Publications (14)42.65 Total impact
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Article: Clarithromycin in treatment of acute asthma exacerbations: principles of appropriate antibiotic.
Pediatric Allergy and Immunology 09/2012; · 2.46 Impact Factor -
Article: Effect of clarithromycin on acute asthma exacerbations in children: an open randomized study.
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ABSTRACT: Asthma exacerbations are major contributors to asthma morbidity and rather difficult to treat. There is inconclusive evidence that macrolide antibiotics may have an effect on asthma exacerbations through their antibacterial and/or anti-inflammatory properties. The aim of the study was to evaluate the efficacy of clarithromycin on medium-term asthma activity when given as an add-on therapy in children with acute asthma. This pilot, open-labeled, randomized, prospective study included 40 school-aged children, with intermittent or mild persistent asthma, presenting with an acute exacerbation. Children were randomized to receive 15 mg/kg of clarithromycin for 3 wk, in addition to their regular (GINA-guided) exacerbation treatment. The microbial trigger of exacerbations was assessed by serology and PCR. Children were followed up with diary cards for 12 wk; lung function was assessed at entry, 3, and 12 wk after the exacerbation. Children in the clarithromycin group had significantly more symptom-free days (78 ± 2 vs. 69 ± 6 days, p < 0.00001) and less total number of periods with loss of control (9 vs. 19, respectively, p = 0.013) during the follow-up period, compared to controls. Moreover, treated children presented reduced duration of the index episode (5.0 ± 1 vs. 7.5 ± 1 days, p < 0.00001). Lung function did not differ between groups. When added to regular treatment, a 3-wk course of clarithromycin was associated with an increase in the number of symptom-free days, reductions in the number and severity of days with loss of control following index episode, and a decrease in the duration of the initial asthma exacerbation.Pediatric Allergy and Immunology 03/2012; 23(4):385-90. · 2.46 Impact Factor -
Article: Immunization of preterm infants with 10-valent pneumococcal conjugate vaccine.
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ABSTRACT: The safety and immunogenicity of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in preterm infants were assessed in this study. Three parallel groups of infants received 3-dose primary immunization with PHiD-CV at 2, 4, and 6 months of age and a booster dose at 16 to 18 months: preterm I (gestation period ≥ 27 and <31 weeks, N = 50); preterm II (≥31 and <37 weeks, N = 87); and term (≥37 weeks, N = 149). Solicited symptoms and adverse events were recorded. Immune responses to PHiD-CV and coadministered vaccine antigens were measured. The incidence of solicited general symptoms was similar across groups, and the frequency of grade 3 general symptoms was low. Incidences of redness and swelling were generally lower in preterm infants. PHiD-CV was immunogenic for each of the 10 vaccine pneumococcal serotypes (postprimary, ≥92.7% of infants reached enzyme-linked immunosorbent assay antibody concentrations ≥ 0.2 μg/mL and postbooster, ≥97.6%) and for protein D, with a trend for lower postprimary geometric mean antibody concentrations and opsonophagocytic activity (OPA) titers in preterm infants for some pneumococcal serotypes. Postbooster, ≥91.9% of subjects in each group had an OPA titer ≥ 8 for each of the vaccine serotypes. Pneumococcal antibody concentrations and OPA titers after priming and booster vaccination were comparable between the 2 preterm groups. PHiD-CV was well tolerated and immunogenic in preterm infants when given as a 3-dose primary vaccination, with robust enzyme-linked immunosorbent assay antibody and OPA booster responses in the second year of life.PEDIATRICS 08/2011; 128(2):e290-8. · 4.47 Impact Factor -
Article: Risk factors and psychosocial characteristics of potential problematic and problematic internet use among adolescents: a cross-sectional study.
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ABSTRACT: Problematic internet use (PIU) is associated with a plethora of psychosocial adversities. The study objectives were to assess the determinants and psychosocial implications associated with potential PIU and PIU among adolescents. A cross-sectional study design was applied among a random sample (n = 866) of Greek adolescents (mean age: 14.7 years). Self-completed questionnaires, including internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire, were utilized to examine the study objectives. Among the study population, the prevalence rates of potential PIU and PIU were 19.4% and 1.5%, respectively. Multinomial logistic regression indicated that male gender (Odds Ratio, OR: 2.01; 95% Confidence Interval, 95% CI: 1.35-3.00), as well as utilizing the internet for retrieving sexual information (OR: 2.52; 95% CI: 1.53-4.12), interactive game playing (OR: 1.85; 95% CI: 1.21-2.82), and socialization, including chat-room use (OR: 1.97; 95% CI: 1.36-2.86) and email (OR: 1.53; 95% CI: 1.05-2.24), were independently associated with potential PIU and PIU. Adolescents with potential PIU had an increased likelihood of concomitantly presenting with hyperactivity (OR: 4.39; 95% CI: 2.03-9.52) and conduct (OR: 2.56; 95% CI: 1.46-4.50) problems. Moreover, adolescent PIU was significantly associated with hyperactivity (OR: 9.96; 95% CI: 1.76-56.20) and conduct (OR: 8.39; 95% CI: 2.04-34.56) problems, as well as comprehensive psychosocial maladjustment (OR: 8.08; 95% CI: 1.44-45.34). The determinants of potential PIU and PIU include accessing the internet for the purposes of retrieving sexual information, game playing, and socialization. Furthermore, both potential PIU and PIU are adversely associated with notable behavioral and social maladjustment among adolescents.BMC Public Health 07/2011; 11:595. · 2.00 Impact Factor -
Article: Evaluation of potential medical and economic benefits of universal rotavirus vaccination in Greece.
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ABSTRACT: To evaluate the potential benefits of introducing universal rotavirus (RV) vaccination in Greece. A decision analytic model was developed to compare the burden and cost of rotavirus gastroenteritis (RVGE) with and without a universal RV vaccination (88% vaccination coverage) for a cohort of children followed from birth until the age of five. Universal RV vaccination would substantially decrease the RVGE burden on the National Health System by reducing RVGE-related hospitalizations/emergency visits and medical consultations by 83% and 75%, respectively. Total RVGE-related costs was estimated at about 7.6 M€ and would be reduced by 5.9 M€ (-78%) if RV vaccination was introduced. A rapid effect is expected with 76% of cases and 84% of costs avoided would be averted within 2 years postvaccine introduction. The societal benefit would also be significant: total annual number of RVGE cases and parent's lost work days would be reduced by 67% and 78%, respectively. Including indirect costs, the total disease cost reduction would be 9 M€. Introduction of universal RV vaccination in Greece could offer considerable medical and economic benefits for the National Health System and society. Potential herd immunity would improve results in favour of vaccination.Acta Paediatrica 01/2011; 100(5):732-9. · 2.07 Impact Factor -
Article: Determinants of Internet addiction among adolescents: a case-control study.
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ABSTRACT: Internet Addiction (IA) is associated with adverse psychosocial development and mental disorders. The study aims were to evaluate the psychosocial profiles and psychiatric comorbidities associated with IA among adolescents. A case-control study was conducted among 129 adolescents in the outpatient setting of the Adolescent Health Unit of the Second University Department of Pediatrics in Athens, Greece. The case group consisted of 86 adolescents with IA as evaluated following psychiatric interview with two independent examiners. The control group consisted of 43 adolescents without IA, frequency matched for age and gender with case group participants. The study findings indicated that adolescents with IA were significantly more likely to have divorced parents (p = 0.012) and/or dysfunctional familial relationships (p < 0.0001). The proportion of adolescents with poor academic performance (p < 0.0001) and unexcused school absences (p = 0.004) was greater among those with IA. Moreover, approximately two-thirds of the adolescents with IA were engaged in high-risk behaviors (p < 0.0001). Finally, adolescents with IA were 3.89 times more likely to present with comorbid psychiatric conditions (CI 95%: 1.19-12.70), including depression (10.5 vs. 0%; p = 0.022). Adolescent IA is associated with deterred familial functions, poor academic performance, engagement in high-risk behaviors, and an augmented likelihood for depression.TheScientificWorldJOURNAL 01/2011; 11:866-74. · 1.66 Impact Factor -
Article: Adolescents dealing with sexuality issues: a cross-sectional study in Greece.
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ABSTRACT: To evaluate the prevalence of sexual activity and contraception methods used by Greek adolescents. To assess the effect of various factors in the decision making on sexual activity. A cross-sectional study design was applied. SETTING-PARTICIPANTS: The population (N = 1538) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. Anonymous self-completed questionnaires were used to assess sexual practices, contraception methods, and factors affecting sexual activity choices. Spearman association calculations and chi-square were used, while regression analysis models were also applied. We examined the sexual practices among Greek adolescents, and indicated the psychosocial factors that may influence adolescents' sexual behavior. 16% of the adolescents have had sexual intercourse, while the boy/girl ratio was 3/1 (P < 0.05). Mean age of sexual debut was 14 +/- 1.5 years. An additional 20% have had any other sexual experience at a mean age 13.5 +/- 1.5 years. Although sexually active adolescents generally use condoms (90.6%), only 32% use them properly (at every and throughout sexual contact). At least half of them do not have adequate protection (no method used or unreliable methods applied), while 8.2% of the girls have used emergency contraception. Adolescents with unstable home environment (divorce, recent death, not living with mother) or sexually experienced peers, as well as those that seek sexual education from siblings or friends have higher possibilities of being sexually active. Greek adolescents can be sexually active at a young age and they need sexual education on safe sex practices.Journal of pediatric and adolescent gynecology 10/2010; 23(5):298-304. · 0.90 Impact Factor -
Article: Adenovirus genome in the placenta: association with histological chorioamnionitis and preterm birth.
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ABSTRACT: Adenovirus is isolated frequently from the amniotic fluid and has been implicated in severe neonatal infections. A case control study was carried out to examine the association of detection of adenovirus in placentas with preterm birth and histological chorioamnionitis. Placentas from preterm and full term deliveries were collected prospectively. Preterm cases were divided into three subgroups according to the gestational age. PCR was carried out on placental tissues for the detection of adenovirus genome. Placentas were evaluated histologically for the presence of chorioamnionitis. Chi-square and odds ratios (OR) were used to determine if detection of adenovirus is associated with preterm birth and histological evidence of inflammation. Seventy-one preterm and 122 full term placentas were studied. Adenovirus genome was detected in 29 (40.8%) of preterm cases and in 25 (20.5%) of the full term controls (OR = 2.6; 95% CI, 1.4-5.1; P = 0.002). Detection of adenovirus in preterm placentas was significantly higher compared to full term particularly in the lower gestational age. Detection of adenovirus in placenta followed the seasonal variation of adenovirus infections. Thirty-seven preterm and 21 full term placentas were also selected for paraffin inclusion and histological examination. Chorioamnionitis was present more frequently in preterm adenovirus-positive placentas compared to preterm adenovirus-negative placentas (75% vs. 36%; P = 0.026) as well as compared to term adenovirus-positive placentas (75% vs. 19%; P = 0.003). This study demonstrates that adenovirus infection of the placenta is associated strongly with histological chorioamnionitis and preterm birth.Journal of Medical Virology 08/2010; 82(8):1379-83. · 2.82 Impact Factor -
Article: Adolescent pornographic internet site use: a multivariate regression analysis of the predictive factors of use and psychosocial implications.
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ABSTRACT: The study objectives were to evaluate the prevalence, predictors, and implications of pornographic Internet site (PIS) use among Greek adolescents. A cross-sectional study was conducted among 529 randomly selected Greek high school students. The prevalence of overall PIS use was 19.47% (n = 96). Among PIS users, 55 (57.29%) reported infrequent and 41 (42.71%) reported frequent PIS use. The predictors of infrequent PIS use included male gender (adjusted odds ratio [AOR] = 8.33; 95% confidence interval [CI] = 3.52-19.61), Internet use for sexual education (AOR = 5.26; 95% CI = 1.78-15.55), chat rooms (AOR = 2.95; 95% CI = 1.48-5.91), and purchases (AOR = 3.06; 95% CI = 1.22-7.67). The predictors of frequent PIS use were male gender (AOR = 19.61; 95% CI = 4.46-83.33), Internet use for sexual education (AOR = 7.39; 95% CI = 2.37-23.00), and less than 10 hours per week Internet use (AOR = 1.32; 95% CI = 1.10-1.59). Compared to non-PIS users, infrequent PIS users were twice as likely to have abnormal conduct problems (odds ratio [OR] = 2.74; 95% CI = 1.19-6.28); frequent PIS users were significantly more likely to have abnormal conduct problems (OR = 4.05; 95% CI = 1.57-10.46) and borderline prosocial score (OR = 4.22; 95% CI = 1.64-10.85). Thus, both infrequent and frequent PIS use are prevalent and significantly associated with social maladjustment among Greek adolescents.Cyberpsychology & behavior: the impact of the Internet, multimedia and virtual reality on behavior and society 09/2009; 12(5):545-50. · 1.59 Impact Factor -
Article: Detection of cytomegalovirus, parvovirus B19 and herpes simplex viruses in cases of intrauterine fetal death: association with pathological findings.
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ABSTRACT: There are previous indications that transplacental transmission of cytomegalovirus (CMV), parvovirus B19 (PB19) and herpes simplex virus types 1 and 2 (HSV-1/2) cause fetal infections, which may lead to fetal death. In a prospective case-control study we examined the incidence of these viruses in intrauterine fetal death and their association with fetal and placenta pathological findings. Molecular assays were performed on placenta tissue extracts of 62 fetal deaths and 35 controls for the detection of CMV, PB19 and HSV-1/2 genomes. Formalin-fixed, paraffin-embedded liver, spleen and placenta tissues of fetal death cases were evaluated histologically. Thirty-four percent of placental specimens taken from intrauterine fetal deaths were positive for any of the three viruses (16%, 13%, and 5% positive for CMV, PB19, and HSV-1/2, respectively), whereas only 6% of those taken from full term newborns were positive (P = 0.0017). No dual infection was observed. This difference was also observed when fetal deaths with a gestational age <20 weeks or a gestational age >20 weeks were compared with the controls (P = 0.025 and P = 0.0012, respectively). Intrauterine death and the control groups differed in the detection rate of CMV DNA (16% and 3%, respectively; P = 0.047), which was more pronounced in a gestational age >20 weeks (P = 0.03). Examination of the pathological findings among the PCR-positive and PCR-negative fetal deaths revealed that hydrops fetalis and chronic villitis were more common among the former group (P = 0.0003 and P = 0.0005, respectively). In conclusion, an association was detected between viral infection and fetal death, which was more pronounced in the advanced gestational age. Fetal hydrops and chronic villitis were evidently associated with viral DNA detection in cases of intrauterine death.Journal of Medical Virology 10/2008; 80(10):1776-82. · 2.82 Impact Factor -
Article: Internet use and misuse: a multivariate regression analysis of the predictive factors of internet use among Greek adolescents.
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ABSTRACT: The internet is an integral tool for information, communication, and entertainment among adolescents. As adolescents devote increasing amounts of time to utilizing the internet, the risk for adopting excessive and pathological internet use is inherent. The study objectives include assessing the characteristics and predictors of excessive internet use and evaluating the prevalence of pathological internet use among Greek adolescents. A cross-sectional study design was applied to this effect. The study population (n = 897) consisted of a random sample of adolescents residing in Athens, Greece. Self-completed questionnaires, pertaining to internet access characteristics and Young's Internet Addiction Scale (YIAS) score, were applied in order to investigate the study objectives. The multivariate regression analysis indicated that the most significant predictors of overall internet use included accessing the internet via one's own home portal and for the purpose of social interaction. Internet access via the school environment was a significant deterrent among low (1-3 h/week) internet users, while access via internet cafés was a significant predictor for high (11-20 h/week) internet users. Moreover, accessing the internet for the purposes of game playing was the most significant predictor for excessive (>20 h/week) internet use. The prevalence of borderline internet use among the study population was 12.8%, while 1.00% reported addictive internet use. Also, 10.4% of male excessive internet users reported addictive internet use (p < 0.0001). In conclusion, excessive internet use is predicted solely by the location of internet access (own home portal) and the scope of internet use (i.e., sites relating to socialization and game playing) and may lead to internet addiction, particularly among male adolescents.European Journal of Pediatrics 09/2008; 168(6):655-65. · 1.88 Impact Factor -
Article: Does respiratory syncytial virus subtype influences the severity of acute bronchiolitis in hospitalized infants?
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ABSTRACT: Respiratory syncytial virus (RSV) subtypes A and B are present either simultaneously or alternate during yearly epidemics. It is still not clear whether clinical severity of acute bronchiolitis differs between the two subtypes. Reverse transcription polymerase chain reaction was used to subtype RSV in previously healthy infants hospitalized with RSV bronchiolitis during a winter epidemic. A severity index based on heart rate, respiratory rate, wheezing, difficulty in feeding and oxygen saturation was calculated upon admission. Infants infected with RSV subtype-A were found to have a significantly higher (more severe) clinical score than those infected with RSV-B. There was no statistically significant difference in duration of hospitalization or need of intensive care. Boys and infants younger than 3 months of age were also more severely affected than girls or older infants, respectively. These results support the notion that RSV-A-induced bronchiolitis is more severe than RSV-B-induced one, in agreement with the majority of previously published studies.Respiratory Medicine 10/2004; 98(9):879-82. · 2.47 Impact Factor -
Article: Human Metapneumovirus as a causative agent of acute bronchiolitis in infants.
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ABSTRACT: Human Metapneumovirus (hMPV), has been recently isolated from children with acute respiratory tract infections (RTIs), including bronchiolitis, and classified in the Pneumovirinae subfamily within the Paramyxoviridae family. Since most bronchiolitis studies fail to detect any viral pathogen in part of the samples, we sought for the presence of hMPV in a well characterized bronchiolitis cohort. Nasal washes were obtained from 56 children admitted to the hospital for acute bronchiolitis. RNA extraction and subsequent RT-PCR were used to detect hMPV, and correlated the presence of the virus with clinical characteristics of the disease. PCR revealed the presence of hMPV in 16% of bronchiolitis cases, whereas respiratory syncytial virus (RSV; 67.9%) was the most frequently encountered viral pathogen. hMPV was identified either as a unique viral pathogen or co-existed with RSV, with whom they shared a similar seasonal distribution. There were no differences in disease characteristics, either clinical or laboratory, between bronchiolitis cases where hMPV was present and those caused by RSV or other viral pathogens. These findings suggest that hMPV is a common and important causative agent in infants with bronchiolitis, with clinical characteristics similar to that of RSV.Journal of Clinical Virology 08/2004; 30(3):267-70. · 3.97 Impact Factor -
Article: Association of rhinovirus infection with increased disease severity in acute bronchiolitis.
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ABSTRACT: Respiratory syncytial virus (RSV) is the major pathogen responsible for acute bronchiolitis in infancy. However, evaluation of the relative importance of rhinovirus or multiple viral infections has been hampered by the lack of sensitive diagnostic methodologies. Therefore, in this study we used the reverse transcription-polymerase chain reaction for 11 respiratory pathogens to assess the etiology in infants with acute bronchiolitis and correlate it with clinical characteristics of the disease. Viruses were detected in 73.7% of patients. RSV was identified in 72.4% of virologically confirmed cases, rhinovirus in 29%, whereas multiple infections represented 19.5% of cases, most of which (69%) were combinations of rhinovirus with RSV. In a logistic regression model controlling for age, sex, birth weight, presence of fever, and day of disease on admission, the presence of rhinovirus was found to increase by approximately five-fold, the risk for severe disease. Multiple pathogens had a similar trend in the univariate analysis, which was eliminated in the multivariate model. Multiple virus cases were admitted to the hospital later in the course of their disease than unique pathogen cases, suggesting successive infections. In conclusion, rhinovirus is second only to RSV as a causative agent of bronchiolitis and is associated with more severe disease. The presence of more than one pathogen may influence the natural history of acute bronchiolitis.American Journal of Respiratory and Critical Care Medicine 06/2002; 165(9):1285-9. · 11.08 Impact Factor
Top co-authors
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Institutions
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2012
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Harokopion University of Athens
Athens, Attiki, Greece
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2002–2011
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National and Kapodistrian University of Athens
- Faculty of Medicine
Athens, Attiki, Greece
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