Epameinondas Zakynthinos

Publications (8)22.06 Total impact

• Source

  Available from: Zoe Daniil

  Article: Ocular disease awareness and pattern of ocular manifestation in patients with biopsy-proven lung sarcoidosis.

  Maria Pefkianaki, Sofia Androudi, Anna Praidou, Vasileios Sourlas, Epameinondas Zakynthinos, Periklis Brazitikos, Konstantinos Gourgoulianis, Zoe Daniil
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  ABSTRACT: The aim of this research is to study the patterns of ocular involvement in patients with biopsy-proven lung sarcoidosis and estimate the level of patients' awareness of possible ocular complications of sarcoidosis. Fifty patients with biopsy-proven lung sarcoidosis were referred from the Department of Respiratory Medicine, University Hospital of Larissa, Greece. The most prominent ocular symptom was foreign body sensation in 15/50 patients (30%); only 6/50 of our patients (12%) were completely asymptomatic with respect to ocular symptoms. Anterior segment findings were: episcleritis in 8/50 patients (16%), iris nodules in 9/50 patients (18%), and cataract in 19/50 patients (38%). Periphlebitis was observed in 8/50 patients (16%), periarteritis in 8/50 patients (16%), epiretinal membrane in 6/50 patients (12%), and branch retinal vein occlusion in 7/50 of our patients (14%). Ten out of 50 patients (20%) had never visited an ophthalmologist before, whereas eight out of 50 patients (16%) had undergone an ophthalmic exam more than 2 years ago. Eye involvement is common in patient with biopsy-proven lung sarcoidosis and may occur even without prominent ocular symptoms.
  Journal of ophthalmic inflammation and infection. 07/2011; 1(4):141-5.
• Article: Sepsis-associated takotsubo cardiomyopathy can be reversed with levosimendan.

  Marios Karvouniaris, John Papanikolaou, Demosthenes Makris, Epameinondas Zakynthinos
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  ABSTRACT: Sepsis is a stressful physical condition, and at the acute phase, overstimulation of the sympathetic nervous system may occur; these events have the potential to induce cardiomyopathy. Takotsubo cardiomyopathy (TTC) is a form of catecholamine-induced cardiomyopathy, which occurs very rarely in sepsis. However, TTC management in critically ill patients with sepsis may be challenging because the use of exogenous catecholamines for circulatory support might augment further TTC. Herein, we report a rare case of TTC after urosepsis; and we point out that cardiac function may improve after catecholamine withdrawal and the application of calcium channel sensitizer levosimendan.
  The American journal of emergency medicine 04/2011; 30(5):832.e5-7. · 1.54 Impact Factor
• Source

  Available from: cnrs.fr

  Article: Correlation of urinary excretion of sodium with severity of sleep-disordered breathing in children: a preliminary study.

  Athanasios G Kaditis, Emmanouel I Alexopoulos, Konstantinos Evangelopoulos, Eleni Kostadima, Vasiliki Varlami, Evangelos Boultadakis, Nikolaos Liakos, Epameinondas Zakynthinos, Elias Zintzaras, Konstantinos Gourgoulianis
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  ABSTRACT: Nocturnal urinary sodium excretion is related to blood pressure (BP) levels. Elevated BP and increased nocturnal natriuresis have been demonstrated in adults with sleep apnea. Although evidence indicates increased BP in children with obstructive sleep-disordered breathing (SDB), it is unknown whether these children have also enhanced urinary sodium excretion. To evaluate the effects of SDB and morning BP on urinary sodium excretion. Consecutive children with snoring (n = 95) underwent polysomnography and morning BP measurement. Fractional excretion of sodium (FE(Na)) was the primary outcome measure and was calculated using sodium and creatinine concentrations in early morning serum and urine specimens. Subjects with moderate-to-severe SDB had similar log-transformed FE(Na) to that of children with mild SDB and higher than children with primary snoring: -0.13 ± 0.53 versus -0.28 ± 0.41 versus -0.61 ± 0.65 (P = 0.657 and P = 0.003). Obstructive apnea-hypopnea index was significantly related to FE(Na) after adjustment for age, gender and body mass index z-score (P = 0.002). Children with moderate-to-severe SDB had similar systolic BP z-scores to those of subjects with mild SDB and higher than participants with primary snoring: 0.7 ± 1.2 versus 0.1 ± 1.0 versus -0.02 ± 1.0 (P = 0.074 and P = 0.046). In addition, participants with diastolic BP z-scores in the upper quartile of measured values had higher FE(Na) than subjects with z-scores in the lower quartiles: -0.08 ± 0.39 versus -0.41 ± 0.57 (P = 0.007). Morning natriuresis is related to severity of SDB in children and this association may be mediated in part by elevated BP.
  Pediatric Pulmonology 10/2010; 45(10):999-1004. · 2.53 Impact Factor
• Article: Effects of obstructive sleep apnea severity on serum lipid levels in Greek children with snoring.

  Emmanouel I Alexopoulos, Eleftheria Gletsou, Eleni Kostadima, Dimitrios Kaditis, Epameinondas Zakynthinos, Konstantinos Gourgoulianis, Athanasios Kaditis
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  ABSTRACT: Although obstructive sleep apnea (OSA) is related to dyslipidemia in adults, limited data are available regarding its effects on serum lipids during childhood. Aim of this study was to assess the potential relationships between severity of OSA and cholesterol or triglyceride levels in a cohort of Greek children. Data from children with snoring who underwent polysomnography and complete serum lipids measurements during a specified study period were analyzed retrospectively. Overall, obese children (n = 261) had lower HDL cholesterol levels than non-obese subjects (n = 113) (49.6 ± 10.5 vs. 53.9 ± 11.4 mg/dL; p = 0.001) and higher triglyceride concentrations (69.8 ± 32.2 vs. 63.2 ± 27 mg/dL; p = 0.041). Non-obese subjects with moderate-to-severe OSA did not differ in triglycerides, total, and LDL cholesterol concentrations but had lower HDL cholesterol, when compared to non-obese children with primary snoring/mild OSA (50.4 ± 13.1 vs. 54.9 ± 10.7 mg/dL; p = 0.008). The risk for having low HDL cholesterol (≤40 mg/dL) was threefold higher in non-obese subjects with moderate-to-severe OSA than in those with primary snoring/mild OSA, even after adjustment for age and gender [OR = 3.44 (95% CI 1.44 to 8.24; p = 0.006)]. Concentrations of serum lipids in obese children were not associated with severity of OSA. HDL cholesterol was 48.5 ± 8.7 mg/dL in subjects with moderate-to-severe OSA and 50.0 ± 11.1 mg/dL in children with primary snoring/mild OSA (p = 0.519). HDL cholesterol levels are inversely related to severity of OSA in non-obese children with snoring.
  Sleep And Breathing 09/2010; 15(4):625-31. · 1.84 Impact Factor
• Article: A 73-year-old woman with tracheobronchiomalacia.

  Demosthenes Makris, Andreas Dimoulis, Charles-Hugo Marquette, Epameinondas Zakynthinos
  European Journal of Intensive Care Medicine 08/2010; 36(8):1441-2. · 5.17 Impact Factor
• Article: Cardiac systolic function in Greek children with obstructive sleep-disordered breathing.

  Athanasios G Kaditis, Emmanouel I Alexopoulos, Melina Dalapascha, Konstantinos Papageorgiou, Eleni Kostadima, Dimitrios G Kaditis, Konstantinos Gourgoulianis, Epameinondas Zakynthinos
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  ABSTRACT: Obstructive sleep-disordered breathing (SDB) in children has been associated with increased ventricular strain and decreased left ventricle (LV) diastolic function. The aim of this study was to assess systolic myocardial function in children with SDB of variable severity. Children who were referred for polysomnography during the study period underwent echocardiography (two-dimensional, Doppler and tissue Doppler imaging). A total of 46 subjects (age 6.4+/-2.6years) were recruited. Fourteen of them had moderate-to-severe SDB (obstructive apnea-hypopnea index (OAHI): 16.6+/-11.6 episodes/h), 13 children had mild SDB (OAHI: 3.1+/-0.7 episodes/h) and 19 subjects had primary snoring (OAHI: 1.2+/-0.6 episodes/h). Children with moderate-to-severe SDB had significantly lower LV shortening fraction (SF) and ejection fraction (EF) than subjects with primary snoring (p<0.05). SF in moderate-to-severe SDB, mild SDB and primary snoring groups was: 34.3+/-5.5%, 36.9+/-3.2% and 37.7+/-4.4%, respectively, and EF: 66.9+/-7.9%, 71.7+/-6.4% and 72.3+/-5.9%, respectively. OAHI, age, and systolic blood pressure were significant predictors of SF and EF (p<0.01). In children with obstructive SDB, LV systolic function is inversely associated with severity of intermittent upper airway obstruction during sleep.
  Sleep Medicine 02/2010; 11(4):406-12. · 3.40 Impact Factor
• Article: Systemic and airway inflammation and the presence of emphysema in patients with COPD.

  Andriana I Papaioannou, Argyro Mazioti, Theodoros Kiropoulos, Irini Tsilioni, Angela Koutsokera, Kalliopi Tanou, Dimitrios J Nikoulis, Panagiotis Georgoulias, Epameinondas Zakynthinos, Konstantinos I Gourgoulianis, Konstantinos Kostikas
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  ABSTRACT: The aim of this study was to determine the impact of HRCT-confirmed emphysema on biomarkers evaluating airway and systemic inflammation in COPD patients. Forty-nine consecutive male COPD outpatients with stable COPD were divided in two groups according to the presence or absence of emphysema on HRCT. Patients underwent pulmonary function tests, plus assessment of exercise capacity, body composition and quality of life. Biomarkers were measured in serum (CRP, interleukin-6, TNF-alpha, leptin, adiponectin, osteocalcin, insulin growth factor-1, and systemic oxidative stress), in plasma (fibrinogen and VEGF) and in whole blood (B-type natriuretic peptide). TNF-alpha, 8-isoprostane and pH were additionally measured in exhaled breath condensate. Patients with emphysema had more severe lung function impairment, lower body-mass index and fat-free mass index, and poorer quality of life. Additionally, they presented increased systemic oxidative stress and plasma fibrinogen and lower BNP compared to patients without emphysema. After proper adjustment for disease severity, all differences remained with the exceptions of body-mass index, fat-free mass index and BNP. COPD patients with HRCT-confirmed emphysema present increased systemic oxidative stress and fibrinogen, suggesting that they may be more prone to the systemic consequences of COPD compared to patients without emphysema.
  Respiratory medicine 10/2009; 104(2):275-82. · 2.33 Impact Factor
• Article: Overnight change in brain natriuretic peptide levels in children with sleep-disordered breathing.

  Athanasios G Kaditis, Emmanouel I Alexopoulos, Fotini Hatzi, Eleni Kostadima, Maria Kiaffas, Epameinondas Zakynthinos, Konstantinos Gourgoulianis
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  ABSTRACT: Obstructive sleep-disordered breathing is accompanied by episodic increases in left ventricle afterload due to large negative swings in intrathoracic pressure and repetitive surges in arterial pressure. Brain natriuretic peptide (BNP) is released by ventricular myocytes in response to pressure and volume overload. It was hypothesized that in children with snoring, overnight change in BNP levels is correlated with severity of disturbance in respiration. Evening and morning plasma levels of BNP were measured in children with snoring referred for polysomnography. A sleep disorders laboratory in a university hospital. Twenty-two children with apnea-hypopnea index (AHI) > or = 5/h (mean +/- SD age, 6.4 +/- 2.5 years), 60 children with AHI < 5/h (mean age, 7 +/- 2.9 years), and 27 control subjects without snoring (mean age, 7.8 +/- 3.7 years) were recruited. Overnight change in BNP (log-transformed ratio of morning-to-evening levels) was larger in children with AHI > or = 5/h, compared to those with AHI < 5/h or to control subjects (0.1 +/- 0.19 vs 0.01 +/- 0.14 vs - 0.06 +/- 0.18; p < 0.05). Children with AHI > or = 5/h had an odds ratio of 4.33 (95% confidence interval, 1.34 to 14) for change in peptide levels > 0.15 relatively to subjects with AHI < 5/h. AHI and oxygen saturation of hemoglobin nadir were significant predictors of overnight change in peptide levels. In children with snoring, overnight increase in BNP levels is correlated with severity of disturbance in respiration during sleep, which may indicate presence of nocturnal cardiac strain.
  Chest 12/2006; 130(5):1377-84. · 5.25 Impact Factor