PubMed Health⌕ Search

Biomedical subjects

C Papamichael

Publications and source records attributed to C Papamichael.

At least 19 recordsLinked to original sources
PubMed2006

Impact of gender on 24-h ambulatory blood pressure and target organ damage.

Differences between male and female subjects in mean 24 h blood pressure (BP) values and target organ damage such as left ventricular mass (LVMASS) and intima-media thickness (IMT) of carotid arteries were explained. The study population consisted of 1,445 subjects. All subjects underwent 24 h ambulatory BP monitoring, left ventricular echocardiography and measurement of IMT of carotid arteries. Men and women did not differ in age, body mass index (BMI) and clinic BP values. Mean 24 h systolic and diastolic BP were significantly higher in men compared to women. LVMASS corrected for body surface area or height(2.7), IMT of common (MCCA) and internal (MICA) carotid arteries were found to be significantly higher in men compared to women. Analysis of covariance showed that men had significantly higher LVMASS, MCCA and MICA than women, after adjustment for BMI, age, smoking status, mean 24 h systolic and diastolic BPs, fasting serum glucose, total cholesterol and triglycerides. These findings indicate that male sex could be an important predictor of higher mean 24 h BP and target organ damage for subjects of similar BMI and clinic BP values.

Blood Pressure↗
PubMed2006

Common carotid arterial stiffness and the risk of ischaemic stroke.

In the present case-control study we aimed to investigate the association of common carotid arterial (CCA) stiffness with ischaemic stroke (IS) and to determine whether this relationship was independent of conventional risk factors including CCA intima-media thickness (CCA-IMT). CCA distensibility, defined as the change of CCA-diameter during the cardiac cycle, and CCA-IMT were evaluated by means of high-resolution B-mode carotid ultrasound examination in consecutive, first-ever IS patients (n=193) and in age- and sex-matched control subjects (n=106). The CCA distensibility (inverse of CCA stiffness) was significantly (P=0.007) lower in IS (0.353 mm, 95% CI: 0.326-0.379) than in control subjects (0.415 mm, 95% CI: 0.378-0.451) even after adjusting for blood pressure values, diastolic CCA-diameter and height. The multivariate logistic regression procedure selected CCA-IMT and CCA distensibility as the only independent predictor variables of IS. Each 1 SD increase in the CCA-IMT and each 1 SD decrease in the CCA distensibility independently increased the likelihood of IS by 167.0% (OR: 2.67, 95% CI: 1.80-3.96, P<0.001) and 59.0% (OR: 1.59, 95% CI: 1.22-2.07, P=0.001) respectively. Increased CCA stiffness is associated with IS independent of conventional risk factors and CCA-IMT. The causal interrelationship between the elastic properties of the CCA and the risk of stroke deserves further investigation by longitudinal studies.

Aged↗
PubMed2006

Association of dehydroepiandrosterone-sulfate with endothelial function in young women with polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to assess non-invasively endothelial function of young women with polycystic ovary syndrome (PCOS) in comparison with healthy age-matched women and a group of young women with idiopathic hirsutism (IH). The possible role of metabolic and hormonal parameters on endothelial function was also examined. DESIGN: Descriptive clinical trial. METHODS: Fifty-six women, 27 with PCOS, 16 with IH and 13 healthy age-matched women were studied. Endothelial function of resistance arteries was assessed by venous occlusion plethysmography. Metabolic and hormonal parameters were estimated in this study population. RESULTS: The duration of reactive hyperemia (durRH) was shorter in PCOS group when compared with normal controls (63.75 +/- 13.33 s vs 113.18 +/- 20.92 s, P = 0.036). A similar finding was observed when PCOS were compared with IH group (63.75 +/- 13.33 s vs 105 +/- 17.20 s, P = 0.05). The durRH did not differ between IH and control group (105 +/- 17.20 s vs 113.18 +/- 20.92 s, ns). A significant positive linear correlation was found between the durRH and dehydroepiandrosterone-sulfate (DHEA-S) levels (r = +0.48, P = 0.04) in the PCOS group. The basal insulin resistance index (HOMA) differed significantly between PCOS, IH and control groups. There was no significant correlation between durRH and HOMA index or testosterone levels in the PCOS group. CONCLUSIONS: Endothelial dysfunction may be an early sign of cardiovascular system abnormalities in young PCOS women. It is possible that increased DHEA-S levels may offer a cardioprotective advantage that attenuates the effects of cardiovascular risk factors that accompany PCOS.

Adult↗
PubMed2005

Metformin administration improves endothelial function in women with polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to investigate the endothelial status in young women with polycystic ovary syndrome (PCOS), using a simple and easily reproducible hemodynamic method combined with a biological marker and to evaluate the effect of metformin treatment on these parameters. DESIGN: Descriptive clinical trial. METHODS: Forty young women, 20 with PCOS and 20 normal women of similar age and body mass index were studied. Metformin (1700 mg daily) was administered for 6 months to the PCOS group. The endothelium status and the metabolic and hormonal profile were studied in both groups, as well as after metformin, by flow-mediated dilatation (FMD) on the brachial artery and by measurements of plasma endothelin-1 (ET-1) levels. RESULTS: FMD was impaired in the PCOS group when compared with controls (3.24+/-0.71% vs 8.81+/-1.07% respectively, P<0.0001), but this difference normalized after metformin treatment (PCOS(post-metformin) vs controls: 8.17+/-1.26 vs 8.81+/-1.07%, P = 0.70) since the values significantly improved after metformin treatment (PCOS(pre-metformin) vs PCOS(post-metformin): 3.24+/-0.71 vs 8.17+/-1.26%, P=0.003). ET-1 levels were significantly higher in the PCOS women compared with the control group (7.23+/-0.50 vs 4.99+/-0.69 fmol/l, P=0.01), they improved significantly after metformin treatment (PCOS(pre-metformin) vs PCOS(post-metformin): 7.23+/-0.50 vs 3.57+/-0.60 fmol/l, P<0.0001) and their difference compared with the control group was reversed (PCOS(post-metformin) vs controls: 3.57+/-0.60 vs 4.99+/-0.69 fmol/l, P=0.13). Metformin administration improved hyperandrogenemia. However, in this study, mathematical methods used to assess insulin resistance failed to show any detected alteration after treatment with metformin. CONCLUSIONS: PCOS women were found to exhibit endothelial dysfunction compared with controls, which was reversed 6 months after metformin administration.

Adult↗
PubMed2003

The androgen receptor gene CAG polymorphism is associated with the severity of coronary artery disease in men.

OBJECTIVE: The role of androgens in the pathogenesis of coronary artery disease (CAD) remains controversial. The length of the polyglutamine stretch of the transactivation domain (CAG repeat) of the androgen receptor (AR) inversely affects androgen activity. The aim of this study was to investigate the effect of this polymorphism of the AR gene in the extent of CAD in male patients. DESIGN AND PATIENTS: The relationship of the length of the AR gene CAG repeat on the severity of CAD was examined in 131 men (36-86 years old) undergoing coronary angiography. MEASUREMENTS: The severity of CAD was assessed by the number (0-3) of coronary vessels with > 50% reduction in the luminal diameter. The interaction of the AR gene polymorphism with the intima media thickness (IMT) of peripheral arteries and serum levels of sex steroids, insulin and biochemical parameters were also studied. RESULTS: The upper quartile of CAG length (range 9-30) was > or = 23 repeats (longAR). The mean body mass index (BMI) of patients with shorter repeats (< 23; shortAR) was significantly lower than in men with longAR (26.1 vs. 27.6, respectively; P = 0.043 M-W Rank test). There was no correlation between the AR gene repeat length and serum testosterone. Oestradiol levels were significantly higher in longAR (0.19 +/- 0.08 nmol/l vs. 0.14 +/- 0.07 in shortAR, P = 0.031). This difference was independent of BMI. Men with shortAR had significant CAD (i.e. one to three arteries with stenosis) more frequently (79.5%) than men with longAR (20.5%); of the subjects with stenosis in no arteries, 56.5% had shortAR and 43.5% longAR (chi2 = 4.3, P = 0.038). This association was independent of age and BMI. The IMT of peripheral arteries, lipid parameters, basal insulin resistance, blood pressure and family history for early CAD, did not differ according to AR length. CONCLUSIONS: The shorter CAG repeat of the AR gene is associated with more severe CAD, which suggests a role for the sensitivity to androgens in the increased frequency of CAD in males. In addition, a protective role of endogenous oestrogen, which is higher in the longAR subgroup, can contribute to the observed difference.

Aged↗
PubMed2001

Liposarcoma of the spermatic cord.

Primary malignant tumors of the spermatic cord are rare. We report a case of paratesticular liposarcoma and discuss the prognosis of this neoplasm and its therapeutic implications.

Genital Neoplasms, Male↗
PubMed1999

Isolated clinic hypertension is not an innocent phenomenon: effect on the carotid artery structure.

This study examines the common carotid intimal-medial wall thickness (CCA-IMT) in untreated patients with elevated clinic blood pressure (BP) but normal ambulatory BP (isolated clinic hypertension, n = 22), in comparison with a group with elevated clinic and ambulatory BP (hypertensives, n = 41) and a group with normal clinic and ambulatory BP (normotensives, n = 17) readings. The three groups did not differ in age, male/female ratio, lipid profile, glucose tolerance test, or smoking habits. No difference existed in CCA-IMT values between the groups with hypertension (0.67 +/- 0.18 mm) and isolated clinic hypertension (0.68 +/- 0.14 mm), but the values in these two groups were significantly higher (one-way ANOVA; F = 8.09, P < .001) than in the group of normotensives (0.50 +/- 0.09 mm). The CCA-IMT did not correlate with clinic systolic or diastolic BP readings or with BP derivatives of 24-h ambulatory monitoring. Mean 24-h BP in the isolated clinic hypertensives did not differ from that in the normotensives, whereas both were lower than in the hypertensives. We conclude that changes in the CCA-IMT occuring in subjects with isolated clinic hypertension are equal to the changes in sustained hypertension, indicating that isolated clinic hypertension may not be a benign condition.

Adult↗
PubMed1999

Outpatient treatment of neutropenic fever with oral antibiotics and granulocyte colony-stimulating factor.

In recent years, several cancer patients who developed neutropenic fever were effectively treated on an outpatient basis with either intravenous or oral antibiotics. This approach is associated with reduced cost and improved patient convenience. However, the appropriate antibiotic regimen and the role of growth factors have not been established yet. In order to address these issues we performed a nonrandomized phase II study to assess the feasibility and efficacy of an oral antibiotic regimen in combination with granulocyte colony-stimulating factor (G-CSF) for the outpatient treatment of cancer patients with low-risk neutropenic fever. In 50 patients with solid tumors or lymphoma, 60 episodes of neutropenic fever were treated with the combination of oral ofloxacin 400 mg twice a day, oral amoxicillin 1 g 3 times a day and G-CSF 5 microgram/kg/day subcutaneously. Patients receiving G-CSF prophylaxis were eligible for our study. Oral antibiotics were administered for at least 5 days and G-CSF was continued until resolution of neutropenia. Our patients were ambulatory, hemodynamically stable, and without significant comorbidity. Our combination was successful in 57 episodes (95%) with a median time for fever resolution of 3 days (range: 1-5 days). There was no significant toxicity associated with the antibiotic regimen with the exception of one case of reversible renal impairment. The role of G-CSF in the success of our antibiotic treatment is highly questionable since one half of our patients developed fever while on G-CSF prophylaxis. The combination of oral ofloxacin and amoxicillin with G-CSF is highly effective for the outpatient treatment of cancer patients who develop uncomplicated febrile neutropenia. The relative contribution of G-CSF needs clarification with a prospective randomized study.

Administration, Oral↗
PubMed1998

Short-term estrogen administration improves abnormal endothelial function in women with systemic sclerosis and Raynaud's phenomenon.

BACKGROUND: Morphologic changes of the vascular endothelium are common in patients with systemic sclerosis and Raynaud's phenomenon. The aim of this study was to evaluate the endothelium-dependent vasodilatation and endothelium-independent vasodilatation and to examine the effects of short-term estrogen administration on vascular responses in these patients. METHODS AND RESULTS: The study included 12 female patients with systemic sclerosis and Raynaud's phenomenon (aged 49+/-14 years) and 12 age- and sex-matched healthy control subjects. With the use of high-resolution ultrasound imaging, brachial artery diameter was measured at rest, during reactive hyperemia (endothelium-dependent response), and after administration of sublingual nitroglycerin (endothelium-independent dilatation). Intima-media thickness of the common carotid artery was also measured. Baseline diameter was similar in patients and control subjects; intima-media thickness was significantly higher in patients (0.83+/-0.3 vs 0.46+/-0.2 mm, P= .002) than in control subjects. Flow-mediated dilatation was reduced in patients (3.6%+/-7% vs 11.9%+/- 4.6%, P = .003); endothelium-independent dilatation also was reduced in patients with Raynaud's phenomenon (14%+/-7% vs 23%+/-6%, P= .003). Vascular responses in 10 patients were examined 15 minutes after administration of conjugated estrogens (25 mg intravenously); there was a significant increase of endothelium-dependent dilatation after estrogen administration (1.7%+/-4% to 6.3%+/-4%, P= .01), whereas endothelium-independent dilatation did not change (13.4%+/-8% to 15.5%+/-7%, not significant). CONCLUSIONS: Endothelium-dependent vasodilatation and endothelium-independent vasodilatation are impaired in patients with Raynaud's phenomenon secondary to systemic sclerosis, whereas intima-media thickness is increased. Short-term estrogen administration can improve endothelial dysfunction in this group of patients.

Adult↗
PubMed1997

Endothelial dysfunction of conduit arteries in insulin-dependent diabetes mellitus without microalbuminuria.

OBJECTIVE: Previous studies have shown that endothelial dysfunction, an early sign of atherosclerosis, occurs in animal models of diabetes mellitus and in resistance vessels of patients with insulin-dependent diabetes. In the present study we examined whether young patients with insulin-dependent diabetes without microalbuminuria present abnormal endothelial function of large peripheral arteries. METHODS: Twenty-six patients with insulin-dependent diabetes without microalbuminuria were compared with 26 normal controls and 5 patients with insulin-dependent diabetes with microalbuminuria. Brachial artery diameter was measured at rest, during reactive hyperaemic flow (endothelium-dependent dilatation) and after sublingual isosorbide dinitrate (endothelium-independent dilatation). RESULTS: Baseline artery diameter and flow as well as the degree of reactive hyperaemia were similar in all groups compared to controls. Flow-mediated dilatation was lower in patients with diabetes without microalbuminuria (5.8 +/- 7 vs 11 +/- 7%. P = 0.01) as well as in patients with diabetes without microalbuminuria (0.75 +/- 2.5 vs 11 +/- 7%, P = 0.003); nitrate-induced dilatation was normal in patients without microalbuminuria and attenuated in patients with microalbuminuria. In the group of diabetes patients without microalbuminuria, those with disease duration > 10 years and HbAlc > 6% had the worse endothelial function. CONCLUSIONS: Our results demonstrate that endothelial dysfunction of conduit arteries can be detected in patients with insulin-dependent diabetes mellitus without microalbuminuria, probably contributing to the high prevalence of atherosclerosis in these patients.

Adolescent↗
PubMed1997

Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values.

Patients with hypothyroidism are considered to have an increased risk of developing atherosclerosis; because endothelial dysfunction is an early sign of atherosclerosis, we investigated whether endothelial dysfunction is present in patients with hypothyroidism. Thirty-five subjects with various TSH levels were investigated by high-resolution ultrasound imaging of the brachial artery to assess endothelial and smooth muscle responses. Flow-mediated, endothelium-dependent vasodilatation was significantly higher in subjects with TSH 0.4-2 microIU/mL (11.8 +/- 2.7%), compared with subjects with TSH 2.01-4 microIU/mL (6.8 +/- 2.9%), 4.01-10 microIU/mL (5.2 +/- 6.3%) and >10 microIU/mL (4.0 +/- 4.4%); TSH levels correlated inversely to endothelium-dependent dilatation. Thus, flow-mediated vasodilatation, a marker of endothelial function, is impaired not only in patients with mild hypothyroidism but also in subjects with "high-normal" serum TSH levels (ie, 2.01-4.0 microIU/mL) that may be characterized as possibly abnormal.

Adult↗
PubMed1993

Physical activity and relationship with coronary heart disease risk factors.

Physical activity was recorded as walking in kilometers per week during leisure time and at work in a random sample of 1205 Athenian adults and was correlated to the coronary heart disease (CHD) risk factors. In general, a low level of physical activity was found in daily life. In particular, 53% of the men and 73% of the women examined walked less than 7 km/week. No difference in walking distance was observed among the 10-year age groups, for both sexes. In men, the logarithm (log) of walking was significantly correlated with log triglycerides (r = -0.0971, p = 0.0185), total lipids (r = +0.0927, p = 0.0246), high density lipoprotein-cholesterol (HDL-C) concentration in mg/dl (r = +0.0842, p = 0.0409), very low density lipoprotein-cholesterol (VLDL-C) concentration in mg/dl (r = -0.1149, p = 0.0052), alpha-lipoproteins as percentage of total lipoproteins (r = +0.0809, p = 0.0497) and pre-beta-lipoproteins as percentage of total lipoproteins (r = -0.1024, p = 0.0129). In women, respectively, log walking was significantly correlated with age (r = -0.1318, p = 0.0011), body mass index (BMI) (r = -0.1459, p = 0.0003), maximal heart rate (r = +0.1181, p = 0.0281), diastolic blood pressure (r = -0.1153, p = 0.0043), cigarette smoking (r = -0.810, p = 0.0448), log triglycerides (r = -0.1468, p = 0.0003), total lipids (r = -0.1415, p = 0.0004), VLDL-cholesterol concentration in mg/dl (r = -0.1475, p = 0.0002), total/HDL cholesterol ratio (r = -0.0968, p = 0.0165), alpha-lipoproteins as percentage of total lipoproteins (r = +0.1141, p = 0.0047), pre-beta-lipoproteins as percentage of total lipoproteins (r = -0.1324, p = 0.0010), urea (r = -0.1035, p = 0.0107) (r = +0.01221, p = 0.0107) and uric acid (r = -0.1221, p = 0.0026). Using a stepwise multiple linear regression analysis model, it was found that log walking was significantly and independently associated with alpha-lipoproteins as percentage of total lipoproteins in men (positive association) and with BMI in women (negative association).

Adolescent↗
PubMed1990

Blood pressure and other risk factors of cardiovascular disease in two communities with different socio-economic statuses: the Athens study.

Blood pressure and other risk factors of cardiovascular diseases were studied in two rural communities of 631 adults (greater than or equal to 18 years old) with different socio-economic statuses, populations A and B. Population A (n = 381) lived in a tourist village on an island, and population B (n = 250) in a remote mountain village. The socio-economic status of population A had improved considerably over the last decade but the physical environment, habits, culture and way of life had been disrupted. Blood pressure, prevalence of hypertension and other risk factors were higher than in population B where socio-economic status was lower but where there had been no disruption of the environment, traditional habits, culture or way of life. These findings might be due to the lack of preventive medicine services in the community.

Adult↗