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Stamatios Lerakis

Publications and source records attributed to Stamatios Lerakis.

23 records · Page 2Linked to original sources
PubMed2004

A comparison of HIV-positive patients with and without infective endocarditis: an echocardiographic study--the Emory Endocarditis Group experience.

OBJECTIVE: To determine the clinical features in HIV-positive patients with and without infective endocarditis (IE). PATIENTS AND METHODS: All bacteremic, HIV-positive patients with suspected IE admitted over a four-year period who underwent either transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE) were retrospectively reviewed with regard to clinical, laboratory, and demographic characteristics. RESULTS: Ten (11.5%) of 87 HIV-positive patients had a clinical diagnosis of IE based on the Duke Criteria. The mean age of patients with IE was 37.8 years and without IE 39.9 years (P = NS). Both patient groups were similar with respect to gender, race, IVDA, renal failure requiring hemodialysis, history of predisposing heart disease, origin of infection, and causative organism of infection. The mean CD4 count (cells/microL) was 200.7 in patients with IE and 95.9 in patients without IE (P = NS). Of 10 HIV-positive patients with IE, seven had left-sided heart involvement, two had complications related to IE, three required cardiothoracic surgery, and three died. CONCLUSIONS: There were no differences found with regard to the clinical characteristics of HIV-positive patients with and without IE. No correlation could be drawn between mortality and the degree of immunosuppression in patients from this study. The high incidence of IE (11.5%) and mortality rate (30%) in this study suggests that IE in HIV-positive patients, including non-intravenous drug abusers, represents a real concern for clinicians and their management of these patients.

AIDS-Related Opportunistic Infections↗
PubMed2004

Quinapril, an ACE inhibitor, reduces markers of oxidative stress in the metabolic syndrome.

OBJECTIVE: Patients with the metabolic syndrome often have abnormal levels of proinflammatory and pro-oxidative mechanisms within their vasculature. We sought to determine whether the ACE inhibitor quinapril regulates markers of oxidative stress in the metabolic syndrome. RESEARCH DESIGN AND METHODS: Forty patients with the metabolic syndrome were randomized in a double-blind manner to either the ACE inhibitor quinapril (20 mg/day) or matching placebo for 4 weeks. Serum markers of vascular oxidative stress were measured. RESULTS: After 4 weeks of therapy, serum 8-isoprostane was reduced by 12% in the quinapril group when compared with placebo (quinapril, 46.7 +/- 1.0; placebo, 52.7 +/- 0.9 pg/ml; P = 0.001). Erythrocyte superoxide dismutase activity increased 35% in the quinapril group when compared with placebo (quinapril, 826.3 +/- 17.1; placebo, 612.3 +/- 6.9 units/g Hb; P < 0.001). In addition, lag time to oxidation of LDL, a marker of oxidative stress, was increased by 48% in the quinapril group when compared with placebo (quinapril 89.2 +/- 9.2 vs. placebo 60.1 +/- 12.3 min; P < 0.001). Therapy with quinapril was well tolerated. CONCLUSIONS: The addition of the ACE inhibitor quinapril reduces markers of vascular oxidative stress and may attenuate the progression of the pathophysiology seen in the metabolic syndrome.

Adult↗
PubMed2003

Clinical and transthoracic echocardiographic predictors of abnormal transesophageal findings in patients with suspected cardiac source of embolism.

BACKGROUND: Approximately 20% of cerebral infarctions are caused by a cardiac source of embolism. Although transesophageal echocardiography (TEE) is a valuable tool for evaluating patients with suspected cardioembolism, its use should be more selective. OBJECTIVE: We attempted to determine whether risk factors derived from the clinical, ECG, and transthoracic echocardiogram (TTE) would make TEE use more selective and increase its yield. METHODS: We retrospectively reviewed the records of 108 patients with suspected embolic stroke who had undergone TEE evaluation. We defined the presence of left atrial appendage spontaneous contrast (LAASC), left atrial appendage thrombus (LAAT), patent foramen ovale (PFO), or intraatrial septal aneurysm (IASA) as TEE endpoints suggestive of cardioembolism. We evaluated the association between the TEE endpoints and (1) age greater than 60 years, (2) the presence of atrial flutter (AFl) or atrial fibrillation (AF) on ECG, (3) left ventricular (LV) dysfunction by TTE (mild, LVEF < 40%; severe, LVEF < 25%), and (4) left atrial (LA) size > 4 cm also determined by TTE. The statistical analysis performed was one-way analysis of variance controlling for interactions between different risk factors and the endpoints. RESULTS The strongest independent predictors for the presence of LAASC or LAAT were age greater than 60 years, presence of AFl/AF, and LV systolic dysfunction. There was no association between any of the risk factors with the presence of PFO or IASA. CONCLUSION: This study demonstrates that clinical characteristics, ECG, and TTE findings can help to better select stroke patients for TEE. Future larger studies are needed to provide more supporting data.

Adult↗