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Biomedical subjects

Ioanna Mitrouska

Publications and source records attributed to Ioanna Mitrouska.

7 recordsLinked to original sources

Genital tuberculosis in a tamoxifen-treated postmenopausal woman with breast cancer and bloody vaginal discharge.

BACKGROUND: Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries. CASE PRESENTATION: A 61-year-old postmenopausal woman who had undergone surgery and treated with adjuvant chemotherapy for infiltrating ductal carcinoma of the breast five years ago, presented with bloody vaginal discharge, fatigue, weight loss, and low grade fevers at night for two months. Histological examination of the endometrium, done based on the suspicion of a second primary cancer due to the tamoxifen therapy, revealed a granulomatous reaction. Liquid and solid mycobacterial cultures of the tissues were performed. Although the acid fast staining was negative, the liquid culture was positive for Mycobacterium tuberculosis. Involvement of other systems was not detected. The patient was treated with a three-drug antituberculosis regimen for 9 months and recovered fully. CONCLUSION: Female genital tuberculosis is a rare but curable disease that should be included in the differential diagnosis of women with menstrual problems. Early diagnosis is important and may prevent unnecessary invasive procedures for the patient.

Anti-Bacterial Agents↗

Peripheral arterial embolism due to a left ventricular diverticulum in a young adult.

A 32-year-old man was admitted to the emergency department of our hospital after experiencing a peripheral arterial embolism. Investigation of the possible embolic sources in an otherwise asymptomatic patient revealed the existence of a left ventricular diverticulum. The left ventricular diverticulum is a rare congenital anomaly, either isolated or as a part of a syndrome including other congenital malformations. The treatment of choice, especially in symptomatic patients, is surgical resection, while in asymptomatic patients anticoagulation therapy is indicated.

Adult↗

Is there any correlation between the ATS, BTS, ERS and GOLD COPD's severity scales and the frequency of hospital admissions?

Disagreement exists between different COPD guidelines considering classification of severity of the disease. The aim of our study was to determine whether there is any correlation between severity scales of various COPD guidelines (ATS, BTS, ERS and GOLD) and the frequency of hospitalisations for COPD exacerbation. A cohort of 67 COPD patients (65 male 2 female, 45 ex-smokers, 22 current smokers, aged (69.4 +/- 1.1)) was recruited from those admitted in the pulmonary clinic of the University Hospital of Heraklion, Crete for an acute exacerbation. Lung function tests and arterial blood gases analyses were performed during stable conditions at a scheduled visit 2 months after discharge. The patients were stratified using the FEV1 percent-predicted measurement of this visit into mild, moderate and severe in accordance to the ATS, BTS, ERS and GOLD scales of severity. The number of hospitalisations for acute exacerbation was recorded for the following 18 months. A total of 165 exacerbations were recorded. The correlation between the severity of COPD and the number of hospitalisations per year was statistically significant using the GOLD classification system of severity (P = 0.02 and r = 0.294). A weak correlation was also found between the number of hospitalisations and the ERS classification system (P = 0.05 and r = 0.24). No statistically significant correlation was found between the number of hospitalisations and the ATS or BTS severity scales. In conclusion the GOLD and ERS classification systems of severity of COPD correlated to exacerbations causing hospitalisation. The same was not true for the ATS and BTS severity scales. Better correlation was achieved with the GOLD scale.

Forced Expiratory Volume↗

Effects of theophylline on ventilatory poststimulus potentiation in patients with brain damage.

Patients with brain damage, in contrast to normal subjects, exhibit a significant ventilatory undershoot when brief hypocapnic hypoxia is terminated abruptly by hyperoxia. This has been attributed to an impairment of activation of short-term potentiation, a brain stem mechanism promoting breathing stability. We hypothesized that in these patients theophylline, a drug that stabilizes breathing, may affect short-term potentiation. Eight stable patients with brain damage and 10 normal adults were studied. Activation of short-term potentiation was examined by brief exposure to hypoxia followed by hyperoxia after pretreatment with placebo or theophylline. Both in patients and normal subjects at the end of hypoxia ventilation increased to a similar magnitude with and without theophylline. In normal subjects independent of pretreatment, when hypoxia was terminated abruptly by hyperoxia, ventilation declined slowly to baseline without an undershoot, indicating activation of short-term potentiation. In patients with placebo, ventilation upon switching to hyperoxia exhibited a significant undershoot. This undershoot was significantly attenuated by theophylline, although compared with normal subjects, a slight hypoventilation was observed. We conclude that in patients with brain damage, theophylline largely prevents the hyperoxic drop of ventilation, presumably by affecting the activation of short-term potentiation. This may underlie the beneficial effect of theophylline on breathing stability.

Double-Blind Method↗

Vascular-specific growth factor mRNA levels in the human diaphragm.

BACKGROUND: Angiogenesis is an adaptation mechanism of skeletal muscles to increased load. Animal data have shown increased vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and transforming growth factor-beta(1) (TGF-beta(1)) mRNA levels in the diaphragm as a result of increased minute ventilation, but there are no data concerning the human diaphragm. OBJECTIVES: The purpose of this study was to investigate the VEGF, bFGF, TGF-beta(1) mRNA levels in the human diaphragm of normal subjects and patients with altered respiratory mechanics. METHODS: We studied 9 patients with chronic obstructive pulmonary disease (COPD), 4 obese patients and 12 controls. We performed multiplex semiquantitative reverse transcription polymerase chain reaction to determine the VEGF, bFGF and TGF-beta(1) mRNA levels in specimens taken from their diaphragm. RESULTS: VEGF mRNA levels were 18% higher in COPD patients compared with controls (p = 0.04), while for the obese patients, these levels were not statistically significantly different. bFGF and TGF-beta(1) mRNA levels in COPD patients or obese individuals compared with controls did not differ significantly either. CONCLUSIONS: The results of our study showed that TGF-beta(1), VEGF and bFGF mRNA was detected in the human diaphragm. The VEGF levels were higher in COPD patients than in normal subjects. This upregulation of VEGF may suggest an enhancement of angiogenesis in the diaphragm in COPD patients.

Adult↗