D Hasiakos

Athens State University, Athens, Alabama, United States

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Publications (32)29.21 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare maternal and neonatal oxygenation and acid-base status after elective cesarean section (CS) under different anesthetic techniques. Three hundred and eighty parturients undergoing elective cesarean section were randomly assigned to receive general (GA, n =140), epidural (EA, n = 117) or subarachnoid anesthesia (SA, n =123). Blood gases, oxygen content, and acid-base status parameters were measured in maternal artery and umbilical cord vessels. Neonatal Apgar scores were also recorded. Umbilical artery pH, HCO3-, and actual base excess (ABE) were significantly higher in the GA compared to SA group (p < 0.001, p < 0.05, andp < 0.05, respectively). Umbilical vein ABE was lower in the SA compared to GA and EA groups (p < 0.05). Oxygen content in maternal artery was higher in the GA and EA groups compared to the SA group (p < 0.05). Neonatal oxygen content in both cord vessels was higher in the GA group compared to EA and SA groups (p < 0.05). Umbilical venous-arterial difference of PO2, oxygen content, and Apgar scores did not differ significantly among groups. Neonatal oxygenation and acid-base status values were better preserved when GA was administered for elective CS compared to regional modalities. Apgar scores and neonatal outcomes were not affected by the anesthetic technique.
    Clinical and experimental obstetrics & gynecology 01/2013; 40(3):367-71. · 0.38 Impact Factor
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    ABSTRACT: To report our experience of autopsied cases of fetal cystic hygroma (CH) and discuss the role of fetal autopsy in genetic counseling. A review of autopsy reports at our institution revealed 18 cases of fetal CH over a 10-year period (from 2000 to 2010). The clinical data, results of cytogenetic analysis and prenatal ultrasound findings were also retrieved and compared to the autopsy findings. Fetal death was due to intrauterine death in eight cases, therapeutic abortion in eight cases and spontaneous abortion in two cases. Cytogenetic analysis was available in 12 cases, and the results showed an abnormal karyotype in seven cases (5 cases of Turner syndrome and 2 cases of trisomy 21). The mean size of CH was 5.4 cm. Other malformations or findings suggestive of the cause of fetal death were diagnosed in 10/18 cases (55.6%). The most common autopsy findings were hydrops and central nervous system anomalies. The autopsy findings were in agreement with the prenatal ultrasound findings in 13/18 cases (72.2%), while in five cases (27.8%) additional findings were detected during autopsy. The most common placental abnormalities were infarcts and calcifications. In addition to prenatal diagnostic studies, fetal autopsy and pathologic examination of fetal and placental tissues may help to establish the exact cause of death and disclose important information as to the presence of various fetal malformations or placental abnormalities.
    Clinical and experimental obstetrics & gynecology 01/2012; 39(3):369-73. · 0.38 Impact Factor
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    ABSTRACT: Postpartum mood disturbances are common among Greek women, with postpartum depression (PPD) being as high as 19%. This study aimed to investigate whether sex steroid hormone levels affect the incidence of postpartum mood disturbances. Fifty-seven women were evaluated for postpartum mood disturbances using the Postpartum Blues Questionnaire and the Edinburgh Postnatal Depression Scale on the 1st and 6th week. Serum estradiol, progesterone and testosterone concentrations were measured upon admission for delivery and daily until the fourth postpartum day. We then studied the association between hormone levels and the scores in the two psychometric scales. Testosterone was the only hormone that was marginally associated with psychometric scoring in simple regression analysis. (Postpartum Blues during days 1-4: b = 4.291, 95% C.I. -0.796 to 9.377 and p-value = 0.096). Women with lower testosterone drops had higher scores in Postpartum Blues Questionnaire. This association, however, lost statistical significance in the multivariable analysis after adjusting for pregnancy duration. In multiple regression analysis, only pregnancy duration had the most constant adverse effect on psychometric scores: The shorter the duration of pregnancy, the higher the scores for Postpartum Blues. (r = -0.39, p < 0.01). Our findings do not indicate an association between the occurrence of postpartum mood disorders and sex steroid hormone levels. Preterm labour may be associated with a higher risk of postpartum mood disturbances.
    Gynecological Endocrinology 08/2011; 27(8):543-50. · 1.30 Impact Factor
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    ABSTRACT: Background: Peutz-Jeghers syndrome is a rare syndrome which is inherited in a dominant manner. It is characterized by hamartomatous polyps of the gastrointestinal tract, hyperpigmented macules of the oral mucosa and an increased risk of developing neoplasms in the gastrointestinal tract, pancreas, breast and genital system. Women with Peutz-Jeughers syndrome often develop an ovarian sex cord tumor and cervical adenocarcinoma of minimal deviation adenoma malignum type. A case of a 58-year-old patient with Peutz-Jeghers syndrome and history of multiple malignancies (thyroid, breast and colon cancer) who presented with metrorrhagia is reported. The dilatation and curettage revealed endometrial adenocarcinoma. The patient underwent total abdominal hysterectomy with bilateral oophorectomy. The histologic examination showed an endometrioid endometrial adenocarcinoma that developed in atypical endometrial hyperplasia. The histologic examination of the right ovary revealed a sex cord tumor with annular tubules, measuring 3 cm. Sex cord tumors with annular tubules in patients with Peutz-Jeghers syndrome are usually small, bilateral tumors of the ovaries which have common characteristics with granulosa cell tumor and Sertoli cell tumor. Hyperestrogenism is a rather common finding with development of estrogen-dependent lesions.
    European journal of gynaecological oncology 01/2011; 32(4):452-4. · 0.58 Impact Factor
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    ABSTRACT: Clear cell cervical adenocarcinoma (CCA) is a rather rare malignancy of the genital tract. We report six cases of CCA, diagnosed in our laboratory during a 15-year period: five patients with sporadic primary CCA and one young patient with CCA and a history of in utero exposure to DES. The possible DES exposure, clinicopathological findings as well as the differential diagnosis and the the prognosis of such patients are presented in a mini-review of the literature.
    European journal of gynaecological oncology 01/2011; 32(1):107-10. · 0.58 Impact Factor
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    ABSTRACT: Angiomyofibroblastoma is a rare benign distinctive mesenchymal tumor that occurs in the genital pelviperineal region, commonly the vulva and vagina. We report a case of angiomyofibroblastoma in a 42-year-old woman, presenting as a "cystic mass" located subcutaneously in the right labial area of the vulva. Recognition of this entity is based on specific histological and immunopathological features, and the correct treatment is important because of the aggressive behavior of other related mesenchymal tumors of the vulva and vagina, such as angiomyxoma and cellular angiofibroma.
    European journal of gynaecological oncology 01/2011; 32(3):353-5. · 0.58 Impact Factor
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    ABSTRACT: We present the clinicopathological findings of a rare case of a monodermal teratoma of the right ovary with functional ovarian stroma and extensive decidualization in a 74-year-old woman. The patient presented with vaginal bleeding. Ultrasound scan revealed a pelvic mass measuring 9.5 cm in the lower right abdomen. A right oophorectomy was performed. The tumor was cystic and multilocular filled with colloid material. Histological examination revealed follicles of thyroid type, and stromal clusters of fusiform or polygonal cells were found in the stroma. An extensive decidual reaction was observed. Morphological and immunohistochemical examination of the tumor revealed cystic struma ovarii with functional ovarian stroma and ectopic decidua. Total abdominal hysterectomy with oophorectomy was performed. A benign endometrial polyp, proliferative endometrium, two fibroids, and an ovarian cyst were observed.
    European journal of gynaecological oncology 01/2011; 32(2):243-5. · 0.58 Impact Factor
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    ABSTRACT: A case is reported of a 60-year old woman who had intermittent abdominal pain due to a mesenteric teratoma which was misdiagnosed by the standard methods of abdominal tumor diagnosis as an ovarian tumor. The neoplasm measured 9 x 8 x 8 cm, was filled by hair and sebum, and histologically presented the typical features of a mature cystic teratoma. The mesentery and overlying small intestine showed an extensive inflammatory granulomatous reaction. The uterus and adnexa were free of neoplasmatic disease. This case of extra ovarian mature cystic teratoma which developed in the mesentery is unique among > 2000 ovarian tumors examined during a 30-year period at Aretaieion Hospital Pathology Laboratory.
    Clinical and experimental obstetrics & gynecology 01/2011; 38(3):291-3. · 0.38 Impact Factor
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    ABSTRACT: Pelvic exenteration is the only potentially curative surgical procedure for patients with recurrent cervical, vaginal, vulvar or rectal cancers, especially following adjuvant chemotherapy or radiotherapy. Morbidity rates, however, remain high, which is significantly attributed to complications of the pelvic floor reconstruction techniques. We describe a novel reconstruction technique of the pelvic floor, involving a combination of an oblique rectus abdominis myocutaneous flap and a synthetic absorbable mesh as a pelvic sling for additional support, in a 63-year-old female patient with recurrent vulvar carcinoma. Combining the use of myocutaneous flaps and prosthetic mesh material can provide an effective alternative solution to the complications arising from pelvic floor reconstruction of large defects after exenteration procedures, especially in previously irradiated settings. Further studies are necessary to define the long-term outcomes and indications of these techniques, as well as the optimal combination between the available myocutaneous flaps and prosthetic materials.
    European journal of gynaecological oncology 01/2010; 31(2):201-5. · 0.58 Impact Factor
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    ABSTRACT: To further study the clinicopathologic and immunohistochemical features of ovarian granulosa cell tumors (GCTs). We retrospectively studied all cases of GCTs diagnosed in our laboratory over the last 10-year period. Immunohistochemistry for inhibin, vimentin, cytokeratin, Ki-67 and p53 was performed on archival paraffin blocks. Pathologic and immunohistochemical findings were correlated with the clinical records of the patients. Twenty-one cases (15 of the adult and 6 of the juvenile type) were retrieved. All patients were FIGO Stage I at the time of diagnosis. Recurrent disease was detected in four patients (19%) during a median follow-up of 36 months (range 2-26 years). Pathology revealed a concomitant theca-cell component in three cases, a Sertoli-Leydig component in one case, and a thecoma in one case. Archival tissue material was available in 12 cases. Immunohistochemistry was positive for: beta-inhibin in 12/12 cases (100%), vimentin in 11/12 cases (91.7%), cytokeratin in 3/12 cases (25%), CD34 in 0 cases (0%), and p53 in 2/12 cases (16.7%). The Ki-67 index was < 5% in 12/12 cases (100%). No significant correlations were observed between the pathologic and immunohistochemical parameters examined and the clinical outcome. Despite the relatively indolent nature and favorable prognosis of most GCTs, late recurrences are not a rare event even in Stage I patients, necessitating a close and long-term follow-up. The identification of novel prognostic markers, in addition to our traditional staging parameters such as clinical staging, is needed in order to more accurately predict probabilities of recurrence in these patients.
    European journal of gynaecological oncology 01/2010; 31(1):94-8. · 0.58 Impact Factor
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    ABSTRACT: The clinical and pathological characteristics of a rare granular cell tumor that developed in the vulva (4 cases) and the breast (1 case) offive women aged 35-52 years are reported. The differential diagnosis from skin carcinomas, melanoma and various soft tissue tumors is emphasized.
    European journal of gynaecological oncology 01/2010; 31(2):222-4. · 0.58 Impact Factor
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    ABSTRACT: Postpartum mood disturbances are very common with postpartum blues being as high as 44.5% among Greek women. This study aimed to investigate whether thyroid function within the normal range affects the incidence of postpartum mood disturbances. In a cross-sectional study in the maternity ward of Aretaieion Hospital, 57 Greek women were evaluated for postpartum mood swings by the Maternity Blues Questionnaire and the Edinburgh Postnatal Depression Scale on the first and sixth week postpartum. Serum Free T4, Free T3 and TSH concentrations as well as thyroglobulin and thyroid peroxidase antibodies were measured on admission for delivery and daily until the fourth postpartum day. We examined the association between hormone and antibody levels, and scores in the two scales evaluating postpartum mood disturbances. Prepartum serum FT3 and FT4 correlated negatively with blues scores in the first week postpartum (blues on day 4: with FT3, rho=-0.44, p < or = 0.01; with FT4 rho=-0.36, p < or = 0.01). Women with lower FT3 and FT4 levels belonged to the high scoring group (high scoring group: FT3=1.22 pg/ml, FT4=0.66 ng/dl; low scoring group: FT3=1.64 pg/ml, FT4=0.73 ng/dl). Serum FT3 showed a negative independent correlation with postpartum blues scores in the first postpartum days. No association was found between thyroid antibody levels and mood scores. Our findings indicate an association between the occurrence of postpartum mood disorders and antenatal thyroid function. Within normal limits, lower levels of serum FT3 and FT4 are associated with increased incidence of mood disturbances in the first postpartum week.
    Journal of affective disorders 07/2009; 121(3):278-82. · 3.76 Impact Factor
  • Journal of Obstetrics and Gynaecology 03/2009; 29(2):153-4. · 0.55 Impact Factor
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    ABSTRACT: To further study the clinicopathologic features of carcinosarcomas of the uterus and ovary. We retrospectively studied all cases of uterine and ovarian carcinosarcomas diagnosed in our laboratory over the last 5-year period. The pathologic and immunohistochemical findings were correlated with the clinical records of the patients. Eleven cases were retrieved . The commonest presenting symptom was vaginal bleeding (9 cases, 81.8%). Most patients (8 cases, 72.7%) were submitted to total abdominal hysterectomy with bilateral salpingo-oophorectomy and adjuvant chemotherapy was administered to all of them. In the majority of cases the tumor was located in the uterine corpus (7 cases, 63.6%), followed by the ovary (4 cases, 36.4%). The tumor was homologous in ten cases (90.9%) and heterologous in one case (9.1%). Most of our patients (6 cases, 54.6%) were diagnosed at an advanced stage (FIGO Stage III or IV). The sarcomatous element was strongly positive for vimentin in all cases and focally positive for cytokeratin 7 in four cases, while the epithelial component showed a strong positivity for cytokeratin 7 and focal staining for vimentin, cytokeratin 20, CA-125 and CEA. Carcinosarcomas of the uterus and ovary are highly aggressive biphasic neoplasms with a prominent epithelial component. Their most common location is the uterine corpus. Although distant metastases are rarely found at the time of diagnosis, the prognosis of these tumors is unfavorable. The optimal chemotherapy remains to be determined.
    European journal of gynaecological oncology 02/2009; 30(1):93-7. · 0.58 Impact Factor
  • International Journal of Gynecology & Obstetrics - INT J GYNECOL OBSTET. 01/2009; 107.
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    ABSTRACT: Immune activation has been shown to be involved in the pathophysiology of anxiety states and major depression and pregnancy is associated with a characteristic immune activation to sustain the fetus. Despite the possibility of a relation between immune parameters and postpartum mood disturbance, few studies have explored this association. Further, no study to-date has examined CSF. Fifty-six Greek parturients were recruited and a detailed medical and obstetric history was recorded. All of them completed the Postpartum Blues Questionnaire (on admission and on days 1-4 postpartum) and the Edinburgh Postnatal Depression Scale (at first and sixth week postpartum). At delivery, a blood sample and a CSF sample while puncturing for epidural analgesia were taken from 33 participants; blood samples only were obtained from the rest of the 23 parturients. TNF-a and IL-6 were quantified with an ELISA assay. A multiple regression analysis of psychometric scores depending on cytokine levels revealed that cytokine levels were positively associated with depressive mood during the first four days postpartum (p=0.035 for CSF IL-6, p=0.025 for CSF TnF-a, p=0.023 for serum TnF-a) and also at sixth week postpartum (p=0.012 for CSF IL-6, p=0.072 for CSF TnF-a). Pregnancy duration had an adverse association to psychometric scores. It is suggested that immune mechanisms may play a role in the etiopathology of postpartum depressive mood shifts. The role of a "rebound" reaction of the maternal immune system postnatal should be further investigated.
    Journal of affective disorders 09/2008; 115(1-2):287-92. · 3.76 Impact Factor
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    ABSTRACT: To further study the clinicopathological features of synchronous ovarian and endometrial carcinomas. We retrospectively studied all cases of synchronous ovarian and endometrial carcinomas diagnosed in our laboratory over the last 15-year period. The pathological findings were correlated with the clinical records of the patients. Seven cases of synchronous primary ovarian and endometrial carcinomas were retrieved. The most common presenting symptom was abnormal vaginal bleeding (5 cases, 71.4%). Five patients (71.4%) were postmenopausal and two (28.6%) were nulliparous. All seven patients had Stage I ovarian and endometrial carcinomas of endometrioid histology. Moreover, in all seven ovarian carcinomas endometriosis foci were observed, while atypical endometriosis was found in four of them. With the exception of one patient, who received adjuvant postoperative radiation, all remaining patients were treated with surgery alone. All patients were alive and free of disease at completion of the study. The correct classification of synchronous primary ovarian and endometrial carcinomas is often problematic because of the frequent confusion with their metastatic counterparts. Although the exact etiology remains unclear, endometriosis seems to be a major risk factor for their development.
    European journal of gynaecological oncology 02/2008; 29(3):256-9. · 0.58 Impact Factor
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    ABSTRACT: Congenital cystic adenomatoid malformations of the fetal lung (CCAM) are rare embryonic developmental abnormalities. They are considered as benign hamartomatous or dysplastic lung tumors characterized by overgrowth of the terminal respiratory bronchioles at the expense of the saccular spaces. A minority of cases may not be identified by prenatal imaging techniques and the pulmonary lesions are recognized postnatally. Two cases of congenital cystic adenomatoid malformation of the fetal lung diagnosed in our institution during the last four years are reported. The ultrasonographic and pathologic findings of these cases are discussed.
    Clinical and experimental obstetrics & gynecology 02/2008; 35(1):76-80. · 0.38 Impact Factor
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    ABSTRACT: Granulosa cell tumors (GCTs) are rare functional sex cord-stromal ovarian tumors constituting approximately 2-3% of all ovarian malignancies. They are characterized by low malignant potential, local spread, late recurrence and high survival rates. We report a case of recurrent ovarian GCT in a 60-year-old woman 25 years after the initial diagnosis. The patient underwent surgical resection of the pelvic masses and refused to receive any adjuvant treatment, considering the late recurrence and high survival rates of this tumor. This case illustrates an example of a very late recurrence and emphasizes the importance of the extended follow-up required for these patients.
    European journal of gynaecological oncology 02/2008; 29(1):86-8. · 0.58 Impact Factor
  • International Journal of Gynecology & Obstetrics 01/2008; 99(3):248-9. · 1.84 Impact Factor

Publication Stats

104 Citations
29.21 Total Impact Points

Institutions

  • 2007–2012
    • Athens State University
      • Department of Biology
      Athens, Alabama, United States
  • 2009–2010
    • National and Kapodistrian University of Athens
      Athínai, Attica, Greece
  • 2008
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece