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Biomedical subjects

I Ilias

Publications and source records attributed to I Ilias.

18 recordsLinked to original sources
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↗
PubMed2000

Relationship between interleukin-6 (IL-6) and hypothalamic-pituitary-adrenal axis hormones in rheumatoid arthritis.

Systemic symptoms in rheumatoid arthritis (RA) are mediated, at least in part, by elevated levels of circulating interleukin 6 (IL-6), which is a potent activator of the human hypothalamic-pituitary-adrenal (HPA) axis. In a recent study, we observed that the 24 h time-integrated plasma ACTH and cortisol, as well as urinary free cortisol levels of untreated RA patients were not significantly different from control subjects, in spite of their active disease. However, an earlier morning surge of plasma ACTH and cortisol in RA patients was found. Plasma ACTH and cortisol responses to oCRH were similar between RA patients and controls. Plasma IL-6 levels showed a pronounced circadian variation and were significantly increased in the RA patients, compared to control subjects. In the RA patients, we detected a positive temporal correlation between plasma levels of IL-6 and ACTH/cortisol, with IL-6 preceding ACTH and cortisol by 1 and 2 h, respectively. In the same patients, we detected a negative effect of cortisol upon IL-6 exerted with a delay of 5 h. In patients with early untreated RA--although endogenous IL-6 stimulates the ACTH and cortisol secretion--the overall secretory activity of the HPA axis remains "inappropriately" normal despite elevated plasma IL-6 levels. The resulting "inappropriately" normal cortisol levels are apparently insufficient to satisfactorily limit the inflammation in these patients. In patients with Sjögren's syndrome the ACTH and cortisol response after CRH stimulation has been found to be blunted. On the other hand, patients suffering from systemic lupus erythematosus, when subjected to insulin tolerance testing, showed a lower cortisol response compared to healthy controls. These data indicate a direct and/or indirect involvement of a defective HPA axis in the pathogenesis of certain autoimmune-related pathologic entities.

Adrenocorticotropic Hormone↗
PubMed2000

Case report. Chronic necrotizing pulmonary aspergillosis in a non-neutropenic patient treated with liposomal amphotericin B.

Chronic necrotizing pulmonary aspergillosis is a rare infection encountered mainly in immunocompromised patients. We present the case of a young woman where the diagnosis of chronic necrotizing pulmonary aspergillosis was established after an open biopsy of the right lung. Liposomal amphotericin B was administered postoperatively for 10 days with moderate success. In a concise review we summarize the basic notions of chronic necrotizing pulmonary aspergillosis.

Adult↗
PubMed2000

Maternal hypothalamic-pituitary-adrenal axis in pregnancy and the postpartum period. Postpartum-related disorders.

During pregnancy, placenta-derived CRH increases exponentially in the plasma. Circulating levels of CRH-binding protein decrease considerably in the last trimester of pregnancy, resulting in further elevation of bioavailable plasma CRH. The adrenal glands during pregnancy gradually become hypertrophic because of the increase in ACTH, which parallels that of CRH. Thus, pregnancy is a transient period of relative hypercortisolism. The activation of the hypothalamic-pituitary-adrenal axis during pregnancy has been proposed to function as a biological clock. In this model, the placenta is perceived as a stress-sensitive organ and placental CRH as a timing starter, determining a preterm, term, or postterm labor. During pregnancy, as well as during the immediate postpartum period, the hypothalamic maternal CRH secretion is suppressed, because of the circulating levels of cortisol. Hypothalamic CRH secretion normalizes within 12 weeks. This transient postpartum maternal hypothalamic CRH suppression, together with the steroid withdrawal that follows parturition, might be causally related to the mood disorders and the vulnerability to autoimmune diseases such as thyroiditis or rheumatoid arthritis often observed during the postpartum period.

Adrenocorticotropic Hormone↗
PubMed1999

Thyroid disease associated with rheumatoid arthritis is not adequately screened with a sensitive chemiluminescence thyrotrophin assay.

The objective of this study was to screen for thyroidopathies in patients with rheumatoid arthritis (RA). Screening for thyroid disorders is advocated in patients with autoimmune diseases, and rheumatoid arthritis has been linked to thyroid autoimmune disorders, more particularly Hashimoto's thyroiditis and sometimes Graves' disease. We performed thyroid disease screening in 69 patients with RA free of medication for at least a 2 weeks period, not in remission, and in 65 patients with osteoarthritis (OA). The latter were studied as a control group of non-autoimmune arthritis patients. Basal levels of thyrotrophin (TSH) were measured using a sensitive chemiluminescence serum TSH assay. Serum antithyroperoxidase and antithyroglobulin (anti-Tg) autoantibodies were measured as well. If TSH values were found to be outside the normal limits, serum total thyroxine, total triiodothyronine (T3), resin T3 uptake, the free thyroxine index (FT4I) and free triiodothyronine index (FT3I) were evaluated. Rheumatoid arthritis patients exhibited statistically significant lower mean TSH values as compared to OA patients. However, RA patients with low TSH values did not have elevated FT4I. Previous use of corticosteroids in some of the RA patients may be responsible for these results. The autoantibodies levels did not differ between the two groups. We conclude that thyroid function screening with sensitive TSH assays is not sufficient for assessment of early stages of autoimmune thyroidopathies in patients with RA. Thyroid hormones should also be estimated.

Arthritis, Rheumatoid↗
PubMed1999

Soluble interleukin 2 receptors' levels versus thyroid hormones levels in nonthyroidal disease.

Serum soluble interleukin-2 receptor levels, basal thyrotropin, total thyroxine, total triiodothyronine and free triodothyronine were assayed in 29--otherwise healthy--patients with pulmonary tuberculosis before initiation of anti-tuberculosis treatment and after two weeks of therapy. Twenty seven out of 29 patients presented low-normal total triiodothyronine levels, showing a statistical elevation after anti-tuberculosis therapy. Total triiodothyronine levels before anti-tuberculosis therapy were inversely correlated with levels of serum soluble interleukin-2 receptors. Further investigation on the relationship between soluble interleukin-2 receptor's levels and thyroid hormones in non-thyroidal disease can be envisaged.

Adult↗
PubMed1999

Combined protocols for myocardial perfusion imaging in patients with hypertension.

OBJECTIVE: Patients diagnosed previously with hypertension submitted to exercise testing for myocardial scintigraphy often respond with excessive elevation of the blood pressure, even when baseline blood pressure is normal, resulting in interruption of the test or false positive results for coronary artery disease. The aim of this study was to evaluate the haemodynamic changes and the safety of the combined examination protocols of dipyridamole plus handgrip exercise and of dipyridamole plus symptom-limited exercise testing on a treadmill in patients with hypertension. METHODS AND RESULTS: We performed scintigraphic myocardial single photon emission computed tomography in 240 patients with hypertension as follows: in 27 patients who were administered dipyridamole alone, in 126 patients who were administered dipyridamole and were also submitted to isometric handgrip exercise and in 87 patients who were administered dipyridamole and were also submitted to treadmill, symptom-limited exercise (modified Bruce protocol). Mean systolic blood pressure, mean diastolic blood pressure and heart rate did not rise excessively in patients submitted to exercise testing (192 +/- 18 mm Hg, 106 +/- 14 mm Hg and 111 +/- 21 bpm for the dipyridamole plus handgrip group and 180 +/- 28 mm Hg, 104 +/- 10 mm Hg and 149 +/- 19 bpm for the dipyridamole plus treadmill group, respectively), with two patients from each exercise group presenting a maximum systolic blood pressure higher than 220 mm Hg and no subsequent major cardiac complications (such as death, myocardial infarction, unstable angina or life-threatening arrhythmia). Moreover, patients in these exercise groups experienced fewer non-cardiac side effects than with dipyridamole alone, while attaining a good level of exercise stress. CONCLUSIONS: Both combined dipyridamole and exercise protocols for scintigraphic myocardial single photon emission computed tomography in patients with hypertension are safe and increase heart rate without an excessive elevation in blood pressure. Consequently, they can be recommended for clinical use. Dipyridamole combined with treadmill, symptom-limited exercise would be the first choice, with dipyridamole and isometric handgrip exercise reserved for patients with physical handicaps.

Adult↗
PubMed1998

Pulmonary tuberculosis and its therapy do not significantly affect thyroid function tests.

Basal thyrotropin, total thyroxine, total tri-iodothyronine and free tri-iodothyronine were measured in 30 HIV-negative patients with focal pulmonary tuberculosis upon starting and after one and two weeks of isoniazid, rifampicin and pyrazinamide therapy. Rapid and statistically significant elevations in free tri-iodothyronine and total tri-iodothyronine were noted after the first and second week of treatment respectively. For most patients, however, hormone levels remained within normal limits throughout the study. Overall, the effects of pulmonary tuberculosis and of its therapy on the thyroid function parameters examined, in otherwise healthy individuals, appear to be minimal.

Adult↗
PubMed1998

Thyroid function and autoimmunity in sarcoidosis: a case-control study.

AIM: To evaluate thyroid function and the presence of antithyroid autoantibodies in patients with sarcoidosis, compared to patients with chronic obstructive pulmonary disease (controls). METHODS: Sera were obtained from 26 patients (19 women and 7 men) with active sarcoidosis, age and sex matched to 26 patients with diagnosed chronic obstructive pulmonary disease. Baseline thyrotropin, total triiodothyronine and thyroxine, antithyroglobulin autoantibodies, and antithyroid peroxidase autoantibodies were analyzed. RESULTS: Only antithyroglobulin autoantibodies were significantly elevated in sarcoidosis patients (p=0.041, Wilcoxon two-sample test). CONCLUSION: Basic thyroid function parameters, with the exception of antithyroglobulin autoantibodies, were within the normal limits in patients with sarcoidosis. Their presence should be interpreted as another characteristic of a generalized immune dysfunction in sarcoidosis. Screening of thyroid disease in patients with sarcoidosis does not seem necessary.

Adult↗