchyma involvement, eight had pulmonary and pleural TB, and four had disseminated disease. The mean (+/-SD) albumin-adjusted serum calcium concentration and the mean ionized calcium concentration were significantly higher in the TB group (2.49+/-0.21 mmol l(-1) and 1.27+/-0.02 mmol l(-1) respectively) than in the control group (2.36+/-0.11 mmol l(-1) and 1.19+/-0.02 mmol l(-1), P<0.05). In the TB group no correlation between type of disease and albumin-adjusted or ionized calcium concentration was seen. Hypercalcaemia was detected in 22 patients with TB (25%) but only three showed symptoms associated with it. We conclude that, although hypercalcaemia is a common laboratory finding among Greek patients with TB before anti-TB chemotherapy, it is usually asymtomatic.

Adult↗