E Economou

Harokopion University of Athens, Athens, Attiki, Greece

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Publications (16)54.48 Total impact

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    Article: The implication of second-trimester amniotic fluid TNF-alpha, cytochrome C and cell death nucleosomes in the prediction of preterm labor and/or premature rupture of membranes.
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    ABSTRACT: The multifactorial pathway leading to preterm labor possibly includes the implication of apoptosis. This study aimed to clarify the role of amniotic fluid apoptotic molecules (TNF-alpha, cytochrome C and cell death nucleosomes) at midtrimester as possible predictors of preterm labor (PTL) and/or premature rupture of membranes (PROM). In this case-control study, comprising 360 women undergoing genetic amniocentesis and out of whom 38 delivered preterm and 18 out of the latter after PROM, the above apoptotic molecules were determined by ELISA. The 38 cases with PTL and 18 cases with PROM were matched for age with 38 and 18 respective controls delivering at term, and the levels of apoptotic molecules were compared. Cell death nucleosome levels were found to be significantly associated with preterm delivery. Specifically, for every unit increase in nucleosomes, women were on average 0.2% more likely to deliver preterm (OR: 1.002, CI: 1.0-1.003, p = 0.018). In contrast, such an association was not found concerning the other two apoptotic molecules (TNF-a and Cytochrome C). Second-trimester amniotic fluid cell death nucleosomes' levels are significantly associated with preterm delivery and could possibly serve as predicting markers.
    Archives of Gynecology 04/2011; 285(1):37-43. · 0.91 Impact Factor
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    Article: Maternal serum levels of TNF-alpha and IL-6 long after delivery in preeclamptic and normotensive pregnant women.
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    ABSTRACT: To evaluate maternal TNF-alpha and IL-6 plasma levels in normotensive pregnant women, women with preeclampsia, and to examine the temporal changes in their levels from the antepartum to the postpartum period correlated with the regression of preeclampsia. A prospective study was performed in the 2nd Department of Obstetrics and Gynecology, University of Athens. Blood samples were obtained: (1) antepartum at the time of clinical diagnosis of the syndrome, 2. 12-14 weeks postpartum. No statistically significant differences were found in IL-6 levels, whereas a difference was found in TNF-alpha levels between preeclamptic and controls in antepartum period (0.80 pg/ml versus 0.60 pg/ml, P : .04). Long after delivery, TNF-alpha levels were significantly higher in preeclamptic compared to normotensive controls (0.86 pg/ml versus 0.60 pg/ml, P : .004). No difference was observed in TNF-alpha before and after delivery in both groups. No difference was noticed in IL-6 levels in women of normotensive group long after delivery compared to that before delivery. Long after delivery IL-6 levels were statistically significant higher in preeclamptic women compared to normal controls (3.53 ± 0.52 pg/ml versus 1.69 ± 0.48 pg/ml, P : .02). Preeclamptic women remain under a status of increased inflammatory stress up to 12-14 weeks postpartum despite the fact that all the other signs of preeclampsia are resolved.
    Mediators of Inflammation 01/2010; 2010:908649. · 3.26 Impact Factor
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    Article: The varying patterns of neurotrophin changes in the perinatal period.
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    ABSTRACT: Neurotrophins (NTs), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), NT-3, and NT-4 are of major importance in prenatal and postnatal brain development, due to their neuroprotective action. Developmental changes alter the neuronal responsiveness to certain NTs, which subsequently are variously expressed, to properly balance their action. The following study aimed at examining the pattern of perinatal changes of the four NTs--NGF, BDNF, NT-3, and NT-4 in 30 appropriate for gestational age (AGA) full-term fetuses and neonates by determining their circulating levels at characteristic time points. This study show a gradual decrease of circulating levels of the NTs, NT-3 and NT-4 from umbilical cord (UC) to neonates day 4 (N4), while circulating levels of NGF and BDNF present the opposite pattern: an increase from UC to N4. These patterns of perinatal changes differ according to their impact on the process of neuronal development and their reaction to perinatal stress. NT3 and NT4 have been documented to act at early stages of neuronal development and to decrease after hypoxia-ischemia, while NGF and BDNF to increase. Further studies should investigate these patterns in premature or full-term infants, presenting various pathological conditions in the perinatal period.
    Annals of the New York Academy of Sciences 01/2007; 1092:426-33. · 3.15 Impact Factor
  • Article: The Varying Patterns of Neurotrophin Changes in the Perinatal Period
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    ABSTRACT:  Neurotrophins (NTs), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), NT-3, and NT-4 are of major importance in prenatal and postnatal brain development, due to their neuroprotective action. Developmental changes alter the neuronal responsiveness to certain NTs, which subsequently are variously expressed, to properly balance their action. The following study aimed at examining the pattern of perinatal changes of the four NTs—NGF, BDNF, NT-3, and NT-4 in 30 appropriate for gestational age (AGA) full-term fetuses and neonates by determining their circulating levels at characteristic time points. This study show a gradual decrease of circulating levels of the NTs, NT-3 and NT-4 from umbilical cord (UC) to neonates day 4 (N4), while circulating levels of NGF and BDNF present the opposite pattern: an increase from UC to N4. These patterns of perinatal changes differ according to their impact on the process of neuronal development and their reaction to perinatal stress. NT3 and NT4 have been documented to act at early stages of neuronal development and to decrease after hypoxia-ischemia, while NGF and BDNF to increase. Further studies should investigate these patterns in premature or full-term infants, presenting various pathological conditions in the perinatal period.
    Annals of the New York Academy of Sciences 11/2006; 1092(1):426 - 433. · 3.15 Impact Factor
  • Article: Plasma levels of active extracellular matrix metalloproteinases 2 and 9 in patients with essential hypertension before and after antihypertensive treatment.
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    ABSTRACT: This study was designed to test the hypothesis that plasma concentrations of matrix metallo-proteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9), two enzymes that share similar substrate specificity (collagen type IV and V), possibly related to vascular remodelling, are altered in essential hypertension. The second aim of the study was to assess whether chronic antihypertensive treatment with the calcium channel blocker amlodipine would normalize these alterations. To test this hypothesis, we measured plasma concentrations of active MMP-2 and MMP-9 in 42 patients with never-treated essential hypertension and in 25 normotensive control subjects. Measurements were repeated after 6 months of treatment with the calcium channel blocker amlodipine. Baseline values of MMP-2 and MMP-9 were decreased (P=0.01 and 0.002, respectively) in hypertensive patients compared with normotensives. Hypertensive patients with systemic vascular resistances <1440 dyn s/cm(5) exhibited higher values of MMP-2 (P=0.005) and MMP-9 (P=0.001) than hypertensive patients with systemic vascular resistances >1440 dyn s/cm(5). Treated patients attained a nonsignificant increase in MMP-2 plasma concentrations, but a significant increase in MMP-9 plasma concentrations (P=0.01) compared to respective values before treatment. In conclusion, these findings suggest that plasma concentrations of active MMP-2 and MMP-9, mainly related to vascular extracellular matrix metabolism, are depressed in patients with essential hypertension. A 6 month treatment with amlodipine can normalize MMP-9 but not MMP-2 plasma concentrations. The hypothesis that antihypertensive treatment may modulate collagen metabolism remains to be determined by further studies.
    Journal of Human Hypertension 02/2003; 17(2):119-24. · 2.80 Impact Factor
  • Article: Biochemical changes involved in the mechanism of vasovagal syncope.
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    ABSTRACT: Vasovagal syncope elicits one of the most powerful transient vasodilatory responses in humans. Many studies have shown an altered neurohumoral response to tilting in patients with vasovagal syncope. Vasopressin (VP) has been of particular interest, but its exact role remains unclarified, whereas the possible role of the potent vasoactive end products of arachidonic acid metabolism has not yet been addressed. We determined the changes in plasma levels of VP, thromboxane (TXA2), and prostacyclin (PGI2) in 34 syncopal patients undergoing a standardized head-up tilt-table testing protocol and compared these changes between patients with positive and negative test results. Blood samples were collected at baseline, 15 minutes in the head-up position, and at the termination of the tilt test (the induction of syncope or the completion of a negative test). Sixteen patients had a positive test result, whereas 18 completed the test without developing any syncopal symptoms. In the tilt-positive group, VP levels presented a 20-fold increase at the time of syncope when compared with baseline levels (p = 0.0000), without any increase at earlier stages. No change was detected at any stage in the tilt-negative patients. We did not find any difference in the levels of PGI2 at any stage in any group of patients or between the 2 groups. TXA2 levels increased significantly at 15 minutes in the upright position in both tilt-positive and tilt-negative patients. No further increase was noticed at the time of syncope in the tilt-positive group, whereas in patients with a negative test result, there was a tendency to decline at the time of the test's completion. It is concluded that although VP is markedly increased during tilt-induced vasovagal syncope, vasoactive amines such as TXA2 and PGI2 play a minor role in the vasodilatory component of the response.
    The American Journal of Cardiology 09/2001; 88(4):376-81. · 3.37 Impact Factor
  • Article: Chemokines in patients with ischaemic heart disease and the effect of coronary angioplasty.
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    ABSTRACT: Percutaneous coronary transluminal angioplasty (PTCA) may release inflammatory mediators such as chemokines. Monocyte chemoattractant protein-1 (MCP-1) and eotaxin (EOX) are monocyte- and eosinophil-specific chemokines involved in the inflammation and pathogenesis of coronary atherosclerosis. A total of 28 patients undergoing elective PTCA, 20 coronary artery disease (CAD) patients undergoing coronary angiography and 28 healthy controls were studied. In PTCA patients before the procedure, MCP-1 plasma levels (441+/-64 pg/ml) were similar to those of CAD patients (430+/-24 pg/ml), and significantly higher compared with controls (145+/-17 pg/ml, P<0.01). MCP-1 rose significantly after 3 and 6 months following PTCA (696+/-89 and 876+/-86 pg/ml, respectively, P<0.01 vs. before PTCA). EOX plasma levels (155+/-14 pg/ml) were similar to those of CAD patients (157+/-14 pg/ml), but significantly higher compared with controls (83.2+/-10 pg/ml, P<0.05). EOX rose significantly 24 h (273+/-41 pg/ml, P<0.05) but not 3 months after PTCA (160+/-20 and 158+/-19 pg/ml, respectively). These findings indicate that chemokine-induced monocyte- and eosinophil-specific chemoattraction is stimulated in patients with coronary artery disease. MCP-1 levels remain significantly elevated for at least 6 months following elective PTCA, suggesting an inflammatory stimulation.
    International Journal of Cardiology 08/2001; 80(1):55-60. · 7.08 Impact Factor
  • Article: Heat production of atherosclerotic plaques and inflammation assessed by the acute phase proteins in acute coronary syndromes.
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    ABSTRACT: Several studies have shown that inflammation plays an important role in the pathogenesis of coronary heart disease (CHD). Serum amyloid A (SAA) and C-reactive protein (CRP) reactants of the acute phase of inflammation, have been shown to be increased in patients with CHD. Recently ex vivo studies demonstrated that some types of atherosclerotic plaques show substantially warmer regions. A catheter-based technique has been developed to measure the temperature of human arteries in vivo. Therefore, the aim of the present study was to measure the luminal surface temperature in patients with CHD and to correlate it with the acute phase proteins in order to discriminate the role of inflammation in heat production in acute coronary syndromes. Sixty patients were studied with CHD (20 with stable angina, 20 with unstable angina and 20 with acute myocardial infarction) and 20 sex- and age-matched controls without coronary artery disease, by measuring plasma levels of SAA, CRP, plasma lipids and intracoronary arterial luminal wall temperature. Intracoronary temperature was measured with a thermography catheter developed in our Institution: a thermistor probe with a temperature accuracy of 0.05 degrees C, was attached at the distal end of a long 3F polyurethane shaft. It was found that the median temperature differences at the site of the lesion from the core temperature was increased in patients with unstable angina (1.025 degrees C) and acute myocardial infarction (2.150 degrees C) compared with stable angina (0.300 degrees C), P<0.001 for each comparison. Furthermore, stable angina has increased temperature differences compared with controls (0.200 degrees C, P<0.001). There were very good correlations between CRP and SAA with the temperature (r=0.796, P=0.01 and r=0.848, P=0.01, respectively). Local heat at the site of lesion is increased in patients with acute coronary syndromes and may arise from an aggressive inflammatory response occurring in these situations. The sensitive measurement of plaque temperature as a prognostic marker may be useful in the management of coronary heart disease.
    Journal of Molecular and Cellular Cardiology 02/2000; 32(1):43-52. · 5.17 Impact Factor
  • Article: Increased proinflammatory cytokines in patients with chronic stable angina and their reduction by aspirin.
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    ABSTRACT: Proinflammatory cytokines released by injured endothelium facilitate interaction of endothelial cells with circulating leukocytes and thus may contribute to development and progression of atherosclerosis. We investigated whether cytokines and C-reactive protein (CRP) are indicative of myocardial ischemia or of diseased vessels and whether they are influenced by aspirin treatment in patients with chronic stable angina. Plasma macrophage colony stimulating factor (MCSF), IL-1b, IL-6, and CRP were measured in 60 stable patients after 48-hour Holter monitoring and in 24 matched controls. All patients had angiographic documentation of disease and positive exercise ECGs. Patients with ischemia on Holter monitoring (n=40) received aspirin or placebo in a 6-week, randomized, double blind, crossover trial. Blood sampling was repeated at the end of each treatment phase (3 weeks). Compared to controls, patients had more than twice median MCSF (800 versus 372 pg/mL), IL-6 (3.9 versus 1.7 pg/mL), and CRP (1.25 versus 0.23 mg/L) levels (P<0.01 for all comparisons). MCSF was related to ischemia on Holter monitoring (P<0.01), to low ischemic threshold during exercise (P<0.01), and together with IL-1b to number of diseased vessels (P<0.05). MCSF, IL-6, and CRP were all reduced after 6 weeks of aspirin treatment (P<0.05). These findings suggest that cytokines are associated with both ischemia and anatomic extent of disease in patients with stable angina. Reduced cytokine and CRP levels by aspirin may explain part of aspirin's therapeutic action.
    Circulation 08/1999; 100(8):793-8. · 14.74 Impact Factor
  • Article: Lipid peroxidation in healthy fetuses, preterm and fullterm neonates.
    Acta Obstetricia Et Gynecologica Scandinavica 02/1998; 77(1):124-6. · 1.77 Impact Factor
  • Article: Circulating endothelin-3 and prolactin concentrations in healthy lactating women during the early puerperium.
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    ABSTRACT: To study the association between the circulating concentrations of endothelin-3 and prolactin in the early puerperium. Prospective clinical study, including twenty-five healthy puerperal women breast-feeding their healthy full-term infants. Venous blood was drawn on day 1 and 4 post partum, and plasma endothelin-3 and serum prolactin were determined. Circulating endothelin-3 and prolactin levels on day 4 did not differ significantly from the corresponding levels on day 1. However, a significant negative correlation was found on day 4 between endothelin-3 and prolactin values (r = -0.688, P < 0.001) and an even stronger negative association existed between the net change in endothelin-3 from days 1 to 4 and the corresponding change in prolactin values (r = -0.732, P < 0.001). On the fourth day post partum, lactating healthy women show negative correlation between circulating endothelin-3 and prolactin levels. Whether this indicates a role for endothelin-3 in the control of prolactin secretion in the post partum period remains to be clarified.
    European Journal of Endocrinology 02/1998; 138(2):181-4. · 3.42 Impact Factor
  • Article: Endothelin 1-21 plasma concentrations on days 1 and 4 of life in healthy and ill preterm neonates.
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    ABSTRACT: Endothelins (ETs) are highly vasoconstrictive 21-amino acid peptides possessing also cell-proliferative properties. They have been implicated in a variety of perinatal pathologic conditions, and their plasma concentrations have been found elevated in humans at birth. The purpose of this study was to determine ET 1-21 plasma concentrations in healthy and ill preterm infants and to investigate possible concentration changes with time from birth in cases of normal and abnormal adaptation to extrauterine life. The study comprised 36 preterm infants. Twenty-eight, comprising group A, were healthy (22/28) or minimally affected (6/28) and 8, comprising group B, were moderately (2/8) or severely ill (6/8) requiring continuous positive airway pressure or intermittent positive pressure ventilation as well as surfactant administration. All infants in group B had intraventricular hemorrhage grade > or = II. Venous blood from all neonates was drawn on days 1 and 4 and ET 1-21 plasma concentrations were determined by radioimmunoassay (Amersham kit RPA 5559). ET 1-21 plasma concentrations were on day 1: 16.25 +/- 8.14 and 21.81 +/- 5.87 and on day 4: 12.89 +/- 4.56 and 16.16 +/- 5.43 pmol/l, for groups A and B, respectively. The statistical analysis showed a significant reduction in plasma ET concentrations on day 4 in both groups (p = 0.009 and p = 0.025, respectively). Nevertheless, ET 1-21 plasma concentrations were on day 4 significantly higher in ill preterm infants presenting symptoms from tissues involved in the elimination of ETs from the circulation as well as in their production.
    Biology of the Neonate 01/1995; 67(5):317-21. · 1.90 Impact Factor
  • Article: Endothelin 1-21 plasma levels in fetuses at 18-24 weeks of gestation.
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    ABSTRACT: This study aimed to establish normal endothelin (ET) ranges in non malformed appropriate for gestational age fetuses of 18-24 weeks gestation and to investigate a possible correlation between maternal and fetal ET plasma levels. Twenty "mother-fetus" pairs were included in the study. The determination of ET 1-21 was performed by radioimmunoassay using 1 ml of fetal blood obtained by cordocentesis--indicated for various reasons--and in 2 ml of maternal venous blood. The statistical analysis involved the Wilcoxon test for pair differences and the Spearman rank correlation coefficient. Fetal and maternal ET 1-21 levels were respectively 11.39 +/- 2.22 pmol/L and 6.44 +/- 1.00 pmol/L. Fetal levels were significantly higher (p < 0.01) thus excluding passive ET transfer through the placenta, while no correlation between maternal and fetal levels was found. It is speculated that high fetal ET 1-21 levels result from increased ET production, which possess cell proliferative properties and/or decreased ET removal from the fetal circulation because of hypofunctioning lungs and kidneys. It can be assumed that the increased amounts of fetal ETs contribute to normal growth and development directly as well as by regulating vascular tonus and local blood flow.
    Journal of Perinatal Medicine 01/1995; 23(4):321-5. · 1.70 Impact Factor
  • Article: Endothelin 1-21 plasma levels on the first and fourth postpartum day in normal full-term neonates.
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    ABSTRACT: Endothelins (ETs), recently discovered and highly vasoactive substances, have been implicated in the pathogenesis of various perinatal problems, such as preeclampsia, intrauterine growth retardation, intraventricular hemorrhage, pulmonary hypertension and necrotizing enterocolitis. Although fetal ET levels have been measured at birth, reference ET values for healthy newborns in the first days of life have not been established. The purpose of this study was to determine in normal healthy neonates ET 1-21 plasma values on day 1 and 4 postpartum and to investigate possible changes after adaptation of the newborn to extrauterine life. The study comprised 20 healthy full-term neonates, born after vaginal delivery (n = 10), or cesarean section (CS; n = 10) because of a previous CS. Venous blood was drawn on day 1 and 4 from all neonates and ET 1-21 levels were determined in the plasma by radioimmunoassay (Amersham kit RPA 5559). ET 1-21 values were on day 1 11.83 +/- 2.39 pmol/l (n = 20) and on day 4 9.45 +/- 1.88 pmol/l (n = 20). The statistical analysis showed a significant reduction of plasma ET levels on day 4 (p = 0.004), but no influence of the mode of delivery on plasma ET levels. In conclusion irrespective of the mode of delivery the high ET 1-21 plasma levels on day 1 postpartum are significantly reduced on day 4 of life.
    Developmental pharmacology and therapeutics 02/1993; 20(3-4):195-8.
  • Article: Endothelin 1-21 plasma concentrations in children and adolescents with insulin-dependent diabetes mellitus.
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    ABSTRACT: This study is based on the hypothesis that endothelins (ETs), which are 21-amino acid peptides with vasoactive and proliferative properties, could be implicated in the development of complications of insulin dependent diabetes mellitus (IDDM) in children and adolescents. We determined plasma ET 1-21 concentrations by radioimmunoassay in 59 patients with IDDM (32 male, 27 female) and in 41 healthy siblings (20 male, 21 female) and investigated the association of ET 1-21 concentrations with age, sex, control of diabetes (expressed as % of glycosylated hemoglobin), duration of disease and presence of complications. Plasma ET 1-21 concentrations (mean +/- SEM) were 14.12 +/- 0.30 pg/ml in IDDM and 15.34 +/- 0.47 pg/ml in healthy siblings. The difference was statistically significant (p = 0.01) after controlling for age and sex by multiple logistic regression. In the group with IDDM, analysis of covariance showed duration of disease to be the only variable associated with ET 1-21 values (b = 0.2179 pg/ml/yr, p = 0.04). It is concluded that in youngsters with IDDM ET plasma concentrations are lower than in healthy controls, negatively associated with duration of the disease and not directly implicated in diabetic angiopathy.
    Journal of pediatric endocrinology & metabolism: JPEM 9(4):463-8. · 0.88 Impact Factor
  • Article: Mid-trimester amniotic fluid interleukins (IL-1β, IL-10 and IL-18) as possible predictors of preterm delivery.
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    ABSTRACT: Strong evidence implicates chronic intraamniotic inflammation in the etiology of preterm delivery. The purpose of this study was to determine whether amniotic fluid IL-1β, IL-10 and IL-18 concentrations in women undergoing mid-trimester amniocentesis can identify those at risk for preterm labor or preterm rupture of membranes. A case-control study was conducted to compare mid-trimester concentrations of amniotic fluid IL-1β, IL-10 and IL-18 in women delivering at term or preterm. Out of 362 women included in the study, 38 presented with preterm labor. Thirty-eight women with term delivery, matched for chronological and gestational age served as controls. Women with abnormal fetal karyotypes or major anomalies were excluded. IL-1β, IL-10 and IL-18 concentrations were determined by ELISA. Conditional logistic regression was applied in the statistical analysis. IL-1β was found to be positively and significantly associated with preterm delivery. Specifically, for every unit increase in IL-1β, women were on average 7.2 (OR: 7.2, CI: 1.94-26.77, p=0.003) times more likely to deliver preterm. IL-18 levels as well as gender were significantly associated with preterm delivery. Specifically, for every unit increase in IL-18, women were on average 1% less likely to have a preterm delivery (OR: 0.99, CI: 0.98-0.99, p=0.04). On the other hand, IL-10 was not significantly associated with preterm delivery. Mid-trimester IL-1β concentrations are positively associated with preterm delivery. Therefore, IL-1β, determined on the occasion of mid-trimester amniocentesis could possibly serve as a marker of preterm delivery. In contrast, IL-10 and IL-18 concentrations are not elevated in mid-trimester amniotic fluid and probably cannot serve this purpose.
    In vivo (Athens, Greece) 25(1):141-8. · 1.17 Impact Factor

Institutions

  • 2010–2011
    • Harokopion University of Athens
      Athens, Attiki, Greece
  • 2001
    • Hippokration General Hospital, Athens
      Athens, Attiki, Greece
  • 2000
    • National and Kapodistrian University of Athens
      • Division of Cardiology III
      Athens, Attiki, Greece
  • 1995
    • Athens State University
      Athens, AL, USA