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Polyxeni Nicolaidou

Publications and source records attributed to Polyxeni Nicolaidou.

31 records · Page 2Linked to original sources
PubMed2006

Effects of anticonvulsant therapy on vitamin D status in children: prospective monitoring study.

Reports of hypovitaminosis D associated with anticonvulsant drugs in pediatric patients are conflicting. The effects of carbamazepine or sodium valproate on vitamin D status were evaluated prospectively in 51 ambulatory epileptic children who were followed during the first year of the study and in 25 and 6 children during the second and third year, respectively. Serum 25-hydroxyvitamin D, parathyroid hormone, calcium, and phosphorus levels were determined before and every 3 months during anticonvulsant therapy. Our subjects were grouped into four classes (0, 1, 2, and 3 consisted of the patients before and during the first, second, and third years of the treatment, respectively). The control group consisted of 80 healthy children. Comparisons between controls and patients of class 0 for the means for each season of all variables showed no significant differences. A decreasing trend in serum 25-hydroxyvitamin D (P < .03) and an increasing trend in serum parathyroid hormone (P < .04) levels were noticed in all seasons from class 0 to class 3. Twenty-five patients (49%) acquired hypovitaminosis D during the study period. The effects of seasonality on serum 25-hydroxyvitamin D, parathyroid hormone, and calcium were noticed in our patients grouped in classes 0, 2 and 3, as well as in controls. Evidence is provided that carbamazepine or sodium valproate can cause hypovitaminosis D in children.

Anticonvulsants↗
PubMed2005

Serum eosinophil cationic protein and CD23 in acute RSV bronchiolitis.

BACKGROUND: Elevated concentrations of eosinophil cationic protein (ECP) have been found in acute viral wheezing during infancy. Furthermore, RSV infection has been suggested to stimulate type-2 cytokine responses. The aim of this study was to test whether serum ECP and soluble CD23 levels, which are markers of eosinophil and IgE responses, respectively, are elevated in infants hospitalized for acute respiratory syncytial virus (RSV) bronchiolitis. MATERIAL/METHODS: Fifty-five infants aged 1-12 months (median: 4.2 months) consecutively hospitalized for acute bronchiolitis were divided into two groups: RSV-positive (n=26) and RSV-negative patients (n=29). Serum ECP (s-ECP), soluble CD23 (sCD23), and total IgE were measured in all patients and in 23 asymptomatic infants (controls). RESULTS: Lower s-ECP levels were detected in the RSV-positive group (5.4+/-4.3 ng/dl) compared with controls (9.38+/-5.95 ng/dl, p=0.02), but they did not differ significantly from the values of RSV-negative patients (7.8+/-5.7 ng/dl). There was a trend to higher s-ECP values in patients with a positive family history of atopy and/or a history of atopic dermatitis in the RSV-positive group (p=0.06). No differences in sCD23 and total IgE levels among the groups were detected. No correlation between total IgE and sCD23 values was observed. CONCLUSIONS: There is no evidence from our data to suggest that either RSV-positive or RSV-negative acute bronchiolitis is associated with significant eosinophil-mediated degranulation. There is no evidence from the sCD23 data to support the hypothesis that IgE antibody responses are prominent during the acute illness.

Bronchiolitis, Viral↗
PubMed2005

Subjective and objective nasal obstruction assessment in children with chronic rhinitis.

OBJECTIVE: The present study was undertaken, to test the hypothesis that schoolchildren on long-term treatment for chronic rhinitis under-report their nasal congestion. METHODS: Ninety-seven children aged 8.3-15.5 years (median 12.7) with non-purulent perennial rhinitis, for 1.4-8.5 years (median 2.8) self-graded their nasal blockage as "severe" (group-A), "moderate" (group-B), "mild" (group-C) or "absent" (group-D). An additional 48 normal children served as controls (group-E). Subsequently active anterior rhinomanometry for total nasal airway resistance (TNAR) measurement and decongestion test (>20% TNAR fall) were employed as objective means of nasal congestion. RESULTS: Mean pre-decongestion TNAR values did not show any significant difference between the group-A, -B and -C; significant differences were observed between group-A and -D (p=0.04) and between all groups as compared to -E. Positive decongestion test was detected in 57.1%, 53.8%, 48.3%, 32.3% and 10.4% of children in group-A, -B, -C, -D and -E, respectively (group-A, -B, -C versus -E p<0.001, group-D versus -E p=0.03). CONCLUSIONS: Schoolchildren on long-term treatment for perennial rhinitis frequently under-report their symptom of nasal stuffiness.

Adolescent↗
PubMed2005

Mother to child transmission of hepatitis C virus: rate of infection and risk factors.

To determine the rate of mother-to-child transmission of hepatitis C virus (HCV) and identify risk factors associated with HCV transmission we prospectively studied 86 infants born to anti-HCV positive mothers. HCV infection was verified in all mothers before delivery and their HCV viral load was measured at or near delivery using reverse transcription polymerase reaction. For HCV genotyping the INNO-LiPA II probe assay was used. All mothers were tested for HIV infection. Possible risk factors for vertical transmission were recorded. The children were followed up for a minimum of 18 months for evidence of HCV infection, as determined by persistent HCV antibodies, or detection of HCV-RNA. Vertical transmission was restricted to infants born to viraemic mothers and the rate was 3.6% (95% CI 0.004-0.123). The HIV-infected mothers and those using drugs intravenously were more likely to transmit HCV to their children. The infected children had the same genotype as their mothers. Although the HCV RNA titre was higher in mothers who transmitted the virus than in those who did not, the viral load had borderline significance (p=0.08). Viral transmission was not influenced by mother's age, mode of delivery, genotype or type of feeding. Mother-to-child transmission of hepatitis C virus is uncommon and restricted to infants born to HCV viraemic mothers. Active drug use and HIV coinfection increase the risk for HCV vertical transmission.

Adult↗
PubMed2005

Bronchial hyper-responsiveness in selective IgA deficiency.

Secretory IgA in mucosal secretions has a broad protective function. The insufficient protection provided by the respiratory mucosa in children with selective IgA deficiency (sIgAD) might facilitate the development of bronchial hyper-responsiveness (BHR) and consequently asthma symptoms. This study was conducted to clarify the prevalence of BHR in sIgAD children and the relationship with atopic status. A cohort of 20 children (group A) aged 6.4-20.1 yr (median: 12.6) with sIgAD (serum IgA <6 mg/dl) were evaluated for BHR using inhaled hypertonic saline test as well as for atopy by skin prick testing (SPT) to eight common aero-allergens. Seventy other children with normal levels of serum IgA, but sensitized to aero-allergens (group B) and 102 with normal IgA and negative SPTs (group C) were also evaluated. Baseline spirometry demonstrated that forced vital capacity (FVC) values in group A were significantly lower than in C. Forced expiratory volume in 1 s values were similar in all groups, but impairment of the forced expiratory flow over the middle half of the FVC was detected in group B. The prevalence of BHR was similar among group A (30.0%) and group B (35.7%) (p = 0.79) but they differed from group C (5.9%) (p = 0.005). An association between BHR and reported current (p = 0.001) but not lifetime asthma symptoms among group A was also observed. There was no association between atopy and BHR in group A but only to mites' sensitization (p = 0.03). In conclusion, these results indicate that sIgAD constitutes a risk factor for development of BHR but it appears to be related to sensitization to mites.

Adolescent↗
PubMed2005

The role of timely intervention in middle lobe syndrome in children.

STUDY OBJECTIVES: Middle lobe syndrome (MLS) in children is characterized by a spectrum of clinical and radiographic presentations, from persistent or recurrent atelectasis to pneumonitis and bronchiectasis of the right middle lobe (RML) and/or lingula. This study was undertaken to evaluate the effect of early intervention, including fiberoptic bronchoscopy (FOB), in the development of bronchiectasis in MLS. DESIGN: Children with atelectasis of the RML and/or lingula persisting for > 1 month or recurring two or more times despite conventional treatment underwent high-resolution CT (HRCT) scanning and FOB. Appropriate treatment and follow-up were provided, and the effect of the duration of symptoms on clinical outcome and the development of bronchiectasis was investigated. The patient cohort was retrospectively reviewed. PATIENTS: We evaluated 55 children with MLS. The median age at diagnosis, duration of symptoms, and duration of clinical deterioration before diagnosis were 5.5 years (range, 3 months to 12 years), 14.5 months (range, 3 to 48 months), and 8 months (range, 3 to 36 months), respectively. MEASUREMENTS AND RESULTS: FOB revealed marked obstruction in two children (ie, a foreign body and an endobronchial tumor) and positive findings for a culture of BAL fluid in 49.1% of patients. The remaining 53 patients were followed up for a median duration of 24 months (range, 5 to 96 months). The clinical outcome was "cure" in 60.4% of patients, "improvement" in 32.1% of patients, and "no change" in the remaining patients. Bronchiectasis was documented prior to FOB by HRCT scan in 15 patients (27.3%). The duration of the deterioration of symptoms prior to presentation positively correlated with the development of bronchiectasis (p = 0.03) and an unfavorable clinical outcome (ie, improvement or no change) [p = 0.02]; a positive correlation was also found between the duration of symptoms and the development of bronchiectasis (p = 0.04). CONCLUSIONS: Timely medical intervention in patients with MLS that includes FOB with BAL prevents bronchiectasis that may be responsible for an ultimately unfavorable outcome.

Bronchiectasis↗
PubMed2004

Can chest X-ray predict pneumonia severity?

Predictors of the severity of pneumonia have not been thoroughly evaluated among children in developed countries. We investigate whether chest radiographic findings could be used as predictors of severity of childhood pneumonia. The study included 167 children, aged more than 12 months, hospitalized in our department during a 4-year period with unilateral lobar or segmental pneumonia. The durations of fever and of hospitalization were considered indicators of severity of the disease. The size of the consolidation and its location in the left hemithorax were independently associated with severity of the disease. Univariate analysis showed that the mean duration of fever and of hospitalization as well as the prevalence of pleural effusion was significantly higher among children with left-sided pneumonia. A multiple logistic regression analysis revealed that only the presence of pleural effusion was significantly more likely in left-sided pneumonia (odds ratio, 2.65; 95% confidence interval, 1.09-6.47; P = 0.031). We conclude that the size of consolidation and the side of its location can be used as predictors of severity of pneumonia, with left-sided pneumonia running a more severe course, possibly due to increased risk for the development of pleurisy.

Adolescent↗
PubMed2003

Urinary excretion of endothelin-1 in children with absorptive idiopathic hypercalciuria.

Urinary excretion of endothelin-1 (ET-1) and plasma ET-1 were measured in 21 children with absorptive idiopathic hypercalciuria (AIH) and 22 controls. The absorptive type of idiopathic hypercalciuria was determined by a calcium loading test. Daily urinary excretion of ET-1 and urinary ET-1/creatinine ratio were significantly increased ( P=0.005 and P=0.007, respectively) in patients with AIH (9274+/-6444 pg/24 h and 14.04+/-9.52 pg/mg, respectively) compared with controls (4699+/-2120 pg/24 h and 7.36+/-4.71 pg/mg, respectively). Plasma ET-1 levels were significantly lower in patients with AIH (0.84+/-0.64 pg/ml) than in controls (1.54+/-0.54 pg/ml, P=0.0001). In conclusion, patients with AIH had increased urinary ET-1 excretion and decreased plasma ET-1 levels. This is most likely due to the decreased reabsorption of ET-1 in the renal tubule and increased renal production.

Calcium↗
PubMed2003

Mesenteric lymphadenopathy as a cause of abdominal pain in children with lobar or segmental pneumonia.

We investigated whether mesenteric lymphadenopathy could be a cause of abdominal pain in children with lobar or segmental pneumonia. The study population consisted of 1)119 consecutive children with lobar pneumonia, older than 4 years of age, and 2) 31 healthy controls. Demographic, clinical, inflammatory, and radiographic data were recorded in all patients. All study subjects underwent abdominal ultrasound, focusing on the identification of mesenteric lymphadenopathy. One month later, a follow-up ultrasound was performed in patients with enlarged mesenteric lymph nodes at the initial examination. Forty patients complaining of abdominal pain were included in group 1, while the remaining 79 were in group 2. The two groups of patients did not significantly differ regarding their demographic, clinical (other than abdominal pain), and radiographic indices. In contrast, enlarged mesenteric lymph nodes with a sagittal diameter of at least 10 mm were identified significantly more commonly in the children of group 1 (P = 0.001). The association of enlarged lymph nodes with the presence of abdominal pain remained significant when the data were analyzed through multiple regression analysis (odds raio, 1.47; 95% confidence interval, 3-44). Enlarged mesenteric lymph nodes were found in a significantly lower ratio of healthy controls (3/31) compared to that observed in group 1 (P = 0.003). In all patients who were followed up, mesenteric lymph nodes had either decreased or were not detectable. Our findings indicate that mesenteric lymphadenopathy might be considered as a mechanism responsible for the development of abdominal pain in a relatively high percentage of children with pneumonia.

Abdominal Pain↗
PubMed2003

Endothelin-1 in children with acute poststreptococcal glomerulonephritis and hypertension.

BACKGROUND: Endothelin-1 (ET-1), the most potent vasoconstrictor peptide, is known to play a role in arterial hypertension. In patients with acute poststreptococcal glomerulonephritis (APSGN) an increase in the production of ET-1 is suspected due to damaged endothelium, platelet activation and increased thrombin production in the glomeruli. The aim of the present study was to investigate whether the levels of plasma ET-1 are elevated in children with APSGN. Furthermore, we examined the association between plasma ET-1 levels and blood pressure levels in the same children. METHODS: We studied 18 children (14 boys) with APSGN (mean age 7.44 to approximately 2.82 years). Fourteen healthy children served as controls. The following parameters were evaluated: plasma ET-1, plasma atrial natriuretic peptide (ANP), plasma renin (Rn), serum aldosterone (Aldo), creatinine clearance (Ccr) and fractional excretion of sodium (FENa). RESULTS: The mean plasma ET-1 concentrations were higher in patients with APSGN (3.39 to approximately 1.86 pg/mL) compared to controls (1.40 to approximately 0.15 pg/mL; P=0.0001). Patients with APSGN also had higher plasma ANP concentrations (41.67 to approximately 27.99 pg/mL) than the controls (22.80 to approximately 4.24 pg/mL; P=0.011). Plasma Rn concentrations were lower in patients (24.54 to approximately 16.34 microU/mL) compared to controls (56.76 to approximately 32.36 microU/mL; P=0.027). A positive correlation was found between ET-1 plasma concentrations and the height of systolic or diastolic blood pressure (r=0.57, P=0.013 and r=0.53, P=0.023, respectively). CONCLUSIONS: Our results suggest that increased plasma ET-1 concentrations may play an important role in the pathogenesis of hypertension in children with acute poststreptococcal glomerulonephritis.

Acute Disease↗
PubMedDate not supplied

Pseudohypoparathyroidism type Ia and growth hormone deficiency. Growth hormone releasing hormone receptor defect?

We report a boy with pseudohypoparathyroidism (PHP), hypothyroidism and low growth hormone (GH) values with no response to growth hormone releasing hormone (GHRH). He presented at age 17 mo because of developmental delay. He had the typical features (short stature, obesity, round face, brachydactyly) of Albright's hereditary osteodystrophy (AHO) and the biochemical profile of PHP; low serum calcium and high phosphate, raised parathormone (PTH) values and lack of response of urinary phosphate and cyclic AMP to PTH administration. The serum total thyroxine value (T4) was 37.32 nmol/L and the thyroid stimulating hormone (TSH) 29 mU/L. Peak GH values during two provocative tests (Glucagon, L-Dopa) were <2.5 microg/L and <1.7 microg/L, respectively, while following GHRH administration the maximum GH value was 0.2 microg/L. The IGFI value was 65 ng/ml and rose to 253 ng/ml after GH administration for three days. This boy had PTH and TSH receptor defect and we speculate that he also has GHRH receptor defect.

Journal Article↗