Publications by authors named "Panagiotis Plotas"

37 Publications

Plasma nesfatin-1 and DDP-4 levels in patients with coronary artery disease: Kozani study.

Cardiovasc Diabetol 2021 08 13;20(1):166. Epub 2021 Aug 13.

2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, Attikon University General Hospital, Athens, Greece.

Background: Nesfatin-1, a novel adipokine and dipeptidyl peptidase-4 (DPP4), a mam malian serine protease, are potent factors of atherosclerosis. In the present cross-sectional study, we investigated whether the plasma nesfatin-1 and DPP4 is associated with the prevalence and severity of coronary artery disease (CAD) with and without diabetes mellitus (DM).

Methods: We consecutively enrolled a total of 240 patients with significant CAD (previous revascularization or angiographically-proven coronary artery stenosis > 50%) presented with either unstable angina (UA, N = 76) or stable chronic CAD (SCAD, N = 165). 85 patients with at least 2 classical cardiovascular risk factors but without significant CAD served as controls. The severity of CAD was assessed using coronary angiography by the Gensini score. Clinical parameters, glycemic and lipid profile, high-sensitivity CRP (hsCRP), nesfatin-1 and DPP4 levels were assayed.

Results: No differences were found for age, sex, hypertension and diabetes distribution between groups. Low nesfatin-1 levels were found in both CAD groups (UA & SCAD) with respect to controls. The difference between UA and SCAD groups was marginally non-significant. There was a significant increase of DPP4 along UA to SCAD and control groups. Differences between groups remained unchanged in non-diabetic participants. Nesfatin-1 significantly correlated to hsCRP (r = - 0.287, p = 0.036), HOMA-IR (r = - 0.587, p = 0.007) and hyperlipidemia (r = - 0.331, p = 0.034). DPP4 was significantly associated with hs-CRP (r = 0.353 p < 0.001) and FPG (r = 0.202, p = 0.020) in univariate analysis, but those correlations were lost in multiple regression analysis. There was a negative correlation between nesfatin-1 and the severity of CAD, quantified by the Gensini score (r = - 0.511, p < 0.001), but no association was found for DPP4.

Conclusions: Serum DPP4 levels are increased in patients with CAD, while serum nesfatin-1 levels have a negative association with both the incidence and the severity of CAD. These results are independent of the presence of diabetes mellitus. In addition, both peptides have a strong association with hsCRP. Trial registration ClinicalTrials.gov Identifier: NCT00306176.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12933-021-01355-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362239PMC
August 2021

Effects of hormone replacement therapy on endothelial function, arterial stiffness and myocardial deformation in women with Turner syndrome.

J Hypertens 2021 Oct;39(10):2051-2057

2nd Department of Cardiology.

Objectives: Turner syndrome (TS) is associated with increased cardiovascular risk. We investigated whether hormone replacement therapy (HRT) affects endothelial function, arterial stiffness and myocardial deformation in women with TS.

Methods: Twenty-five women with TS were studied in the estrogen phase of the HRT and two months after discontinuation of HRT. The following measurements were made: flow-mediated dilation (FMD) of the brachial artery, pulse wave velocity (PWV-Complior) and central systolic blood pressure (cSBP), carotid intima-media thickness (cIMT), aortic (Ao) elastic indexes - namely Ao strain, distensibility, stiffness index and pressure strain modulus (Ep) - and left ventricular (LV) global longitudinal strain (GLS) using speckle-tracking echocardiography. Ten healthy female of similar age and BMI served as a control group.

Results: Compared to controls, women with TS on HRT had higher PWV (9.1 ± 2.4 vs. 7.5 ± 0.5 m/s), cSBP (130 ± 15 vs. 121 ± 6 mmHg), cIMT (0.66 ± 0.06 vs. 0.55 ± 0.05 mm), aortic stiffness index, Ep and LA strain, and lower FMD (7.2 ± 4 vs. 10.5 ± 2.3%), Ao strain, Ao distensibility and GLS (-18.8 ± 2.7 vs. -21.9 ± 1.5%) (P < 0.05 for all comparisons). Two months after discontinuation of HRT, all women increased FMD (11.7 ± 6 vs. 7.2 ± 4%) and reduced PWV (7.8 ± 1.7 vs. 9.1 ± 2.4 m/s) and cSBP (123 ± 14 vs. 130 ± 15 mmHg). There were no statistically significant changes in BMI, cIMT and GLS (P > 0.05 for all comparisons). The percentage decrease of cSBP was associated with the percentage decrease of PWV (r = 0.54) and reversely related with the percentage increase of FMD (r = -0.57; P < 0.05 for all comparisons).

Conclusions: HRT in women with TS may deteriorate endothelial function contributing to increased arterial stiffness and central arterial blood pressure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/HJH.0000000000002903DOI Listing
October 2021

Bee Sting-Induced Acute Ischemic Stroke: A New Manifestation of Kounis Syndrome?

Ann Indian Acad Neurol 2021 Jan-Feb;24(1):118-120. Epub 2021 Feb 16.

Department of Cardiology, University of Patras Medical School, Patras, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/aian.AIAN_54_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061506PMC
February 2021

Late-Onset Bilateral Choroidal Metastases from Clear Cell Renal Cell Carcinoma.

Case Rep Urol 2020 9;2020:8862203. Epub 2020 Dec 9.

Department of Ophthalmology, Medical School, University of Patras, Rio, 265 04 Patras, Greece.

Aim: To present a case of clear cell renal cell carcinoma with late-onset bilateral choroidal metastases. . A 57-year-old male patient in the Oncology Clinic complained of reduced vision in the right eye (OD) for 7 days. The patient, who was under immunotherapy with nivolumab, had been diagnosed with clear cell renal cell carcinoma in the left kidney 15 years ago that recurred in the right kidney before 2 years. Metastases in the brain, lungs, and bones had also been diagnosed. On ophthalmological examination, the visual acuity was 20/50 OD and 20/20 in the left eye (OS). Dilated fundus examination in OD revealed a single raised oval-shaped yellowish choroidal nodule infratemporally with macular involvement. A similar lesion, sparing the macula, was observed in OS. Fundus autofluorescence revealed diffuse punctate hyperautofluorescence on the lesions. Serous macular detachment was also observed in OD. A standardized A-scan ultrasound demonstrated an irregular structure of the lesions with moderate to high internal reflectivity. Based on the history and clinical and echographic characteristics, the diagnosis of bilateral choroidal metastases from renal cell carcinoma was set.

Conclusion: Choroidal metastases from the primary renal tumor are extremely rare. The time interval between primary malignancy and choroidal metastasis is reported to be 12-96 months. Bilateral choroidal metastases have been described in 9 cases. We describe a rare case where bilateral choroidal metastases were diagnosed 15 years after the initial diagnosis of clear cell renal cell carcinoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2020/8862203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787867PMC
December 2020

Echocardiography, an Indispensable Tool for the Management of Diabetics, with or without Coronary Artery Disease, in Clinical Practice.

Medicina (Kaunas) 2020 Dec 18;56(12). Epub 2020 Dec 18.

Second Department of Internal Medicine, 'Attikon University Hospital', Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Diabetes mellitus is a major factor contributing to the development of cardiovascular disease. As morbidity and mortality rates rise dramatically, when target organ damage develops pre-symptomatic assessment is critical for the management of diabetic patients. Echocardiography is a noninvasive and reproducible method that may aid in risk stratification and in evaluation of treatment effects. The aim of this review is to analyze the echocardiographic techniques which can detect early alteration in cardiac function in patients with diabetes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/medicina56120709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767240PMC
December 2020

Effect of intravitreal injection of aflibercept on cardiovascular risk parameters in patients with neovascular age related macular degeneration.

Curr Clin Pharmacol 2020 Oct 16. Epub 2020 Oct 16.

Department of Ophthalmology, University of Patras, Medical School. Greece.

Objective: Systemic administration of anti-vascular endothelial growth factors (anti-VEGFs) has been associated with severe cardiovascular adverse events in oncologic patients. The purpose of this pilot study is to evaluate the short-term effect of a single intravitreal injection of aflibercept on biomarkers related to increased risk of cardiovascular disease.

Patients And Methods: Forty-seven treatment naïve patients with neovascular age related macular degeneration in one eye were enrolled in the study. The patients underwent treatment with one intravitreal injection of aflibercept in the affected eye. Laboratory biomarkers of cardiovascular disease were evaluated before the first intravitreal injection of aflibercept and at 7 and 30 days after aflibercept administration. More precisely, we evaluated the levels of homocysteine, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol and C-reactive protein.

Results: There was not any statistically significant change in the levels of the evaluated parameters up to one month after the first intravitreal injection of aflibercept.

Conclusions: According to our study, administration of a single dose of aflibercept in eyes with neovascular age-related macular degeneration does not seem to affect the evaluated biomarkers that are related to cardiovascular disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1574884715666201016121934DOI Listing
October 2020

The Acute Effects of Electronic Cigarette Vaping and Tobacco Cigarette Smoking on Choroidal Thickness in Young, Healthy, Habitual, Dual Smokers.

Toxics 2020 Oct 11;8(4). Epub 2020 Oct 11.

Department of Ophthalmology, Medical School, University of Patras, 26504 Patras, Greece.

The present study aims to evaluate and compare the acute effects of tobacco cigarettes (TC) smoking and electronic cigarette (EC) vaping on foveal and choroidal thickness (CT) in young, healthy, dual smokers. Participants underwent four trials: 5 min TC; 5 min EC; 30 min EC; and 60 min nothing (sham trial). Scans before and immediately after each trial were obtained using spectral domain optical coherence tomography with the enhanced depth imaging mode. Changes in central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and CT at fourother points, 500 μm and 1000 μm temporally and nasally to the fovea, were measured. Forty-seven participants (33 male, 14 female; mean age 24.85 ± 1.57 years) were included. They smoked 13.53 ± 5.27 TCs/day for 6 ± 2.3 years and vaped ECs for the past 2.4 ± 1.08 years. We did not observe any statistically significant change in SFCT, CFT, and CT of the other points after any of the fourtrials. The acute changes in CFT and CT after EC vaping or TC smoking did not differ significantly compared to the sham trial. Smoking and vaping does not seem to result in statistically significant acute alterations in foveal and CT in young, dual smokers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/toxics8040085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712466PMC
October 2020

Echocardiography in Autoimmune Rheumatic Diseases for Diagnosis and Prognosis of Cardiovascular Complications.

Medicina (Kaunas) 2020 Sep 1;56(9). Epub 2020 Sep 1.

Second Department of Dermatology and Venereology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Autoimmune rheumatic diseases are systemic diseases frequently affecting the heart and vessels. The main cardiovascular complications are pericarditis, myocarditis, valvular disease, obstructive coronary artery disease and coronary microcirculatory dysfunction, cardiac failure and pulmonary hypertension. Echocardiography, including transthoracic two and three-dimensional echocardiography, Doppler imaging, myocardial deformation and transesophageal echo, is an established and widely available imaging technique for the identification of cardiovascular manifestations that are crucial for prognosis in rheumatic diseases. Echocardiography is also important for monitoring the impact of drug treatment on cardiac function, coronary microcirculatory function, valvular function and pulmonary artery pressures. In this article we summarize established and evolving knowledge on the role of echocardiography for diagnosis and prognosis of cardiovascular abnormalities in rheumatic diseases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/medicina56090445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558642PMC
September 2020

Lung Function Variability in Children and Adolescents With and Without Asthma (LUV Study): Protocol for a Prospective, Nonrandomized, Clinical Trial.

JMIR Res Protoc 2020 Aug 7;9(8):e20350. Epub 2020 Aug 7.

Pediatric Respiratory Unit, University Hospital of Patras, Patras, Greece.

Background: Variability analysis of peak expiratory flow (PEF) and forced expiratory volume at 1 second (FEV1) has been used in research to predict exacerbations in adults with asthma. However, there is a paucity of data regarding PEF and FEV1 variability in healthy children and adolescents and those with asthma.

Objective: The objective of this study is the assessment of PEF and FEV1 variability in (1) healthy children and adolescents, to define the normal daily fluctuation of PEF and FEV1 and the parameters that may influence it, and (2) children and adolescents with asthma, to explore the differences from healthy subjects and reveal any specific variability changes prior to exacerbation.

Methods: The study will include 100 healthy children and adolescents aged 6-18 years (assessment of normal PEF and FEV1 variability) and 100 children and adolescents of the same age with diagnosed asthma (assessment of PEF and FEV1 variability in subjects with asthma). PEF and FEV1 measurements will be performed using an ultraportable spirometer (Spirobank Smart; MIR Medical International Research) capable of smartphone connection. Measurements will be performed twice a day between 7 AM and 9 AM and between 7 PM and 9 PM and will be dispatched via email to a central database for a period of 3 months. PEF and FEV1 variability will be assessed by detrended fluctuation and sample entropy analysis, aiming to define the normal pattern (healthy controls) and to detect and quantify any deviations among individuals with asthma. The anticipated duration of the study is 24 months.

Results: The study is funded by the "C. Caratheodory" Programme of the University of Patras, Greece (PN 47014/24.9.2018). It was approved by the Ethics Committee (decision 218/19-03-2019) and the Scientific Board (decision 329/02-04-2019) of the University Hospital of Patras, Greece. Patient recruitment started in January 2020, and as of June 2020, 100 healthy children have been enrolled (74 of them have completed the measurements). The anticipated duration of the study is 24 months. The first part of the study (assessment of lung function variability in healthy children and adolescents) will be completed in August 2020, and the results will be available for publication by October 2020.

Conclusions: Healthy children and adolescents may present normal short- and long-term fluctuations in lung function; the pattern of this variability may be influenced by age, sex, and environmental conditions. Significant lung function variability may also be present in children and adolescents with asthma, but the patterns may differ from those observed in healthy children and adolescents. Such data would improve our understanding regarding the chronobiology of asthma and permit the development of integrated tools for assessing the level of control and risk of future exacerbations.

Trial Registration: ClinicalTrials.gov NCT04163146; https://clinicaltrials.gov/ct2/show/NCT04163146.

International Registered Report Identifier (irrid): DERR1-10.2196/20350.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/20350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442949PMC
August 2020

Inflammation, Thrombosis, and Platelet-to-Lymphocyte Ratio in Acute Coronary Syndromes.

Angiology 2021 01 4;72(1):6-8. Epub 2020 Aug 4.

Department of Cardiology, 37795University of Patras Medical School, Patras, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003319720946213DOI Listing
January 2021

Sugammadex-induced atropine-resistant bradycardia: clinical, pathophysiologic, and electrocardiographic considerations.

JA Clin Rep 2020 May 7;6(1):31. Epub 2020 May 7.

Department of Cardiology, University of Patras Medical School, Queen Olgas Square, 7 Aratou Street, 26221, Patras, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40981-020-00336-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205945PMC
May 2020

Effects of electronic cigarette on platelet and vascular function after four months of use.

Food Chem Toxicol 2020 Jul 25;141:111389. Epub 2020 Apr 25.

Laboratory of Haematology & Blood Bank Unit, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

We examined the effects of electronic cigarette on platelet and vascular function after 4 months of use compared to tobacco smoking. Forty smokers without cardiovascular disease were randomized to smoke either conventional cigarettes or an electronic cigarette (nicotine concentration of 12 mg/ml). At baseline and after four months, we measured a) platelet function by Platelet Function Analyzer PFA-100 and Light Transmission Aggregometry, b) pulse wave velocity, c) plasma malondialdehyde levels as oxidative stress index and d) the exhaled CO level. After 4 months, continuation of conventional cigarette smoking further impaired platelet function compared to vaping as assessed by PFA (mean increase 27.1 vs 11.6 s, p for interaction = 0.048) and by LTA (decline 24.1 vs 9.4%, p for interaction = 0.045). Conversely, compared to smoking, vaping resulted in greater reduction of exhaled CO (6.9 ppm vs 2.6, p for interaction < 0.001), improvement of PWV (decrease of 0.8 m/s vs increase of 0.8 m/s, p for interaction = 0.020) and reduction of MDA (reduction 0.13 vs increase 0.19 nmol/L, p for interaction = 0.035). Switching to electronic cigarette for 4 months has a neutral effect on platelet function while it reduces arterial stiffness and oxidative stress compared to tobacco smoking.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.fct.2020.111389DOI Listing
July 2020

Effect of intravitreal injection of aflibercept on blood coagulation parameters in patients with age-related macular degeneration.

Ther Adv Ophthalmol 2020 Jan-Dec;12:2515841420903929. Epub 2020 Feb 11.

Department of Hematology, University Hospital of Patras, Patras, Greece.

Purpose: Treatment with intravitreal injections of anti-vascular endothelial growth factor agents has been associated with an increased risk of arterial thromboembolic events. The aim of the present pilot study was to assess the effect of a single intravitreal injection of aflibercept on coagulation.

Methods: Treatment-naïve patients with age-related macular degeneration ( = 47), who were scheduled to undergo treatment with intravitreal injections of aflibercept, were enrolled. None of the included patients received any anticoagulation therapy or had a history of a recent arterial thromboembolic event. Blood samples were collected before the first intravitreal injection, and at 7 and 30 days after aflibercept administration. We evaluated coagulation parameters, such as platelet count and plasma fibrinogen and D-dimer levels; functional clotting parameters, such as prothrombin time, international normalized ratio, and activated partial thromboplastin time; and anticoagulant parameters, such as the levels of Proteins S and C.

Results: The levels of all of the evaluated biomarkers were within the normal range at baseline and at both the time points throughout the study. No statistically significant changes were observed in any of the measured parameters at 1 week and 1 month after aflibercept administration.

Conclusion: A single intravitreal injection of aflibercept in treatment-naïve patients with exudative age-related macular degeneration has no statistically significant effect on blood coagulation parameters for up to 1 month after aflibercept administration. Our results also provide an explorative statistical data, and further studies are required to evaluate any significant clinical effects of aflibercept on blood coagulation parameters.

Clinicaltrialsgov Id: NCT03509623.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2515841420903929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013113PMC
February 2020

β-Amyloid and mitochondrial-derived peptide-c are additive predictors of adverse outcome to high-on-treatment platelet reactivity in type 2 diabetics with revascularized coronary artery disease.

J Thromb Thrombolysis 2020 Apr;49(3):365-376

Laboratory of Haematology & Blood Bank Unit, 'Attikon University Hospital', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Background And Aims: Increased β-amyloid and decreased mitochondrial-derived peptide (MOTS-c), are reported in diabetes. We investigated their additive value to high on-clopidogrel platelet reactivity (HPR) for adverse outcome in type 2 diabetics after recent revascularization.

Patients And Methods: In 121 type II diabetics, treated with clopidogrel and aspirin, (93 males, mean age 67.2 years) we measured: (a) maximum platelet aggregation to adenosine diphosphate (ADP) by light transmission aggregometry (LTAmax), (b) malondialdehyde (MDA), as oxidative stress marker, (c) MOTS-c, (d) β-amyloid blood levels. Cardiac death and acute coronary syndromes (MACE) were recorded during 2 years of follow-up.

Results: Out of 121 patients, 32 showed HPR (LTAmax > 48%,). At baseline, HPR was associated with β-amyloid > 51 pg/ml (p = 0.006) after adjusting clinical variables, HbA1c, MOTS-c, MDA and medication. During follow-up, 22 patients suffered a MACE. HPR, β-amyloid > 51 pg/ml and MOTS-c < 167 ng/ml were predictors of MACE (relative risk 3.1, 3.5 and 3.8 respectively, p < 0.05) after adjusting for confounders and medication. There was significant interaction between HPR and β-amyloid or MOTS-c for the prediction of MACE (p < 0.05). Patients with HPR and β-amyloid > 51 mg/dl or HPR and MOTS-c concentration < 167 ng/ml had a fourfold higher risk for MACE than patients without these predictors (relative risk 4.694 and 4.447 respectively p < 0.01). The above results were confirmed in an external validation cohort of 90 patients with diabetes and CAD.

Conclusions: Increased β-amyloid or low MOTS-c are additive predictors to high on-clopidogrel platelet reactivity for adverse outcome in diabetics with CAD during 2-years follow-up. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique identifier: NCT04027712.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11239-020-02060-4DOI Listing
April 2020

Bacteriology and Antimicrobial Susceptibility Patterns of Childhood Acute Bacterial Conjunctivitis in Western Greece.

Med Hypothesis Discov Innov Ophthalmol 2019 1;8(4):266-271. Epub 2019 Oct 1.

Department of Pediatrics, ''Karamandaneio'' General Pediatric Hospital, Patras, Greece.

Acute bacterial conjunctivitis is a common, highly contagious infection in children and is usually treated empirically with broad spectrum topical antibiotics. In the current study we investigated bacteriology and antibiotic susceptibility patterns in childhood acute bacterial conjunctivitis in Western Greece. We conducted a retrospective analysis of presumed acute bacterial conjunctivitis cases in ''Karamandaneio'' Pediatric General Hospital of Patras, Western Greece, between February 1, 2013 and January 31, 2018. Specimens from the lower conjunctiva fornix were isolated from 191 cases and outcomes were analyzed to identify the pathogenic bacteria of acute bacterial conjunctivitis and their corresponding antibiotic susceptibility patterns. Patients were divided into 3 groups; Group A included neonates under 28 days of life, Group B children from 1 month to 2 years and Group C from 2 years to 14 years. Results revealed that spp., spp. and spp. were the most prevalent pathogens. No significant differences in isolated pathogens were found between the age groups. Antibiotic resistance rates were higher against ampicillin, ceftriaxone, ceftazidime and sulfamethoxazole. Resistance rates to Ciprofloxacin were low while none of the evaluated isolates were resistant to vancomycin. We concluded that predominant pathogens of childhood acute bacterial conjunctivitis in Western Greece were spp., spp. and spp. Continuous surveillance, focused in distinct geographic areas, is encouraged to prepare more precise protocols of empirical treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778672PMC
October 2019

Effect of a single session of micropulse laser trabeculoplasty on corneal endothelial parameters.

Clin Exp Optom 2020 07 16;103(4):479-483. Epub 2019 Oct 16.

Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.

Background: To evaluate the effect of a single session of micropulse laser trabeculoplasty on the cornea in eyes with primary open-angle glaucoma and pseudoexfoliation glaucoma.

Methods: This single-centre, prospective, case series enrolled patients with primary open-angle and pseudoexfoliation glaucoma under treatment with glaucoma agents that required additional intraocular pressure reduction. Eyes underwent 360 degrees treatment with 532 nm micropulse laser trabeculoplasty. Central corneal thickness, endothelial cell count, hexagonal cell ratio and co-efficient of variation of endothelial cells were measured before micropulse laser trabeculoplasty and at one, three and six months after treatment.

Results: Twenty eyes of 20 patients (mean age 67.6 ± 8.0 years) with primary open-angle glaucoma and 18 eyes of 18 patients (mean age 71.44 ± 6.43 years) with pseudoexfoliation glaucoma were included in the study. Treatment with micropulse laser trabeculoplasty resulted in statistically significantly lower intraocular pressure compared to baseline in both primary open-angle and pseudoexfoliation glaucoma eyes (p < 0.0001 at both comparisons). Central corneal thickness, endothelial cell count, hexagonal cell ratio and co-efficient of variation of the endothelial cell size showed no significant change between baseline and six months after micropulse laser trabeculoplasty in both primary open-angle and pseudoexfoliation glaucoma eyes.

Conclusion: A single session of micropulse laser trabeculoplasty did not affect central corneal thickness and corneal endothelium parameters in eyes with primary open-angle and pseudoexfoliation glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/cxo.12968DOI Listing
July 2020

Hypotension Associated With IV Acetaminophen Administration in Pediatric Cardiac Patients.

Pediatr Crit Care Med 2019 10;20(10):1003-1004

Department of Cardiology, University of Patras Medical School, Rion, Patras, Achaia, Greece Department of Electrophysiology, Queen Elizabeth Hospital, Birmingham, United Kingdom Department of Internal Medicine Department, University Hospital of Patras, Patras, Greece Department of Ophthalmology, Medical School, University of Patras, Patras, Greece Department of Cardiology, Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Via Madonna di Genova, 1, 48033 Cotignola RA, Italy Department of Cardiology, University of Patras Medical School, Rion, Patras, Achaia, Greece Department of Cardiology, "Saint Andrews" State General Hospital, Patras, Achaia, Greece Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany Department of Cardiology, University of Patras Medical School, Rion, Patras, Achaia, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PCC.0000000000002061DOI Listing
October 2019

Angiographic and Midterm Thrombosis of Bioresorbable Vascular Scaffold for Coronary Bifurcation Narrowings.

Am J Cardiol 2019 04 7;123(7):1189-1190. Epub 2019 Feb 7.

Department of Cardiology, University of Patras School of Medicine, Patras, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjcard.2019.02.001DOI Listing
April 2019

Analgesic Effect of a Single Drop of Nepafenac 0.3% on Pain Associated with Intravitreal Injections: A Randomized Clinical Trial.

J Ocul Pharmacol Ther 2019 04 28;35(3):168-173. Epub 2019 Jan 28.

Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.

Purpose: To evaluate the analgesic effect of nepafenac 0.3% in patients undergoing intravitreal injections (IVI) of antivascular endothelial growth factors.

Methods: This is a single-center, prospective, randomized, blinded, triple-arm, placebo-controlled interventional study. Patients were randomized into 3 Groups. Group 1 (n = 33) received nepafenac 0.1%, Group 2 (n = 32) received nepafenac 0.3%, and Group 3 (n = 31) received placebo 40 min before IVI. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the visual analog scale (VAS), the Main Component of the SF-MPQ, and the present pain intensity (PPI) scores immediately and 6 h postinjection.

Results: Immediately after IVI, the VAS pain score was statistically significantly lower in patients treated with nepafenac 0.1% and 0.3%, compared with placebo (P < 0.001 and P = 0.001, respectively). The PPI scores were statistically significantly lower when nepafenac 0.1% or 0.3% was instilled compared with placebo (P = 0.01 and P < 0.0001, respectively). The Main Component of the SF-MPQ scores were statistically significantly lower after nepafenac 0.1% and 0.3% administration compared with placebo (P = 0.001 and P < 0.001, respectively). Six hours post-IVI the nepafenac 0.3% demonstrated statistically significantly higher analgesic effect compared with nepafenac 0.1% and placebo as this was indicated by the VAS pain score (P = 0.013 and P < 0.00001, respectively) and by the PPI score (P = 0.01 and P < 0.00001, respectively).

Conclusions: A single instillation of nepafenac 0.1% or 0.3% before IVI could effectively alleviate the IVI-related pain. The 0.3% formula exerts its analgesic effect more intensively at 6 h after the IVI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jop.2018.0113DOI Listing
April 2019

Dexamethasone implant for immunogammopathy maculopathy associated with IgA multiple myeloma.

Ther Adv Ophthalmol 2019 Jan-Dec;11:2515841418820441. Epub 2019 Jan 8.

Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.

Background: We describe a case where hyperviscosity retinopathy and immunogammopathy maculopathy were the presenting features of IgA multiple myeloma and report the response of maculopathy to intravitreal injection of dexamethasone implants.

Case Presentation: A 56-year-old man presented at the Department of Ophthalmology with the chief complain of reduced vision for the past 10 days in both eyes. Ophthalmic examination revealed central retinal vein occlusion resembling signs with severe macular edema in both eyes with prominent serous macular detachment. After comprehensive evaluation, an IgA type kappa multiple myeloma was diagnosed complicated with hyperviscosity-associated retinopathy and immunogammopathy maculopathy. Patient was treated with multiple sessions of plasmapheresis, systemic chemotherapy, and finally intravitreal implants of dexamethasone with complete restoration of macular edema and serous macular detachment in both eyes. The visual function and the hyperviscosity-associated retinopathy were partially restored.

Conclusion: Ocular manifestation might be the only presenting sign of a life-threatening disease such as IgA multiple myeloma. A high level of suspicion is required to diagnose and treat such cases promptly and effectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2515841418820441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329023PMC
January 2019

Brinzolamide-brimonidine fixed combination for the prevention of intraocular pressure elevation after phacoemulsification.

Eur J Ophthalmol 2020 Mar 10;30(2):293-298. Epub 2018 Dec 10.

Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece.

Aim: To evaluate the effectiveness of brinzolamide-brimonidine fixed combination to control the intraocular pressure elevation throughout the first 24 h following uncomplicated phacoemulsification cataract surgery.

Patients And Methods: A total of 62 patients who underwent phacoemulsification cataract surgery were included in this prospective randomized comparative case series. The brinzolamide-brimonidine fixed combination group (34 eyes) was administered a single dose of brinzolamide-brimonidine fixed combination immediately after phacoemulsification. No treatment was administered in the control group (28 eyes). Intraocular pressure was measured 1 day before surgery (baseline) and at 6, 12 and 24 h postoperatively.

Results: The brinzolamide-brimonidine fixed combination group had significantly lower intraocular pressure at 6, 12 and 24 h after phacoemulsification compared to baseline (p < 0.0001 for all comparisons), while in control group, intraocular pressure was significantly higher at 6 and 12 h after surgery compared to baseline (p < 0.001 and p < 0.0001, respectively). In control group, an intraocular pressure elevation ⩾ 5 mm Hg was noted in 32.4% of the eyes at 6 and 12 h and in 5.9% of eyes at 24 h after surgery, while in brinzolamide-brimonidine fixed combination group, only 8.8% of the eyes at 6 h postoperatively had such an intraocular pressure elevation.

Conclusion: The administration of a single drop of brinzolamide-brimonidine fixed combination effectively prevented intraocular pressure elevations and intraocular pressure spikes during the first 24 h after uneventful phacoemulsification.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1120672118817997DOI Listing
March 2020

Intravitreal aflibercept for choroidal neovascularization secondary to angioid streaks in a non-responder to intravitreal ranibizumab.

Int Med Case Rep J 2018 18;11:229-231. Epub 2018 Sep 18.

Department of Ophthalmology, University of Patras, Patras, Greece,

Purpose: To report the 12-month outcomes of a patient switching from intravitreal ranibizumab to aflibercept for choroidal neovascularization (CNV) associated with angioid streaks (AS).

Results: A 42-year-old Caucasian female with CNV associated with AS underwent intensive treatment with ranibizumab without significant functional or anatomic change. Treatment was then switched to aflibercept and the patient received the proposed age-related macular degeneration treatment regimen. After 3 loading doses of aflibercept, best-corrected visual acuity (BCVA) improved from 3/10 to 6/10, while optical coherence tomography (OCT) demonstrated resolution of the subretinal fluid with a reduction of the intraretinal fluid. After 12 months and 7 intravitreal injections of aflibercept, BCVA returned to 3/10, while OCT had demonstrated further morphologic improvement.

Conclusion: Our case shows that aflibercept may be an alternative treatment for advanced cases of CNV associated with AS that respond insufficiently to ranibizumab injections. Prospective studies are required to further evaluate the effect of aflibercept and to propose a standardized treatment protocol for this entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/IMCRJ.S166473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149836PMC
September 2018

Cystoid Macular Edema Due to Accidental Latanoprost Overdose After Uncomplicated Phacoemulsification.

Curr Drug Saf 2018 ;13(3):208-210

Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.

Objective: We present an interesting case of accidental overdose of latanoprost eye drops.

Case Report: A 71-year-old patient underwent an uncomplicated cataract surgery in his right eye. During the first postsurgical week he mistakenly used latanoprost eye drops six times daily instead of the prescribed tobramycin/dexamethasone eye drops. The patient experienced gradually decreasing visual acuity and was diagnosed with cystoid macular edema seven weeks after surgery. The cystoid macular edema resolved 4 weeks later after treatment with nepafenac 0.3% eye drops and oral acetazolamide. The cystoid macular edema recurred 2 weeks after rechallenge with latanoprost. The rechallenge-induced cystoid macular edema once again resolved after cessation of latanoprost and retreatment with nepafenac eye drops. A Naranjo assessment score of 7 was obtained, indicating a probable relationship between the patient's symptoms and the suspect drug.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1574886313666180619163845DOI Listing
January 2019

Analgesic Effect of Topical Nepafenac 0.1% on Pain Related to Intravitreal Injections: A Randomized Crossover Study.

Curr Eye Res 2018 08 16;43(8):1061-1064. Epub 2018 Apr 16.

a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece.

Purpose: To evaluate the analgesic effect of nepafenac 0.1%, a topical non-steroidal anti-inflammatory agent, in patients undergoing treatment with intravitreal injections (IVIs).

Material And Methods: It is a single center, prospective, randomized, double-blinded, placebo-controlled, crossover interventional study. Fifty-two patients scheduled to undergo IVI of anti-vascular endothelial growth factors were included in the study. Patients were randomized in a 1:1 ratio to receive topical nepafenac 0.1% or placebo 1 h before subsequent IVIs. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the Visual Analogue Scale (VAS), the Main Component of the SF-MPQ (MC-SF-MPQ), and the Present Pain Intensity (PPI) scores immediately and 6-h post-injection.

Results: The VAS pain score was statistically significant lower immediately and 6-h post-IVI in patients treated with nepafenac (p = 0.001 and < 0.001, respectively). The MC-SF-MPQ scores were also statistically significant lower after nepafenac administration at both time points (p < 0.001). Finally, the PPI score was statistically significant lower when nepafenac was instilled before IVI (p = 0.015 immediately and p < 0.001 at 6-h post-injection).

Conclusions: A single drop of nepafenac 0.1% before IVI could effectively alleviate the IVI-related pain immediately and up to 6 h after the injection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/02713683.2018.1461908DOI Listing
August 2018
-->