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Copyright © 2011 Katerina Koniari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work... more
Copyright © 2011 Katerina Koniari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 ...
Background Acute kidney injury (AKI) is a frequent form of organ injury in cardiogenic shock. However, data on AKI markers such as plasma proenkephalin (P-PENK) and neutrophil gelatinase-associated lipocalin (P-NGAL) in cardiogenic shock... more
Background Acute kidney injury (AKI) is a frequent form of organ injury in cardiogenic shock. However, data on AKI markers such as plasma proenkephalin (P-PENK) and neutrophil gelatinase-associated lipocalin (P-NGAL) in cardiogenic shock populations are lacking. The objective of this study was to assess the ability of P-PENK and P-NGAL to predict acute kidney injury and mortality in cardiogenic shock. Results P-PENK and P-NGAL were measured at different time points between baseline and 48 h in 154 patients from the prospective CardShock study. The outcomes assessed were AKI defined by an increase in creatinine within 48 h and all-cause 90-day mortality. Mean age was 66 years and 26% were women. Baseline levels of P-PENK and P-NGAL (median [interquartile range]) were 99 (71–150) pmol/mL and 138 (84–214) ng/mL. P-PENK > 84.8 pmol/mL and P-NGAL > 104 ng/mL at baseline were identified as optimal cut-offs for AKI prediction and independently associated with AKI (adjusted HRs 2.2 [9...
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Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle,... more
Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential therapeutic targets. High levels of circulating Triggering Receptor Expressed on Myeloid cells-1 (TREM-1), were associated with death in acute myocardial infarction confirming excessive inflammation as determinant of bad outcome. The present study aims to describe the association of soluble TREM-1 with 90-day mortality and with various organ injuries in patients with CS. This is a post-hoc study of CardShock, a prospective, multicenter study assessing the clinical presentation and management in patients with CS. At the time of this study, 87 patients had available plasma samples at either baseline, and/or 48 h and/or 96–120 h for soluble TREM-1 (sTREM-1) measurements. Plasma concentration of sTR...
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Background: The role of glucose alterations in the pathogenesis of endothelial dysfunction and inflammatory process in diabetic patients remains unclear. We examined the effect of diet or metformin on endothelial function and inflammatory... more
Background: The role of glucose alterations in the pathogenesis of endothelial dysfunction and inflammatory process in diabetic patients remains unclear. We examined the effect of diet or metformin on endothelial function and inflammatory process during glucose ...
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Research Interests: Cardiology, Inflammation, Treatment Outcome, Humans, Metformin, and 13 moreBlood Glucose, Diabetes mellitus, Female, Male, Aged, Middle Aged, Adult, Oral Hypoglycemic Agents, Tumor necrosis factor-alpha, Combination drug therapy, Type 2 Diabetes Mellitus, Combination Therapy, and Cardiovascular medicine and haematology
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Animal studies have shown a neuroprotective effect of human serum albumin (sAlb) in ischemic stroke (IS). Previous studies have shown an association of high sAlb with better outcome. Our aim is to investigate the kinetics of sAlb in acute... more
Animal studies have shown a neuroprotective effect of human serum albumin (sAlb) in ischemic stroke (IS). Previous studies have shown an association of high sAlb with better outcome. Our aim is to investigate the kinetics of sAlb in acute IS and its possible correlation with outcome taking into account the analytical and biological variation of sAlb measurement. In a prospective observational study, we enrolled 105 patients with acute IS. sAlb was measured upon admission, at 24 h, 48 h, 72 h and Day 7 thereafter. Stroke severity was assessed upon admission and at 72 h, and functional outcome on Day 7. Patients were divided into two groups according to functional outcome on discharge. Calculation of reference change value was used to assess the clinical significance of sAlb changes and multiple logistic regression to assess the independent association between variables and outcome. Fifty-one patients (48.6%) had poor outcome. Their sAlb levels exhibit a significant daily decrease unt...
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Background: The role of glucose alterations in the pathogenesis of endothelial dysfunction and inflammatory process in diabetic patients remains unclear. We examined the effect of diet or metformin on endothelial function and inflammatory... more
Background: The role of glucose alterations in the pathogenesis of endothelial dysfunction and inflammatory process in diabetic patients remains unclear. We examined the effect of diet or metformin on endothelial function and inflammatory process during glucose loading, in patients with newly diagnosed diabetes mellitus.Methods: The study consisted of 20 patients with newly diagnosed diabetes mellitus type 2, mean age 60.2±2.7,
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Desmoplastic small round cell tumor is a rare malignancy with poor prognosis that predominantly affects young males. Its etiopathogenesis is still unknown and diagnosis can be achieved only by immunohistochemistry and cytogenetic studies.... more
Desmoplastic small round cell tumor is a rare malignancy with poor prognosis that predominantly affects young males. Its etiopathogenesis is still unknown and diagnosis can be achieved only by immunohistochemistry and cytogenetic studies. Due to our limited knowledge of the pathologic and clinical nature of this disease, there is no clear consensus regarding the optimal therapeutic procedures for treating this neoplasm. A high degree of care and improvements in diagnostic capabilities are required in order to identify this entity and avoid misdiagnosis. We report a new case of a 29-year-old male who proceeded to our Emergency Department complaining about non-specific abdominal pain. Physical examination revealed no abnormalities except for a palpable mass in the lower abdomen and a diffuse abdominal pain. Computed Tomography scan showed enlarged paraortic and mesenteric lymphadenopathy, thickness of the small bowel wall and dispersed masses intraperitoneally. He underwent an explora...
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Background: Inflammation plays a major role in the development of acute coronary syndromes. However, the role of viral infections remains unclear. We examined the role of hepatitis A virous (HAV), cytomegalovirus (CMV), herpes simplex... more
Background: Inflammation plays a major role in the development of acute coronary syndromes. However, the role of viral infections remains unclear. We examined the role of hepatitis A virous (HAV), cytomegalovirus (CMV), herpes simplex virus (HSV), helicobacter pylori (HP), C-reactive protein (CRP), on endothelial function and clinical stability in patients with coronary artery disease.Methods: The study population consisted of 97
Research Interests: Helicobacter pylori, Cytomegalovirus, Endothelial dysfunction, Clinical Sciences, C reactive protein, and 12 moreAcute Coronary Syndrome, Endothelial Function, Viral Infection, Group, Maximum Flow, hepatitis A, Coronary Artery Disease, Healthy Subjects, Strain Gauge, Unstable Angina, Herpes Simplex Virus, and Coronary artery
IntroductionDesmoplastic small round cell tumor is a rare malignancy with poor prognosis that predominantly affects young males. Its etiopathogenesis is still unknown and diagnosis can be achieved only by immunohistochemistry and... more
IntroductionDesmoplastic small round cell tumor is a rare malignancy with poor prognosis that predominantly affects young males. Its etiopathogenesis is still unknown and diagnosis can be achieved only by immunohistochemistry and cytogenetic studies. Due to our limited knowledge of the pathologic and clinical nature of this disease, there is no clear consensus regarding the optimal therapeutic procedures for treating this neoplasm. A high degree of care and improvements in diagnostic capabilities are required in order to identify this entity and avoid misdiagnosis.