Publications by authors named "Chrysi Christodoulaki"

6 Publications

  • Page 1 of 1

Polycystic Ovary Syndrome Triggers Atrial Conduction Disorders: A Systematic Review and Meta-Analysis.

Eur J Investig Health Psychol Educ 2022 Jul 13;12(7):802-813. Epub 2022 Jul 13.

Family Planning Unit, Third Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece.

Polycystic ovary syndrome (PCOS) is closely related to various adverse cardiovascular manifestations and increased cardiovascular risk. However, atrial fibrillation (AF) development and atrial conduction abnormalities have not been thoroughly studied in patients with PCOS. This meta-analysis (CRD42021261375) was conducted in accordance with the PRISMA guidelines. Our aim was to investigate associations between PCOS and disorders in atrial conduction parameters linked with an increased risk for AF occurrence. Five cohort studies with aggregate data on 406 adult women (229 with PCOS and 177 age-matched without PCOS) were included in this analysis. Our results showed a significantly increased mean difference in P-wave maximum duration (+7.63 ± 7.07 msec; < 0.01) and P-wave dispersion (+11.42 ± 5.22 msec; = 0.03) of patients with PCOS compared to healthy women. The mean difference in P-wave minimum duration (-2.22 ± 2.68 msec; = 0.11) did not reach the statistical threshold between the compared groups. Echocardiographic measurements of atrial electromechanical delay (AED) also indicated a statistically significant mean difference in favour of the PCOS group in all assessed parameters, except for atrial electromechanical coupling (PA) in the tricuspid annulus. Particularly, PCOS was associated with increased lateral PA, septal PA, inter- and intra-AED durations (mean difference: +17.31 ± 9.02 msec; < 0.01, +11.63 ± 7.42 msec; < 0.01, +15.31 ± 9.18 msec; < 0.01, +9.31 ± 6.85 msec; < 0.01, respectively). PCOS is strongly associated with alterations in several electrocardiographic and echocardiographic parameters indicating abnormal atrial conduction. Therefore, PCOS could be considered as a causal or triggering factor of AF. Larger studies are needed to confirm these results and investigate direct associations between PCOS and AF.
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July 2022

Migration and newborn screening: time to build on the European Asylum, Integration and Migration Fund?

Eur J Contracept Reprod Health Care 2022 Jun 21:1-5. Epub 2022 Jun 21.

3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.

Purpose: The authors discuss the need for newborn screening in the context of the migration policy of the European Union, and particularly, the European Asylum, Migration and Integration Fund.

Methods: The authors searched scholarly databases (Pubmed, Scopus, Google scholar) and grey literature (LexEuropa, Policy reports) to identify original peer-reviewed research examining the migration to the European Union and the provision of healthcare to infants born to refugees and immigrant mothers. Resources in language different from English, French, German and Greek were not taken into consideration.

Results: Every year, a large number of refugees and immigrants from sub-Saharan Africa and Middle East countries travel to and enter in Europe. It has been estimated that two thirds of those seeking asylum are women and children. Many of these children have been born on the way to Europe or in migrant camps. Essential newborns' health screening is not accessible in most cases. Congenital conditions such as hypothyroidism and phenylketonuria may remain untreated, and once these infants are diagnosed, the organic damage could be irreversible. Prolonged necessary hospitalisation might be out of consideration at a time when clinics and hospitals are overstrained with COVID-19 patients.

Conclusions: It is essential to ensure that newborn screening will be performed in a timely and evidence-based manner as well as that the information will be communicated between hospitals and within countries' health networks. In order to achieve these goals interdisciplinary and international technical and logistical collaboration are required.
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June 2022

Early changes of the heat-shock protein 60 to 70 ratio as prediction of miscarriage in pregnancy.

Am J Reprod Immunol 2019 03 14;81(3):e13087. Epub 2019 Feb 14.

4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Problem: To study the balance of circulating heat shock protein (HSP)60 and HSP70 in pre-term delivery.

Method Of Study: A two-stage approach was used. At first stage, we run retrospective analysis of prospective collected clinical data, and at a second stage, we studied an animal model of pre-term delivery (PTD). Blood samples were collected for prenatal screening in 3629 women. Samples from 23 women with miscarriage before gestational week 21 and 53 well-matched comparators for age, body mass index, parity, and previous miscarriage with full-term pregnancy were depicted. Women with risk factors were excluded. HSP60 and HSP70 were measured by an enzyme immunosorbent assay. PTD was induced after injection of low dose of bacterial lipopolysaccharide; mice were killed for the measurement of HSP60 and HSP70 in blood and tissues. The study endpoint was the association of the HSP60 to HSP70 ratio to miscarriage.

Results: A ratio >6 could distinguish between women who will miscarry from women with term pregnancies with sensitivity 60%, specificity 81.8%, positive predictive value 81.8%, and negative predictive value 60% (OR: 6.750, P = 0.025). Mice of the LPS-group PTD had this ratio significantly increased in maternal serum, placentas, and embryos compared to the sham-operation group. Gene expression of hsp60/70 remained in tissues unaltered.

Conclusion: A HSP60/HSP70 ratio equal to or more than 6 until gestational week 12 is accompanied with great likelihood for miscarriage. A similar ratio applies in an animal model of PTD induced by low-dose LPS.
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March 2019

Dehydroepiandrosterone-Sulfate, Insulin Resistance and Ovarian Volume Estimation in Patients With Polycystic Ovarian Syndrome.

J Family Reprod Health 2017 Mar;11(1):24-29

The Third Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.

To investigate the potential association of DHEA-S with metabolic and hormonal alterations and with disorders of ovarian morphology. The present study was based on women with PCOS that attended the Gynaecological Endocrinology - Paediatric and Adolescence Endocrinology Department of our clinic. Overall, 321 patients who met the Rotterdam ESHRE/ ASRM - Sponsored criteria for the definition of PCOS were included. Women's personal medical history was recorded, anthropometric parameters were assessed and blood was drawn for analysis of metabolic and hormonal parameters. A gynaecological ultrasound was also performed to evaluate ovarian morphology. Correlation analysis revealed a significant negative correlation of DHEA-S with the mean volume of the right and left ovary and with the maximum volume of the largest ovary. This finding remained significant after adjusting for age and BMI (β ± SE = -0.39 ± 0.17, p = 0.023 in the case of mean ovarian volume and β ± SE = -0.36 ± 0.17, p = 0.032 in the case of the maximum volume of the maximum ovarian volume). The findings of our study reveal a clear negative association of DHEA-S with ovarian volume. To date, however, current evidence in this field are restricted to experimental animal models. Future clinical studies are needed in this field to corroborate our findings.
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March 2017

The amount and duration of smoking is associated with aggravation of hormone and biochemical profile in women with PCOS.

Gynecol Endocrinol 2016 28;32(2):143-6. Epub 2015 Oct 28.

a 3rd Department of Obstetrics and Gynecology and.

We investigated the association between the amount and duration of smoking on biochemical, clinical parameters and the ovarian morphology in women with polycystic ovary syndrome (PCOS). That was a retrospective study. These women were divided into two groups, non-smokers (217) and smokers (92). The amount of cigarettes and duration of smoking was measured in pack-years. Both groups underwent clinical evaluation, biochemical and hormone analysis, transvaginal ultrasound and oral glucose tolerance tests (OGTT). The mean value of the number of cigarettes was 14.8 (±8.8) and the median value of pack-years in the smokers group was 4.0 (1.5-7.5). Smokers group has significantly higher free testosterone (F-T), 17-hydroxyprogesterone (17-OHP), delta 4 androstenedione (Δ4-A), T4, low-density lipoprotein (LDL), and white blood cells (WBC). During correlation of all the above parameters and pack-years, there has been significant positive correlation in F-T and Δ4-A. The participants with more pack-years showed statistically higher values of F-T and Δ4-A. There was also a significant positive correlation between total cholesterol, triglycerides, WBC and pack-years of the participants. Prolactin (PRL) has been inversely associated with pack-years. We concluded that the increase of pack-years aggravated lipid profile, WBC and decreased PRL levels, in PCOS patients.
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December 2016

Hypoxia-inducible factor-1α (HIF-1α) expression in placentae of women with iron deficiency anemia and β-thalassemia trait.

J Matern Fetal Neonatal Med 2015 Mar 4;28(4):470-4. Epub 2014 Jun 4.

Department of Obstetrics and Gynecology, Medical School, University of Thessaly , Larissa , Greece .

Objective: To investigate hypoxia-inducible factor-1α (HIF-1α) expression in placentae of women with iron-deficiency anemia and β-thalassemia trait and to correlate the results with hematological parameters as well as with parameters associated with the outcome of pregnancy.

Methods: About 126 women who delivered in the Larissa University Hospital were divided in three groups: iron-deficiency anemia (n = 39), β-thalassemia trait carriers (n = 53) and control group (n = 34). HIF-1α expression was assessed with immunochemical assays and statistical analysis was performed with chi-squared test and ANOVA.

Results: HIF-1α immunostaining was intense in the two groups of anemia. A statistically significant association was found between HIF-1α immunoreactivity and hematocrit (p < 0.001), hemoglobin (p < 0.001), MCV (p < 0.001), transferrin (p < 0.001) and its receptors (p = 0.040), whereas no significant correlations were observed between HIF-1α, iron serum levels (p = 0.256) and ferritin (p = 0.232). We found no association between HIF-1α and birthweight (p = 0.256), placental weight (p = 0.870) and Apgar score at 1' (p = 0.210) and 5' (p = 0.400).

Conclusions: HIF-1α expression is affected by anemia, although this factor has no important direct effect on the perinatal outcome.
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March 2015